Patient-reported outcomes following radiofrequency ablation of the hip: a retrospective study

Background

Chronic hip pain, primarily caused by osteoarthritis, is a prevalent condition that significantly reduces quality of life for many individuals. Radiofrequency ablation (RFA) has emerged as a promising, minimally invasive treatment targeting sensory nerves around the hip joint to provide sustained relief. However, guidelines for selecting suitable patients and predicting outcomes remain unclear.

Objective

This study aimed to evaluate patient-reported pain outcomes following hip RFA and to identify pre-procedure patient factors influencing treatment response.

Methods

In this retrospective study conducted at a tertiary academic center, data was collected from patients undergoing unilateral or bilateral RFA of the articular branches of the obturator and femoral nerves between August 2019 and August 2024. Information collected included demographics, osteoarthritis severity, opioid and antidepressant use, and pre- and post-procedure numeric rating scale (NRS) scores for pain. Primary outcome measures were pre-post difference NRS score, considering clinically meaningful a ≥2-point improvement in NRS and ≥50 % pain reduction. Secondary outcomes included patient perceptions measured using the Patient Global Impression of Change (PGIC) scale. Logistic regression analysis was conducted to identify predictors of treatment success.

Results

Fifty-four patients (64 procedures) participated, predominantly female (64.8 %), with an average age of 68 years old and BMI of 31.43 kg/m². A significant median reduction of 2.5 points in NRS was reported post-procedure (p < 0.001). Overall, 56.25 % of patients achieved a clinically meaningful ≥2-point NRS reduction, and 43.75 % experienced ≥50 % pain reduction. Approximately 66 % of patients reported improvement on the PGIC scale. The average duration of pain relief among responders was six months. Patients without pre-procedure opioid use (OR = 0.24, p = 0.027) and those with higher BMI (p = 0.04) had significantly better outcomes.

Conclusion

Hip RFA demonstrates potential in reducing pain levels and improving patient-reported outcomes in individuals with chronic hip pain. Better outcomes were notably associated with the absence of pre-procedure opioid use and higher BMI. Further research is needed to refine patient selection guidelines and to evaluate functional improvements following the procedure.