Genicular Nerve Radio Frequency Lesioning (knee joint)
A nerve-targeted treatment for chronic knee pain — typically from osteoarthritis where joint replacement is being delayed, declined, or has not given the expected relief. Radiofrequency interrupts the small sensory nerves around the knee for 6–12 months.
Led by Dr Arul James (Consultant in Pain Medicine, GMC Specialist Register) at The Vesey, Sutton Coldfield. Self-pay and insurance accepted (BUPA, Vitality, AXA, WPA, Cigna, Aviva, Healix). Same-week appointments typical.
Who this procedure is for
- Moderate-to-severe knee osteoarthritis with persistent pain despite physiotherapy, analgesia and (where appropriate) intra-articular injection.
- Patients deferring or unsuitable for knee replacement — including high BMI, cardiac comorbidity, or personal choice.
- Persistent post-knee-replacement pain in the absence of mechanical revision indication.
- Positive diagnostic genicular nerve block — at least 70% short-term relief is confirmed before proceeding.
How the procedure is performed
Ultrasound or fluoroscopy-guided treatment of the superior medial, superior lateral and inferior medial genicular nerves. After local anaesthetic, radiofrequency needles are placed, sensory stimulation confirms correct targeting, and a thermal lesion is created at each nerve. The procedure takes 30–40 minutes; the full visit is 75–90 minutes.
Before, during and after
- Before: light meal allowed. Continue routine analgesia and most regular medications.
- During: you lie on your back, knee gently supported. Awake, with local anaesthetic — expect pressure and brief warm sensations.
- After: the leg is fully weight-bearing immediately. Mild swelling and bruising are normal for a week.
Recovery and aftercare
Walking the same day, normal activities within 48 hours, no driving for 24 hours if sedation was used. Expect a flare for 5–7 days; relief typically settles in by week 2 and peaks at week 4–6. Most patients get 6–12 months of meaningful relief and the procedure can be repeated.
Do I need a diagnostic block before the radiofrequency procedure? +
Yes. A diagnostic genicular nerve block is performed first to confirm that numbing those nerves gives you at least 70% pain relief. This predicts whether the radiofrequency lesion will be effective. Without a positive diagnostic block the procedure is unlikely to help.
Can genicular RFA be done on both knees at the same visit? +
Bilateral genicular RFA is possible but we generally stage the knees 2–4 weeks apart. This allows you to fully weight-bear safely and gives a clearer picture of the outcome in each knee before committing to the second.
Will genicular RFA affect my knee replacement options later? +
No. Genicular radiofrequency treats only small sensory nerves and does not alter the joint anatomy, cartilage or bone. Your eligibility for a knee replacement — and the technical difficulty of the surgery — is completely unchanged.
Can the procedure be repeated if the pain returns? +
Yes. Genicular RFA can be safely repeated once the nerves have regenerated, typically after 9–12 months. Many patients have two or more treatments over several years while deferring or avoiding joint replacement.
Pricing at a glance
Initial consultation £260. Diagnostic genicular block from £800; therapeutic radiofrequency (3-nerve protocol, single knee) from £1,450 including consent, image guidance, drugs and written report. Insurance accepted: BUPA, Vitality, AXA, WPA, Cigna, Aviva, Healix.
Book an appointment
Risks and side effects
Common: mild site soreness, brief skin numbness over the knee. Uncommon: small haematoma, transient weakness of the quadriceps (recovers). Rare: deep infection, thermal injury to surrounding tissue, allergic reaction. Genicular RFA does not damage the joint itself.
When this procedure is not appropriate
Mechanical knee pathology that needs surgery first (locking, recurrent giving-way, large meniscal tear), active joint infection, uncontrolled bleeding disorder, pregnancy.
Cost and pathway
Initial consultation £260. Diagnostic genicular block from £800; therapeutic radiofrequency (3-nerve protocol, single knee) from £1,450 including consent, image guidance, drugs and written report.
- Open 7 days including Sundays — 8am to 8pm, no weekend surcharge
- No GP referral required — book directly with Dr Arul James
- Sutton Coldfield location — serving Birmingham, Walsall, Tamworth, Lichfield and the West Midlands
- CQC-regulated — rated 4.88/5 on Doctify from 700+ verified reviews
View the full pain management pathway →
Sutton Coldfield · Birmingham · Walsall · Tamworth · Lichfield · West Midlands · Open 7 days 8am–8pm
Open 7 days · 8am–8pm · 0121 387 3727