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Comparison of the Efficacy of Conventional Radiofrequency to Intraarticular Steroid Injections for Advanced Hip
Halil Ibrahim Altun1, Fatma Aysen Eren1, Halil Cetingok2
1Department of Anesthesiology, Istanbul Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey.
Background:
Osteoarthritis (OA) is characterized by the destruction of the articular cartilage and narrowing of the joint space and bone formations around the joint due to mechanical, genetic, and inflammatory causes. The hip joints are some of the most commonly affected in OA. Hip OA is also known as coxarthrosis.
Objectives:
This study aimed to compare the effects of conventional radiofrequency (RF) to those of intraarticular steroid treatment methods on pain, limitations, and quality of life in patients who had advanced OA of the hip and could not undergo surgery for any reason.
Study Design:
The study was designed as a randomized, prospective single-center study.
Setting:
A total of 40 patients with advanced primary hip OA who met the inclusion criteria were included in the study.
Methods:
Patients were randomized into 2 groups, each of which included 20 individuals. One group received conventional (thermal) radiofrequency ablation (RFA) to the femoral and obturator sensory branches of the hip, while the other group received intraarticular steroid injections in their hips. Scores on the Visual Analog Scale (VAS) and the physical-function component of the Medical Outcomes Study Short Form Health Survey (SF-36) were completed before, one month after, and 3 months after the procedure. The VAS was recorded both at rest and during activity. Each patient's gender, body mass index (BMI), affected hip side, duration of pain, and previous treatments for the hip were recorded, as were the procedure-related complications each patient experienced.
Results:
Forty patients were followed up on for 3 months. The analysis revealed that at both one month and 3 months after treatment, the 2 groups of patients showed a significant improvement in their scores on the resting VAS, activity VAS, and physical-function component of the SF-36 from the pre-procedure values (P < 0.05). As for resting VAS scores in the hip intraarticular steroid injection (HIASI) group and activity VAS scores in the thermal radiofrequency ablation (TRFA) group, there was a statistically significant difference between the groups at one month and 3 months after the procedure, respectively (P < 0.05). This study found a statistically significant correlation between hip stage and age, but no significant correlation was found for gender and weight. No difference between the groups appeared in the complications related to the procedure at the 3-month follow-up.
Limitations:
The follow-up period was relatively short. The sample size was small, and to avoid neuritis, a half dose of triamcinolone acetonide was given to the patients in the TRFA group.
Conclusions:
Conventional RF is more effective at treating the symptoms of advanced coxarthrosis than are intraarticular steroids, based on observations of the activity in the 3-month follow-up of patients with the condition.
