Fairfax Radiological Consultants

To Schedule an Appointment Call:
703.698.4488

COOLIEF™

What is Chronic Knee Pain? 

If you have been experiencing pain in your knee for two to three months without an adequate explanation, you have chronic knee pain. Chronic knee pain can be caused by injuries, mechanical problems, types of arthritis, and (much less likely) tumors. Chronic knee pain can affect a person of any age. 

Am I at risk?

A number of factors can increase your risk of having chronic knee pain, including: 

  • Being overweight or obese
  • Lack of muscle flexibility or strength
  • Certain sports or occupations that require repetitive stress on the knees
  • A past injury of the knee
  • Age
  • Osteoarthritis
  • Gout
  • Disease

What are the symptoms?

Depending on the cause of problem, the location and severity of pain may vary. However, common symptoms that accompany chronic knee pain include: 

  • Swelling and stiffness 
  • Popping or crunching noises 
  • Weakness or instability 
  • Inability to fully straighten the knee 
  • Redness and warmth to the touch 

How is chronic knee pain treated? 

Physicians typically start with conservative measures to treat chronic knee pain, including anti-inflammatory medication, rest and physical therapy.  If osteoarthritis is suspected, a knee radiograph can be obtained.  

 If conservative measures don't work, and there is persisting pain, an MRI may be pursued. At this point your interventional radiologist becomes involved in treatment of chronic knee pain. An MRI helps physicians see inside the knee to the joint surface cartilage and ligaments that help hold the knee together.  

Chronic knee pain can result from a knee injury that affects any of the ligaments, tendons or fluid-filled sacs (bursae) that surround your knee joint as well as the bones, cartilage and ligaments that form the joint itself.  More commonly, chronic knee pain can be a result of arthritis.  Often the treatment algorithm in this setting is medications beginning with anti-inflammatories (ibuprofen) to stronger categories such as oxycodone (opioid).  Injections for local pain control may also be used. 

Surgical intervention such as knee replacement is also utilized in management of cases not responding to conservative therapy.  If you are not a surgical candidate or you are not ready for surgery, or have persisting pan after surgery your interventional radiologist may suggest genicular nerve ablation (COOLIEF™)—a minor procedure that involves deactivating the nerves responsible for the pain.

What is COOLIEF™? 

COOLIEF™ or Cooled Radiofrequency is a minimally invasive treatment option targeting nerves that transmit pain signals and the first and only radiofrequency treatment FDA-cleared for the relief of osteoarthritis knee pain. 

Is genicular nerve ablation (COOLIEF) right for me? 

Genicular nerve ablation is an excellent option to bring non-surgical relief to those suffering from chronic pain, without the use of opioid medication. So, if you are not ready for surgery, or you don’t like the potential side effects of opioids, then ask your interventional radiologist about COOLIEF.   

In studies of patients who specifically had a COOLIEF treatment one year ago, two-thirds say that their pain level has been cut in half, compared to those who chose intra-articular steroid injections. Eighty-three percent of patients who had been suffering from severe arthritis also report a reduction in pain with COOLIEF.  

COOLIEF is often a good option for people with moderate to severe osteoarthritis pain who are not ready to have knee replacement surgery, or who have health conditions that don't make them a good candidate for surgery. 

Interested in talking to one of our physicians about your Knee Pain treatment options?
We'll walk you through the procedure and answer any questions you may have.

Watch the video below to learn about Coolief treatment

The benefits of treatment include:

DRAMATIC PAIN REDUCTION There was a 93% reduction of patients reporting severe OA knee pain 6 months after receiving COOLIEF*. PAIN RELIEF FOR UP TO 12 MONTHS In clinical studies, most patients receiving COOLIEF* reported that their OA knee pain was significantly reduced for at least 1 year. NO OVERNIGHT HOSPITAL STAY Since this outpatient treatment requires no general anesthesia, you can return home shortly after treatment. QUICK RECOVERY TIME Because the procedure is minimally invasive, most patients can expect to feel pain relief within 1–2 weeks, much sooner than with surgery. NO OPIOID RECOVERY MEDICATION There may be some discomfort for a short period, but this discomfort can be treated with common over- the- counter medication. NO INCISION Unlike surgery, COOLIEF involves no incision.

Why Choose Fairfax Vascular Center?

Over 100 years of combined clinical experience.

Fairfax Vascular Center is one of the largest, long-established interventional radiology practices with more than 100 years of combined clinical experience.

Specialize in COOLIEF™

Our highly trained radiology subspecialists are experts in all imaging modalities and extremely comfortable in utilizing ablation treatments all over the body.  We have a collaborative relationship with our physicians and provide the best MRI imaging in the region.  Additionally, we partner with our interpreting musculoskeletal radiologists (physicians that are highly specialized in imaging evaluation of bones and joints), allowing us to provide you with the best care and outcomes. 

State of the art imaging with subspecialty trained physicians.

