• Margaret Beckwith, Daniel Cushman, Tyler Clark, Peter K Park, Taylor Burnham, Robert Burnham, Zachary L McCormick, and Aaron Conger.
• Division of Physical Medicine and Rehabilitation, Department of Orthopedics, University of Washington St. Louis, St. Louis, Missouri, USA.
• Pain Med. 2023 Feb 1; 24 (2): 150157150-157.

IntroGenicular nerve radiofrequency ablation (GNRFA) is an effective treatment for chronic knee pain related to osteoarthritis. It is often utilized when conservative management has failed and patients wish to avoid arthroplasty, are poor surgical candidates due to comorbid medical conditions, or in those suffering from persistent pain after arthroplasty. The classic targets for GNRFA include the superior lateral genicular nerve, superior medial genicular nerve, and inferior medial genicular nerve but multiple anatomic studies have demonstrated additional sensory innervation to the knee.ObjectiveIn this research article, we propose an image-guided technique that can safely target the infrapatellar branch of the saphenous nerve which also provides sensory innervation to the anterior capsule.ProposalThe proposed technique includes variations for conventional bipolar radiofrequency ablation, cooled radiofrequency ablation, dual-tined bipolar radiofrequency ablation, and monopolar radiofrequency ablation using a long axis approach. The described technique is based on updated anatomic studies and takes into account safety concerns such as thermal risk to the skin and/or pes anserine tendons and breaching of the synovial cavity.ConclusionFuture clinical research should be performed to confirm the safety and effectiveness of this specific approach.© The Author(s) 2022. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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