Tuning Out Knee Osteorthritis Pain with Radio Energy

    Pain medicine specialists at Rush have helped develop, and are among the first in the country to provide, a noninvasive treatment for knee osteoarthritis (OA) that uses cooled radio energy to target and interrupt pain signals. 

    Known as Coolief, the procedure can provide several months of relief from chronic OA pain in patients for whom surgery is not an option. It also decreases the need for a daily regimen of prescription medication and other over-the-counter pain-relieving drugs.

    We’re not taking away the arthritis, just the arthritis pain,” said Sandeep D. Amin, MD, a pain specialist at Rush University Medical Center and chairperson of the Department of Anesthesiology at Rush Oak Park Hospital.

    “We're changing the wiring of the knee to interrupt the pain signal.”

    For several years, Rush pain medicine physicians have treated many types of chronic pain with radiofrequency (RF) ablation technology, which uses the heat from radio wave energy to temporarily neutralize specific nerves that cause chronic pain. The innovative Coolief RF technology combines cold and heat energy to extend the pain-free period much longer.

    During the Coolief procedure, minimally invasive needles and water-cooled electrodes inserted into the knee target 3 nerves responsible for sending pain signals to the brain. RF energy passes through the needle and ablates nerve tissue, greatly reducing the ability of the nerves to send pain signals to the brain for extended periods of time.

    By also cooling the targeted area with the water-cooled electrodes, the Coolief procedure creates a treatment area that is larger than the treatment area for conventional, heat-only RF treatments. The larger treatment area, in turn, extends the time the nerves need to resume sending pain signals.

    In May, the US Food and Drug Administration approved Coolief as the first RF treatment specifically to alleviate chronic knee pain due to OA based primarily on a 2016 clinical study showing that the Coolief system was safe and provided higher levels of pain relief for much longer time periods than intra-articular corticosteroids.

    Although total knee arthroplasty remains the best long-term option for patients with severe knee OA, some people may not be candidates for surgery due to their medical condition or because they are so young that a second knee replacement would be likely.

    “This procedure is proving to be a great option for those patients,” Dr. Amin said.