Radio frequency genicular nerve ablation

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Hi everyone 

I’ve been on this site many a times during my recovery for Ltkr on March 26/2018. I’ve had a hard time thus far thinking I would be past where I’m currently at.  I was released from my surgeon to go back to work. Started back yesterday ( I’m a retail banker) They have accommodated me with a chair but I work in a position that I’m more up than down. During the first month of post visits with my surgeon he said several times that most patients are past the pain , something I still had. He made me feel like there was something wrong with me. He referred me to a pain specialist. I’ve seen him 3 times now including my initial visit. The 3rd time was today after work. My ankle and knee both are swollen. This pain management doctor also said most people don’t have any problems or pain at my stage and suggested radio frequency genicular nerve ablation. Has anyone had this ? I cried in his office telling him that before the surgery I walked and felt better than I do now. When I initially went to my surgeon to have xrays done, he said both knees were bad, but wanted to start with the worse of the two. I have been favoring my ltkr and now my non operated knee is killing me. I’m a very outgoing and positive person generally but since this operation I am second guessing myself if I should have done it. I know we are all different in the healing process but I’m feeling desperate to get my old self back.

I’m sorry this is so long. Any advice would be greatly appreciated.

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  • Posted

    I had my TKR on April 30th, basically a month after you.  I’m still in pain & ive been told that is fairly normal.  My doc after the my 1 month post op visit said...”Oh, this is a very painful procedure!”   If I’m up standing for very long, my knee & ankle swell.  I try to elevate & ice my knee after doing things.  Luckily I don’t have to return to work.  My other knee is not good either & ive noticed that it is acting up a bit more now as I put more pressure on it. 

    Just telling you this so you know that there are others out there that are experiencing similar symptoms.  Don’t think you are doing anything wrong.  Can you ice & elevate your leg on breaks? It seems like a lot of posts here complain of pain & swelling & that it takes 9 months to a full year to get back to normal. (Wish the docs had forewarned us). 

    Just want to wish you the best. There will be others that will give you good advice.  Good luck in finding caring professionals.  

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  • Posted

    I can relate.  I am almost 5 months post op tkr and still have swelling and pain, though its better than it was.  I had a Nerve dissection treatment a couple of weeks ago, and it helped with pain.  I have heard of cardiac ablations, but never heard about raio frequency genicular nerve ablation.  I will google it.

    HOpe you feel better real soon.


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    • Posted

      Thank you Martha

      Yes , I’m going to read everything on it. I’m leaning towards just allowing my knee to take it’s course and do everything possible to heal it is. I’ve and elevate! I don’t want to throw another procedure in the works until I’ve exhausted all efforts!  I’ve not heard of nerve dissection. What is that ? Why did you get it ? 

      Thank you ... Lynda

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    • Posted

      I had the procedure done at a Flexogenix clinic.  A sonographer uses an ultrasound to find major nerve areas, then injects saline and dextrose to uncompress the nerves.  I had immediate relief from nerve pain but I still have the pain from stiffness !  Durn it
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  • Posted

    Hi Lynda,  I am sorry to hear you’re suffering with so much pain.   It’s also annoyingly mg to hear a surgeon would tell you there is some thing wrong with you after three months that you are still in pain!  My suggestion is to get another opinion.  My surgery was March 13, 2018.  Last week I saw my surgeon for the three month visit.  I am still stiff, have pain and ice many times a day for the swelling.  Physical therapy has been very helpful three times a week.  I can’t imagine having to be back at work and standing on your feet all day. My surgeon told me it would be another three months of the pain and swelling.

    a very helpful post I read and have hanging up as a reminder came from this site.  I hope it helps you:

    There are some TKR "rules" that you should be aware of:

    - Your recovery belongs to you.  Comparing yourself to anyone else is an exercise in futility that will screw with your head.  Don't do that.  Own your recovery.

    - There is no "normal"...everyone experiences their recovery differently.  Yes, there are some general guidelines but they apply statistically to entire populations of patients and NEVER to any individual.

    - Give up all your expectations an timetables.  They are meaningless.  This is the most Zen of all surgeries: "I will be better when I am better."  Period.

    - Never, ever use the word "should" as in: "I should be {fill in the blank} by now."  A TKR doesn't work like that.

    All of that being said...and after reading over 4,000 posts, there seems to be a general framework to this:

    - 0 to 3 months: Lots of pain at first with swelling and sleeplessness.  ROM work to get to 0 / +120.  Post-op depression is totally normal.  Done, or almost done, with the walking aids by 3 months.

    - 3-6 months: Levels of pain and swelling are way down and decreasing is the stiffness.  Start to work on your muscle rebuild for your dead quads, glutes and core so you can walk correctly, regain your balance and do stairs again.  This takes many months because you start slowly and is mandatory.  Usually off all the heavy duty meds and down to Tramadol or plain ibuprofen.  Back to work in the 4-6 month range.

    - 6-9 months: You start to feel like your "old self" again.  If you've done the work, there should be minimal swelling unless you push the knee too far on any single day.  Stiffness continues to decrease imperceptibly.  As you get stronger, you can start mastering stairs again...takes all that quad strength.

    - 9-12 months: Pretty much back to normal.  The new knee may still look just a tad larger than your original knee but you have a 2 1/2-pound mechanical device sitting in there.  You end up just forgetting about it.  Dance at your one year anniversary party.

    - 12+ months: There still may be some stiffness up to 18 months or beyond.  Have to keep the knee active or you will experience stiffness even years down the road.  You will still feel nerve pain when you try to kneel on very hard surfaces.  Use a foam pad or knee pads.  That sensation may never go away.

    So that's the reality of this thing.  Hang this on your fridge...

    ...and don't forget your oars for the boat part...


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  • Posted

    1st of arent to the 3 month bench mark period so you shouldn't be feeling guilty about still having pain. I don't know anyone who has had that particular treatment but that's your Drs call and he should have a history of su cesses. Remember the timeline...the knee owns you the 1st year and then you can claim it after that. Much of my lower leg and hip pain is directly related to stenosis. I am going to need back surgery as my stenosis is l-2 through 5 and I'm missing a disc between 3 and 4. So you can see there reasons for leg and hip pain other than the actual tkr. You favor the leg to avoid pain and tweak or hurt something else. This may not be your answer but its just another look.

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