Not every patient with knee or hip pain is ready for or needs a joint replacement. Many patients live with significant chronic pain from arthritis, and they are looking for something between painkillers and surgery. Something that actually works.
Cooled Radiofrequency Ablation (CRFA) is that bridge. It is a minimally invasive, non-surgical procedure that targets the specific sensory nerves that carry pain signals from the knee or hip joint and interrupts them, often providing relief lasting 12-24 months or longer.
Dr. Supreet Bajwa is currently the only orthopaedic surgeon in Mumbai offering Cooled Radiofrequency Ablation for chronic hip and knee pain. This is not a minor distinction; it represents a significant gap in pain management care that most Mumbai patients do not know can be filled without leaving the city.
What Is Cooled Radiofrequency Ablation (CRFA)?
Standard radiofrequency ablation uses heat generated by an electrical current to destroy targeted nerve tissue. The "cooled" variant circulates water through the probe tip while generating heat, allowing a larger and more spherical ablation zone which means better coverage of the nerve targets around a joint.
For the knee, the procedure targets the genicular nerves three specific sensory branches that relay pain from the knee joint to the brain. For the hip, it targets articular branches of the obturator, femoral, and accessory obturator nerves.
Crucially, these are sensory nerves only they carry pain signals but are not involved in motor function. Ablating them does not weaken the knee or hip or affect your ability to walk.
How Is the Procedure Performed?
CRFA is performed as a day procedure no hospital admission, no general anaesthesia required. Here is what to expect:
- Pre-procedure nerve block: First, a diagnostic nerve block is performed using local anaesthetic to confirm that targeting these nerves significantly reduces your This is done 1-2 weeks before the ablation.
- If the block is successful: CRFA is The procedure takes 30-60 minutes.
- Under light sedation and local anaesthesia: Fluoroscopy (live X-ray) is used to guide the placement of probes to the precise nerve locations.
- Ablation: Radiofrequency energy (cooled) is applied for approximately 150 seconds per target point.
- Recovery: Most patients walk out of the clinic the same
Who Is CRFA Right For?
CRFA is suitable for patients who:
- Have moderate to severe knee or hip arthritis pain
- Have not responded adequately to physiotherapy, NSAIDs, or injections (cortisone, hyaluronic acid)
- Are not yet ready for surgery or are not surgical candidates due to age, medical conditions, or personal preference
- Have failed previous joint injections but the diagnostic nerve block provides relief
- Are awaiting hip or knee replacement and need pain relief in the interim
It is not a cure for arthritis the underlying joint damage remains. But for patients whose primary limitation is pain rather than mechanical instability, it can provide months of meaningful relief and improved quality of life.
How Long Does CRFA Last?
CRFA typically provides pain relief for 12 to 24 months. Over time, sensory nerves can regenerate, and pain may gradually return. When it does, the procedure can be repeated.
Published clinical trials, including the MINT study for knee CRFA, show statistically significant and clinically meaningful pain reduction maintained at 6 months, 12 months, and beyond in a majority of patients.
CRFA vs Other Pain Treatments: A Comparison
| Treatment | Duration of Relief | Suitable for | Suitable for |
|---|---|---|---|
| Cortisone injection | 4–8 weeks | Minimal | Mild-moderate pain |
| Hyaluronic acid (Viscosupplementation) | 3–6 months | Minimal | Mild-moderate OA |
| PRP injection | 6–12 months | Minimal | Mild-moderate OA |
| Cooled RFA | 12–24 months | Minimally invasive | Moderate-severe OA |
| Knee / Hip Replacement | Permanent | Major surgery | End-stage OA |
CRFA sits between injections and surgery more durable than injections, less invasive than surgery.
Why Is CRFA Only Available at Select Centres?
Cooled RFA requires specialised training, specific equipment, and precise fluoroscopic guidance. It is standard of care in major centres in the US, UK, and Australia but has been slow to reach India. Dr. Bajwa's training and exposure during his Australian Fellowship gave him the skill set to bring this procedure to Mumbai patients.
Frequently Asked Questions
Is Cooled RFA the same as normal RFA?
They use the same principle but different technology. Cooled RFA creates a larger, more consistent ablation zone and has a stronger evidence base for joint pain than conventional RFA.
Is it covered by insurance?
CRFA coverage in Indian insurance policies varies. Some policies classify it as a pain management procedure and cover it; others do not. Dr. Bajwa's team will check your policy before scheduling.
Is the procedure painful?
The procedure is performed under light sedation and local anaesthesia. Most patients report mild discomfort during probe placement, which resolves quickly.
When will I feel the effect?
Some patients feel relief within days. Most experience the full benefit within 3-4 weeks as inflammation from the procedure settles.
Can I have CRFA if I am already scheduled for knee replacement?
Yes. CRFA is sometimes used as a bridge to planned surgery, providing months of pain relief while other arrangements (insurance, logistics, schedule) are completed.
Book a Consultation: For a transparent, no-pressure discussion about hip replacement costs and options in Mumbai, contact Dr. Supreet Bajwa at Wockhardt Hospital, Mumbai Central & Miraroad. Call or WhatsApp: +91 9820727046