Ep. 71 Genicular Nerve Ablation Insights: Techniques and Data with Dr. John Smirniotopoulos

Dr. John Smirniotopoulos, an interventional radiologist at Georgetown/MedStar Washington Hospital Center, discusses the intricacies of genicular nerve ablation (GNA) for pain management in patients with osteoarthritis and post-surgical knee pain. He delves into the history and evolution of GNA, outlines the neurovascular anatomy, and explains his specific rationale for targeting various nerves for ablation. --- SYNPOSIS Dr. Smirniotopoulos also compares GNA with other procedures such as corticosteroid injections, hyaluronic acid injections, and genicular artery embolization (GAE). He emphasizes the importance of managing patient expectations, the role of physical therapy, and explores different modalities of GNA, including the use of cryoablation versus radiofrequency technology. The episode offers a comprehensive overview of expert insights for evaluating knee pain and performing effective GNA. --- TIMESTAMPS 00:00 - Introduction 03:13 - Understanding Genicular Nerve Anatomy 12:06 - Tailoring GNA Treatment to Each Patient 22:39 - Comparing Ablation Devices and Methods 28:06 - GNA in Surgical and Post-Traumatic Patients 33:19 - Patient-Centered Decision Making 38:50 - Evaluating Functional Outcomes 43:39 - Comparing Treatment Modalities 49:34 - Post-Procedure Counseling and Expectations 58:40 - Future Directions in GNA Research --- RESOURCES Safety and efficacy comparison of three- vs four-needle technique in the management of moderate to severe osteoarthritis of the knee using cooled radiofrequency ablation (Wong, et al 2021): https://pubmed.ncbi.nlm.nih.gov/32968824/