Minimally invasive treatment of osteoarthritis of the hip joint by radiofrequency denervation: a clinical case

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Abstract

Background: At present, there is a growing trend towards osteoarthritis spreading among the population of Russia and the entire world, therefore, the search for an effective and low-traumatic method of the pain syndrome relief in coxarthrosis is an important problem of modern medicine.

Clinical case description: A clinical case of treatment of a 64-year-old patient, a working pensioner, with the complaints of severe pain in the left hip joint and a clinical picture of stage IV coxarthrosis according to the Kellgren and Lawrence classification, is presented. Previously, indications for planned joint arthroplasty were found for this patient due to the ineffectiveness of a conservative treatment. The pain syndrome was estimated as 9 points on the visual analogue scale (VAS), 32 points according to the Harris Hip Score (unsatisfactory result). Due the development of an acute concomitant disease, radiofrequency denervation of the left hip joint was performed. The patient was discharged the next day after the surgery, and a positive outcome was achieved in the form of pain reduction for a long period. VAS: 1st day — 3 points, 1 month — 2 points, 6 months — 6 points, 12 months — 7 points. The Harris Hip Score: 1 month — 82 points (good result), 6 months — 76 points (satisfactory result).

Conclusion: As this clinical case has shown, radiofrequency denervation is a promising alternative for patients with osteoarthritis of the hip joint, for whom total arthroplasty is contraindicated, and a conservative treatment does not give long-term positive results for severe pain syndrome.

About the authors

Mikhail A. Gorokhov

General Medical Center of the Bank of Russia

Author for correspondence.
Email: docgorohov@yandex.ru
ORCID iD: 0000-0002-2279-023X
SPIN-code: 5493-3566

MD

Russian Federation, 66, Sevastopol'skiy prospekt, Moscow, 117593

Nikolay V. Zagorodniy

Priorov Central institute for Trauma and Orthopedics; Peoples' Friendship University of Russia

Email: zagorodniy51@mail.ru
ORCID iD: 0000-0002-6736-9772
SPIN-code: 6889-8166

MD, PhD, Сorrespondent member of the Russian Academy of Sciences

Russian Federation, Moscow; Moscow

Vyacheslav I. Kuzmin

General Medical Center of the Bank of Russia

Email: drkuzmin@inbox.ru
ORCID iD: 0000-0002-5329-6314
SPIN-code: 1669-2625

MD, PhD

Russian Federation, Moscow

Taras G. Sharamko

General Medical Center of the Bank of Russia

Email: sharamko_t@mail.ru
ORCID iD: 0000-0003-0508-8593
SPIN-code: 4481-8526

MD, PhD

Russian Federation, Moscow

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Supplementary files

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1. JATS XML
2. Fig. 1. Radiography of the hip joints.

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3. Fig. 2. Position of the patient on the operating table.

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4. Fig. 3. A Stryker Interventional spine MultiGen RF Console Radio frequency generator (USA).

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5. Fig. 4. Radiofrequency denervation of the obturator and femoral nerves.

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6. Fig. 5. Innervation of the hip joint.

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