Radiofrequency thermocoagulation to the articular branches of the femoral and obturatory nerve in chronic hip pain

In this study, we aimed to apply radiofrequency thermocoagulation to the articular branches of the femoral and obturator nerves in patients with chronic hip pain under the guidance of ultrasonography and fluoroscopy and to investigate the effects of this procedure on chronic pain, hip function and quality of life. The study included 48 patients with hip pain longer than 3 months. Demographic characteristics of the patients, body mass index, comorbidity, duration of hip pain, diagnosis of hip pain, analgesics , Verbal Rating Scale (VRS), WOMAC score, SF-12 score, complications were recorded. VRS, WOMAC and SF-12 scores of the patients were recorded at the 1st, 3rd and 6th months after the procedure.SPSS 21.0 program was used for statistical analysis. For statistical significance, the p value was less than 0.05. 60.4% of the patients were female and 39.6% were male. Hip pain was due to osteoarthritis in 77.1%, postoperative hip pain in 12.5%, malignancy in 8.3%, avascular necrosis in 2.1%. VRS score was 9.0 (6.0-10.0) at baseline, 2.0 (.0-8.0) at first week, 4.0 (.0-9.0) at first month, 5.0 at third month (.0-10.0), 5.0 (.0-10.0) at the sixth month, and a significant decrease was observed in the VRS score compared to the pre-procedure (p <0.001). WOMAC index was 64.5(5.2-95.8) at baseline, 32.3(1.0-88.5) at first month, 43.2(.0-96.9) at third month, 46 at sixth month, 9(5.2-95.8) and resulted in a statistically significant decrease (p<0.001). SF12-PCS score was 42.2 (20.6-70.3) at baseline, 45.7 (18.6-65.0) at first month, 43.7 (22.8-59.7) at third month, and sixth month 44.9(24.0 60.6) months and it was concluded that it increased significantly in the postoperative period (p<0.001). The SF12-MCS score was 41.5±12.7 in the baseline, 45.0±10.7 in the first month, 43.3±9.6 in the third month, 42.7±10.1 in the sixth month, and did not change significantly after the procedure. (p=0.115). It was observed that drug use increased statistically significantly after the first month (p=0.042). As a complication, one patient developed a motor deficit after the procedure, which healed spontaneously after 24 hours. We think that the radiofrequency thermocoagulation procedure to the articular branches of the femoral and obturatory nerve in chronic hip pain will be an effective treatment in reducing pain for up to 6 months, improving hip functions and improving quality of life. Key words: Hip pain, radiofrequency thermocoagulation, femoral nerve, obturator nerve.