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. 2025 Jun 23;60(2):1-6.
doi: 10.1055/s-0044-1800937. eCollection 2025 Apr.

Pain Evaluation after Pulsed Radiofrequency in Patients with Osteoarthritis of the Hip

Rafaela Reis Torrealba  1 , Phercyles Veiga-Santos  1 , Maria Isabella Cruz de Castro  1 , Lourenço Peixoto  1 , Marcelo Felipe Almeida  1 , Conrado Torres Laett  1
Affiliations

Pain Evaluation after Pulsed Radiofrequency in Patients with Osteoarthritis of the Hip

Rafaela Reis Torrealba et al. Rev Bras Ortop (Sao Paulo). .

Abstract
in English, Portuguese

Objective To evaluate the role of pulsed radiofrequency (PRF) in the pain management of patients with hip osteoarthritis (OA) and surgical indication. Methods We selected 30 patients from the waiting list for total hip arthroplasty, with wait time ranging from 1 to 3 years. The OA degree was measured radiographically according to the Tönnis classification. Patients underwent PRF in the surgical center, performed by two senior hip surgeons from the hospital. The procedure was fluoroscopy-guided and occurred under anesthetic sedation. One nurse assessed all patients before and after PRF using the short form-36 questionnaire. Results From the initial sample of 30 patients, only 13 underwent PRF. Per the Tönnis classification, one subject was type I, four were type II, and eight were type III. The results showed an improvement in pain in 6 patients (46%), general health status in 9 (69%), social aspects in 8 (62%), and mental health in 3 (8%). Furthermore, 2 subjects (15%) reported pain worsening after PRF, and 3 (23%) reported general health status worsening. Conclusion In more advanced degrees of hip joint degeneration (Tönnis III), the technique was flawed, risky, and unsatisfactory. The data obtained question PRF cost-effectiveness and its indication for patients with hip OA as a safe and effective alternative conservative treatment.

Objetivo Avaliar o papel da radiofrequência pulsátil (RFP) no manejo álgico de pacientes com osteoartrite (OA) do quadril com indicação cirúrgica. Métodos Foram selecionados 30 pacientes da fila de cirurgia para artroplastia total de quadril com tempo de espera de 1 a 3 anos. O grau de OA foi mensurado radiograficamente de acordo com a classificação de Tönnis. As RFPs foram realizadas no centro cirúrgico por dois cirurgiões seniores especialistas em quadril do hospital. O procedimento foi guiado por fluoroscopia e ocorreu sob sedação anestésica. Todos os pacientes foram avaliados no pré- e pós-procedimento através do questionário Short Form-36 por uma única enfermeira. Resultados Dos 30 pacientes previamente selecionados, apenas 13 realizaram a RFP. Dentre eles, um era classificado como Tönnis tipo I, quatro como II e oito como III. Os resultados evidenciaram a melhora do quadro álgico em apenas 6 pacientes (46%), do estado geral de saúde em 9 (69%), dos aspectos sociais em 8 (62%) e da saúde mental em 3 (8%). Além disso, 2 pacientes (15%) chegaram a relatar piora do quadro álgico após a RFP e 3 (23%) relataram piora do estado de saúde geral. Conclusão Em graus mais avançados de degeneração articular do quadril (Tönnis III) a técnica se mostrou falha, arriscada e insatisfatória. Os dados obtidos colocam em questão não só o custo-efetividade da técnica, mas sua indicação para os pacientes com OA do quadril como tratamento conservador alternativo seguro e eficaz.

Keywords: chronic pain; hip; osteoarthritis; pulsed radiofrequency treatment.

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Conflict of interest statement

Conflict of Interests The authors have no conflict of interest to declare.

Figures

Fig. 1
Fig. 1
(1) Femoral nerve (2) Obturator nerve. Source: Fluoroscopic imaging from the hospital.
Fig. 2
Fig. 2
Variation in the domains assessed before and after pulsed radiofrequency. The group values are presented by boxplots and the individual values by lines. The green lines indicate improvement in the domain, orange indicate worsening, and gray indicate value maintenance. Abbreviation: PRF, pulsed radiofrequency.
Fig. 3
Fig. 3
Scatter diagram of variations in the domains evaluated. Each point indicates a subject and the dotted reference lines indicate the maintenance of values before and after pulsed radiofrequency. Points located in the upper right quadrant indicate subjects with simultaneous improvement in both domains, while points located in the lower left quadrant indicate simultaneous worsening.
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