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Pilot study for treatment of symptomatic shoulder arthritis utilizing cooled radiofrequency ablation: a novel technique

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Skeletal Radiology Aims and scope Submit manuscript

Abstract

Objective

To introduce cooled radiofrequency nerve ablation (C-RFA) as an alternative to managing symptomatically moderate to severe glenohumeral osteoarthritis (OA) in patients who have failed other conservative treatments and who are not surgical candidates or refuse surgery.

Material and methods

This prospective pilot study includes a total of 12 patients experiencing chronic shoulder pain from moderate to severe glenohumeral OA. Patients underwent anesthetic blocks of the axillary, lateral pectoral, and suprascapular nerves to determine candidacy for C-RFA treatment. Adequate response after anesthetic block was over 50% immediate pain relief. Once patients were deemed candidates, they underwent C-RFA of the three nerves 2–3 weeks later. Treatment response was evaluated using the clinically validated American Shoulder and Elbow Surgeons (ASES) score and visual analog scale (VAS) to assess pain, stiffness, and functional activities of daily living. Follow-up outcome scores were collected up to 6 months after C-RFA procedure.

Results

Twelve patients underwent C-RFA procedure for shoulder OA. VAS scores significantly improved from 8.8 ± 0.6 to 2.2 ± 0.4 6 months after the C-RFA treatment (p < 0.001). Patient’s ASES score results significantly improved in total ASES from 17.2 ± 6.6 to 65.7 ± 5.9 (p < 0.0005). No major complications arose. No patients received re-treatment or underwent shoulder arthroplasty.

Conclusion

Image-guided axillary, lateral pectoral, and suprascapular nerve C-RFA has minimal complications and is a promising alternative to treat chronic shoulder pain and stiffness from glenohumeral arthritis.

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Authors and Affiliations

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

    Andrew Tran

  2. Department of Radiology & Imaging Sciences, Orthopedics, and Biomedical Engineering, Emory University School of Medicine, Atlanta, GA, USA

    David A. Reiter

  3. Department of Radiology, NYU Grossman School of Medicine, New York, NY, USA

    Jan Fritz

  4. Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, GA, USA

    Anna R. Cruz

  5. Department of Orthopedic Surgery, Emory University School of Medicine, Atlanta, GA, USA

    Anna R. Cruz, Nickolas B. Reimer & Joseph D. Lamplot

  6. Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, USA

    Felix M. Gonzalez

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

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Tran, A., Reiter, D.A., Fritz, J. et al. Pilot study for treatment of symptomatic shoulder arthritis utilizing cooled radiofrequency ablation: a novel technique. Skeletal Radiol 51, 1563–1570 (2022). https://doi.org/10.1007/s00256-022-03993-y

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  • DOI: https://doi.org/10.1007/s00256-022-03993-y

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