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Chronic and interventional pain: Review article
Radiofrequency Procedures to Relieve Chronic Hip Pain: An Evidence-Based Narrative Review
  1. Anuj Bhatia, MD, MBBS, FRCA, FRCPC (Anesthesia & Pain Medicine), FIPP, FFPMRCA, EDRA, CIPS*,†,‡,
  2. Yasmine Hoydonckx, MD, FIPP*,‡,
  3. Philip Peng, MBBS, FRCP, Founder (Pain Medicine)*,‡ and
  4. Steven P. Cohen, MD§∥
  1. *Department of Anesthesia and Pain Management, Toronto, Ontario, Canada
  2. †Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
  3. ‡University Health Network–Toronto Western Hospital, Toronto, Ontario, Canada
  4. §Departments of Anesthesiology and Critical Care Medicine & Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, MD
  5. ∥Departments of Anesthesiology & Physical Medicine and Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD
  1. Address correspondence to: Anuj Bhatia, MD, MBBS, FRCA, FRCPC (Anesthesia & Pain Medicine), FIPP, FFPMRCA, EDRA, CIPS, Department of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network, McL 2-405, 399 Bathurst St, Toronto, Ontario, Canada M5T 2S8 (e-mail: anuj.bhatia{at}uhn.ca).

Abstract

Background and Objectives Chronic hip pain from osteoarthritis and other degenerative conditions is a common problem. A few publications have recently reported analgesic success of radiofrequency (RF) procedures on nerves innervating the hip, but interpretation is hampered by lack of clarity regarding indications, clinical protocols, anatomic targets, and longevity of benefit from RF procedures.

Methods We reviewed the following medical literature databases for publications on RF procedures on the hip joint for chronic pain: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Google Scholar through February 28, 2017. Existing knowledge on innervation of the hip joint was synthesized. Data on analgesic and functional outcomes and adverse effects measured at any time points following the interventions were also collected, analyzed, and reported in this narrative review.

Results Fourteen publications on ablative RF treatments of innervation of the hip joint were identified. A high success rate of these procedures in relieving chronic pain of the hip joint was reported at 8 days to 36 months after the procedures, but none of the publications were randomized controlled trials. There was evidence for improvement in function and a lack of serious adverse events of RF treatments.

Conclusions Radiofrequency treatments for the sensory innervation of the hip joint have the potential to reduce pain secondary to degenerative conditions. Ongoing concerns remain regarding the anatomic targets, as well as quality, procedural aspects, and monitoring of outcomes in publications on this topic. Randomized controlled trials of high methodological quality are required to further elaborate the role of these interventions in this population.

https://doi.org/10.1097/AAP.0000000000000694

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    Footnotes

    • A.B. helped design the study, conduct the study, analyze the data, and write the manuscript. Y.H. helped conduct the study, analyze the data, and write the manuscript. P.P. helped design and conduct the study. S.P.C. helped design and conduct the study.

      The authors declare no conflict of interest.