Genicular nerve neurolysis with phenol for chronic knee pain: A case series

Chronic knee pain continues to be a common complaint amongst patients and continues to grow as the elderly population lives longer. New ways to treat chronic pain conditions, including chronic knee pain, are necessary as increased co-morbidities prevent patients from being surgical candidates. Recently, the genicular nerves have received more attention due to their role in innervating the anterior knee joint capsule as well as the intraarticular and extraarticular knee ligaments. Initial interest in the genicular nerve included radiofrequency ablation. RFA while effective, also brings with it increased procedure and equipment costs with a non-response rate of around 25%. Alcohol neurolysis of the genicular nerve is being seen as a potential alternative, low-cost, effective option for relieving chronic knee pain in patients. Previous case reports have focused on the use of alcohol, we report the use of phenol for genicular neurolysis. Of the four genicular nerve branches, only three are targeted due to the proximity of the inferolateral genicular nerve to the common peroneal nerve. The purpose of this case report is to show the effectiveness of phenol for neurolysis of the genicular nerves in relieving chronic knee pain in patients in which surgery is not an option.