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Alternative treatment of hip pain from advanced hip osteoarthritis utilizing cooled radiofrequency ablation: single institution pilot study

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Skeletal Radiology Aims and scope Submit manuscript

Abstract

Objective

To establish the effectiveness of cooled radiofrequency ablation in managing hip pain from osteoarthritis at 6 months after receiving treatment in patients who failed conservative treatments and are not surgical candidates due to comorbidities or unwillingness to undergo arthroplasty surgery by targeting the femoral and obturator branches and assessing the degree of hip pain relief and change of function.

Materials and methods

This prospective pilot study includes a total of 11 consecutive patients experiencing persistent chronic hip pain in the setting of advanced osteoarthritis. Patients initially underwent anesthetic blocks of the obturator and femoral nerve branches to determine cooled radiofrequency ablation candidacy. After adequate response to the anesthetic blocks (> 50% immediate pain relief), patients were subjected to the procedures 2–3 weeks later. Treatment response was evaluated utilizing clinically validated questionnaires and visual analog score in order to assess impact on pain severity, stiffness, and functional activities of daily living. Follow-up outcome scores were collected up to 6 months after cooled radiofrequency ablation procedure.

Results

A total of 11 hips were treated consecutively between August 2019 and March 2020 (mean patient age 61.4 years; 8 M:3F). The mean total HOOS score improved significantly from baseline at 17.0 ± 6.0 to 52.9 ± 5.4 at a mean of 6.2 months after treatment (p < 0.0001), with significant improvement in mean pain score from 16.1 ± 6.6 to 53.4 ± 7.4 (p < 0.0001) and mean stiffness score from 15.0 ± 8.1 to 53.6 ± 11.0 (p < 0.0001). No major complications were encountered. No patients went on to re-treatment, surgery, or other intervention.

Conclusion

Image-guided obturator and femoral nerve cooled radiofrequency ablation is effective and safe in treating chronic hip pain/stiffness in the setting of advanced osteoarthritis.

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Authors and Affiliations

  1. Emory University School of Medicine, Atlanta, GA, USA

    Andrew Tran, David Reiter, Philip Kin-Wai Wong & Felix M. Gonzalez

  2. Department of Radiology, Section of Musculoskeletal Imaging, Emory University School of Medicine, 59 Executive Park South, 4th Floor, Suite 4009, Atlanta, GA, 30329, USA

    David Reiter, Philip Kin-Wai Wong & Felix M. Gonzalez

  3. Department of Orthopedics, Emory University School of Medicine, Atlanta, GA, USA

    David Reiter, Anna R. Cruz & Shervin Oskouei

  4. Department of Radiology, Division of Musculoskeletal Radiology, NYU Grossman School of Medicine, New York, NY, 10016, USA

    Jan Fritz

  5. Department of Physical Medicine & Rehabilitation, Emory University School of Medicine, Atlanta, GA, USA

    Anna R. Cruz

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  1. Andrew Tran
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  2. David Reiter
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Correspondence to Felix M. Gonzalez.

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Tran, A., Reiter, D., Wong, P.KW. et al. Alternative treatment of hip pain from advanced hip osteoarthritis utilizing cooled radiofrequency ablation: single institution pilot study. Skeletal Radiol 51, 1047–1054 (2022). https://doi.org/10.1007/s00256-021-03927-0

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  • DOI: https://doi.org/10.1007/s00256-021-03927-0

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