Percutaneous, Thermal, and Pulsed Radiofrequency for Nonmalignant Hip Pain

• Type of Material: Article
• Authors: Gary Kao, Emory University; Jerry Kalangara, Emory University; Anna Woodbury, Emory University
• Language: English
• Date: 2018-03
• Publisher: he American Society of Interventional Pain Physicians and a Clinical Companion Journal to Pain Physician
• Publication Version: Final Published Version
• Copyright Statement: 2018, American Society of Interventional Pain Physicians
• Final Published Version (URL): http://www.ipmreportsjournal.com/current/pdf?article=MTgz&journal=8
• Title of Journal or Parent Work: Interventional Pain Management Reports
• Volume: 2
• Issue: 2
• Start Page: 59
• End Page: 68
• Grant/Funding Information: Dr. Woodbury has received Funding/Support that began August 1, 2017 from a federally funded Career Development Award (CDA-1) through the Veteran’s Affairs Rehabilitation Research and Development Service (RR&D).; The senior investigator on this manuscript has received federal funding/support through the Veteran’s Affairs Rehabilitation Research and Development Service (RR&D).
• Keywords: Radiofrequency, ablation, hip, pain, coxalgia, review, chronic, inoperable, nonsurgical, femoral, obturator
• Research Categories: Health Sciences, General; Health Sciences, Medicine and Surgery

Abstract

Background: Although radiofrequency (RF) has been used to treat several types of chronic osteoarthritic pain, the role of percutaneous thermal RF ablation and pulsed RF in treating nonmalignant hip pain has not been well established. Objective: To estimate the effectiveness of thermal and pulsed RF therapy in treating nonmalignant hip pain and encourage further research. Study Design: A systematic review of English and non-English articles was performed on 1/20/2017 using the following databases: PubMed (1960-2017), Cochrane Controlled Trials Register (1960-2017), and EMBASE (1966-2017). Studies for which complete articles were not accessible were excluded if primary authors could not be successfully contacted after attempts via at least 2 different mediums. Search terms included RF, hip, and human (“radiofrequency”[All Fields] AND (“hip”[MeSH Terms] AND “humans”[MeSH Terms]). Results: Two clinical trials for hip RF (n  =  32) and a collection of 7 case series or studies (n = 25) met our inclusion criteria. Both trials used percutaneous RF of the periarticular sensory branches of the obturator and femoral nerves near the hip joint. Ten studies were found to be eligible after screening title, abstract, and full text for inclusion and exclusion criteria. Both clinical trials saw improved post procedure pain scores when compared with standard conservative treatment for inoperable chronic hip pain. The overall complication rate of pooled cohort of all cases reviewed was 9.5% (6/57), but did not result in any self-reported injury. Conclusions: There is low quality evidence to suggest that thermal or pulsed RF therapy is a suitable option for chronic inoperable hip pain. Higher quality trials are needed for stronger recommendations.