Percutaneous radiofrequency lesioning of sensory branches of the obturator and femoral nerves for the treatment of non-operable hip pain.
BACKGROUND
Chronic hip pain is often a debilitating problem and many patients are not good surgical candidates. Furthermore, hip replacement surgery has significant associated risks. We offer a conservative approach to hip replacement using radiofrequency lesioning.


METHODS
This is a case series of 4 patients who had anterior and or medial hip pain who underwent percutaneous radiofrequency lesioning of the sensory branches of the obturator and femoral nerves. All of the patients had significant co-morbidities and the risks out weighed the benefits of surgery. All the patients had diagnostic blocks with local anesthetic to the sensory articular branches of the obturator and femoral nerves and showed temporary benefit. Continuous radiofrequency lesioning was performed from 60 degrees C to 80 degrees C for 90 seconds. The outcome measures were improvement in visual analogue scale (VAS), improvement in function and the decreased use of pain medications.


RESULTS
All four patients had reduction in pain, while 3 of 4 patients had improved functioning. Two of the four patients had decreased use of their pain medication. One of the four patients reported numbness at the hip and there were no other side effects.


CONCLUSIONS
Percutaneous radiofrequency lesioning of the sensory branches of the obturator and femoral nerves appears to be a safe alternative to hip replacement, especially in those patients where surgery is not an option. Further studies are needed to confirm our results.
Malik
Atif
A
Arnold Pain Center, Department of Anesthesia, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA-02215, USA. amalik@bidmc.harvard.edu
Simopolous
Thomas
T
Elkersh
Mohamed
M
Aner
Musa
M
Bajwa
Zahid H
ZH