Comparative effectiveness of intra-articular corticosteroid injection and radiofrequency ablation for advanced hip osteoarthritis: A retrospective cohort study.

Abstract

Background: This study aims to compare the clinical effectiveness and safety of intra-articular corticosteroid (IAC) injections versus radiofrequency ablation (RFA) of the femoral and obturator articular branches in patients with advanced hip osteoarthritis (OA).

Patients and methods: This single-center, retrospective cohort study included a total of 93 patients including 62 who received IAC and 31 who received RFA between January 2022 and May 2025. Pain severity (Numeric Rating Scale, NRS), clinical improvement (Global Perceived Effect, GPE), and analgesic use were evaluated at baseline, one month, and six months. Longitudinal changes were analyzed using the Generalized Estimating Equations (GEE) adjusted for age, sex, body mass index (BMI), and opioid use.

Results: Of a total of 93 patients included in the study, 17 were male and 76 were female with a mean age of 66.8±12.3 (range, 27 to 89). Both groups exhibited significant reductions in NRS scores at one and six months compared to baseline (p < 0.001). No significant inter-group differences were observed in absolute NRS scores or the proportion of patients achieving a good clinical response (GPE ≥ 6). At six months, the RFA group demonstrated numerically greater improvement; however, differences in absolute (median 2.0 vs. 0.0; p = 0.052) and percentage change (median 25.0% vs. 0.0%; p = 0.054) did not reach statistical significance. Longitudinal analyses using GEE confirmed a significant main effect of time, with no treatment group effect or group-by-time interaction after adjusting for age, sex, BMI, and baseline opioid use.

Conclusion: Both IAC and RFA provide meaningful and comparable pain relief in patients with refractory hip OA. While the analgesic effect of IAC injections appears to diminish by the sixth month, RFA may offer a safe alternative with a potentially more sustained clinical trajectory.