Diagnosis and Treatment of Post-Radiofrequency Synovial Knee Fistula: Case Report

Abstract

Recently, denervation therapies have drawn attention as a promising treatment, and cooled radiofrequency has been proposed as the best option to capture most of the genicular nerves. We present a rare case of synovial knee fistula after radiofrequency and its management. To the best of our knowledge, this is the first case reported in the literature. The treatment included immobilization and chemoprophylaxis. One week later, the fistula was closed, and 14 months later, the procedure was repeated without complications. Genicular radiofrequency ablation is an emerging technique, and providers should be aware of the reported complications to counsel patients and manage potential risks appropriately.

Optimizing genicular nerve chemical ablation

“…The challenge when comparing radiofrequency lesions (electrical field) to chemical denervation (liquid agent) is that the size and shape are not as precise as those created by an electrical field. The larger the lesion the greater the risk of complications, and this applies not only to chemical lesions but also to radiofrequency procedures [ 12 ]. The factors that affect heat lesion size have been previously described in detail but are not the same with phenol [ 13 ].…”