Fairfax Vascular Center is part of Fairfax Radiological Centers, the largest and oldest diagnostic radiology group in the metro D.C. and surrounding region, allowing us to provide our patients with leading edge-imaging technologies and the most experienced diagnostic radiologists with subspeciality training.

Common Questions

  • What do I need to do before a COOLIEF™ procedure?

    Prior to your COOLIEF procedure a test nerve block will be performed; this acts as a trial run to determine if the actual procedure will be effective. Once this has been confirmed, your COOLIEF procedure will follow.  Your interventional radiologist will determine any specific instructions regarding withholding medications or fasting the night prior to the procedure on an individualized basis.

  • What will I feel during the procedure itself?

    The COOLIEF* procedure uses cooled radiofrequency energy to safely target the sensory nerves responsible for sending pain signals. A radiofrequency generator transmits a small current of RF energy through a probe, placed within tissue in the area of the nerve.  Heating of the probes will then help in deactivating the pain causing nerves.  You will lie on the table, on your back.  The knee joint to be treated will be gently cleaned with antiseptic solution and covered in a sterile drape.  The ablation probe will then be positioned in the regions that were pre-determined for treatment based on your initial nerve block.  The procedure is typically performed with local anesthetic—rarely, sedation is used.

  • How long will the procedure last?

    The COOLIEF* procedure time varies depending on your physician and the specific treatment you need, but it typically takes less than an hour.

  • What should I expect after COOLIEF™?

    You may experience some discomfort at the radiofrequency site for a short period, but this discomfort can be treated with common over-the counter medication. It may take a couple of weeks for you to feel the full effects of the procedure. Longer term, you can expect: 

    • Pain relief for up to 12 months. In clinical studies, most patients receiving COOLIEF™* reported that their pain was significantly reduced.
    • Improved mobility. COOLIEF™* has been proven to significantly improve long-term physical function and quality of life for OA knee patients for up to 12 months. 
    • Quick recovery time. Because the procedure is minimally invasive, most patients can expect to feel pain relief within 1-2 weeks, returning to an enhanced quality of life much sooner than with surgery. 
    • No opioid recovery medication. You may experience some discomfort for a short period, but this discomfort can be treated with common over-the-counter medication. 
    • No overnight hospital stay. Since this outpatient treatment requires no general anesthesia, you can return home shortly after treatment. 
    • No incision. Unlike surgery, COOLIEF™* involves no incision.
  • When and where are appointments offered?

    Appointments are available at Fairfax Vascular Center Monday through Friday, 7am to 5pm. Learn more about this location.

Our Physicians

Paul Reha Butros, M.D.

Paul Reha Butros, M.D.

Joined Practice:
Diagnostic Radiology
Ultrasound
Vascular & Interventional Radiology
Body Imaging
Read more

Paul Reha Butros, M.D.

Joined Practice:
Diagnostic Radiology
Ultrasound
Vascular & Interventional Radiology
Body Imaging
Medical School

Baskent University School of Medicine
Completed 2005

Residency

Detroit Medical Center - Wayne State University
Completed 2012

Fellowship

Massachusetts General Hospital/Harvard Medical School
Completed 2014

Miami Cardiac and Vascular Institute
Completed 2015

Board Certification

American Board of Radiology - Diplomate
2012

Professional Affiliations & Memberships

American College of Radiology
American Medical Association
American Roentgen Ray Society
Medical Society of Virginia
Radiology Society of North America
Society of Interventional Radiology

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Alain T. Drooz, M.D.

Alain T. Drooz, M.D.

Joined Practice:
Diagnostic Radiology
Ultrasound
Vascular & Interventional Radiology
Read more

Alain T. Drooz, M.D.

Joined Practice:
Diagnostic Radiology
Ultrasound
Vascular & Interventional Radiology
Medical School

University of North Carolina

Residency

New York University Medical Center
Completed 1988

Fellowship

New York University Medical Center
Body Imaging
Completed 1989

New York University Medical Center
Interventional Radiology
Completed 1990

Board Certification

American Board of Radiology
1989

Professional Affiliations & Memberships

American College of Radiology
Radiological Society of North America
Society of Cardiovascular and Interventional Radiology
Society of Vascular Medicine and Biology - Fellow
Fairfax County Medical Society

Accolades

Top Doctor
Washingtonian Magazine
Northern Virginia Magazine

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Aaron R. DuCoffe, M.D.

Aaron R. DuCoffe, M.D.

Joined Practice:
Body Imaging
Diagnostic Radiology
Ultrasound
Vascular & Interventional Radiology
Read more

Aaron R. DuCoffe, M.D.

Joined Practice:
Body Imaging
Diagnostic Radiology
Ultrasound
Vascular & Interventional Radiology
Medical School

Emory University School of Medicine 
Completed 2013

Residency

University of Florida College of Medicine
Orthopaedic Surgery
Completed 2014

Georgetown University Medical Center
Diagnostic Radiology
Completed 2019

Fellowship

United States Department of Health and Human Services 
Healthcare Policy/Quality - Opioid Safety
Completed 2015

Emory University School of Medicine 
Vascular & Interventional Radiology
Completed 2020

Board Certification

American Board of Radiology 
Board Eligible 2021
Completed 2018

Professional Affiliations & Memberships

Radiology Society of North America
Society of Interventional Radiology 
American College of Radiology
Reviewer for Pain Medicine
National Ski Patrol

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Michael G. Karnaze, M.D.

Michael G. Karnaze, M.D.

Joined Practice:
Diagnostic Radiology
Ultrasound
Vascular & Interventional Radiology
Read more

Michael G. Karnaze, M.D.

Joined Practice:
Diagnostic Radiology
Ultrasound
Vascular & Interventional Radiology
Medical School

University of Kansas School of Medicine
Completed 1982

Residency

Mallinckrodt Institute of Radiology
Completed 1987

Fellowship

Alexandria Hospital
Interventional Radiology
Completed 1988

Board Certification

American Board of Radiology
Diagnostic Radiology 1987
Interventional Radiology 1995

Professional Affiliations & Memberships

Society of Cardiovascular and Interventional Radiology
Chesapeake Interventional Radiology Society (President 1996)
American Heart Association
American College of Radiology
Radiology Society of North America
American Roentgen Ray Society

Accolades

Top Doctor 
Washingtonian Magazine
Northern Virginia Magazine

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Hong Lim, M.D.

Hong Lim, M.D.

Joined Practice:
Diagnostic Radiology
Ultrasound
Vascular & Interventional Radiology
Read more

Hong Lim, M.D.

Joined Practice:
Diagnostic Radiology
Ultrasound
Vascular & Interventional Radiology
Medical School

University of Medicine & Dentistry
Completed 2001

Residency

University of Medicine & Dentistry
Completed 2006

Fellowship

Baptist Cardiac and Vascular Institute
Completed 2008

Board Certification

American Board of Radiology
2006

Professional Affiliations & Memberships

Radiological Society of North America
American College of Radiology
Society of Interventional Radiology

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David J. Spinosa, M.D.

David J. Spinosa, M.D.

Joined Practice:
Diagnostic Radiology
Ultrasound
Vascular & Interventional Radiology
Read more

David J. Spinosa, M.D.

Joined Practice:
Diagnostic Radiology
Ultrasound
Vascular & Interventional Radiology
Medical School

Tufts University School of Medicine
Completed 1984

Residency

Georgetown University Hospital
Radiology
Completed 1992

New England Deaconess Hospital
Surgery
Completed 1987

Fellowship

University of Virginia
Angiography and Interventional Radiology
Completed 1993

Board Certification

American Board of Radiology
Radiology - 1992
Angiography and Interventional Radiology - 1995

Professional Affiliations & Memberships

Society of Interventional Radiologists
American College of Radiology

Accolades

Top Doctor
Washingtonian Magazine
Northern Virginia Magazine

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Mustafa M. Syed, D.O.

Mustafa M. Syed, D.O.

Joined Practice:
Diagnostic Radiology
Vascular & Interventional Radiology
Read more

Mustafa M. Syed, D.O.

Joined Practice:
Diagnostic Radiology
Vascular & Interventional Radiology
Medical School

New York College of Osteopathic Medicine

Completed 2011

Residency

Mount Sinai West Hospital Center 

Completed 2016

Fellowship

Mount Sinai Hospital, Vascular and Interventional Radiology

Completed 2017

Board Certification

American Board of Radiology, 2017

Professional Affiliations & Memberships

Radiological Society of North America

American College of Radiology

American Board of Radiology

Society of Interventional Radiology

 

 

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Jay D. Varma, M.D.

Jay D. Varma, M.D.

Joined Practice:
Diagnostic Radiology
Ultrasound
Vascular & Interventional Radiology
Read more

Jay D. Varma, M.D.

Joined Practice:
Diagnostic Radiology
Ultrasound
Vascular & Interventional Radiology
Medical School

University of Maryland
Completed 1996

Residency

Boston University Medical Center
Completed 2001

Fellowship

Harvard Medical School
Completed 2002

Board Certification

American Board of Radiology
Radiology - 2001
Interventional Radiology - 2003

Professional Affiliations & Memberships

Cardiovascular and Interventional Society of Europe
Chesapeake Interventional Radiology Society 
Medical Society of the District of Columbia
Society of Interventional Radiology
American Roentgen Ray Society
Radiological Society of North America

Accolades

Top Doctor
Washingtonian Magazine
Northern Virginia Magazine

Close

Related Resources

Available at the following location

Fairfax Radiology Vascular Center

Fairfax Radiology Vascular Center

8505 Arlington Boulevard
Suite 400
Fairfax, VA 22031
United States

Tel
703.698.4475
Fax
703.573.4237

Request a Telephone Consultation

Please provide the following information and one of our physicians or experienced staff members will call you back shortly.

If you need an immediate appointment, please call 703.698.4475.