Reg Anesth Pain Med. 2018 Jan;43(1):72-83. doi: 10.1097/AAP.0000000000000694.
Chronic hip pain from osteoarthritis and other degenerative conditions is a common problem. A few publications have recently reported analgesic success of radiofrequency (RF) procedures on nerves innervating the hip, but interpretation is hampered by lack of clarity regarding indications, clinical protocols, anatomic targets, and longevity of benefit from RF procedures.
We reviewed the following medical literature databases for publications on RF procedures on the hip joint for chronic pain: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Google Scholar through February 28, 2017. Existing knowledge on innervation of the hip joint was synthesized. Data on analgesic and functional outcomes and adverse effects measured at any time points following the interventions were also collected, analyzed, and reported in this narrative review.
Fourteen publications on ablative RF treatments of innervation of the hip joint were identified. A high success rate of these procedures in relieving chronic pain of the hip joint was reported at 8 days to 36 months after the procedures, but none of the publications were randomized controlled trials. There was evidence for improvement in function and a lack of serious adverse events of RF treatments.
Radiofrequency treatments for the sensory innervation of the hip joint have the potential to reduce pain secondary to degenerative conditions. Ongoing concerns remain regarding the anatomic targets, as well as quality, procedural aspects, and monitoring of outcomes in publications on this topic. Randomized controlled trials of high methodological quality are required to further elaborate the role of these interventions in this population.
由骨关节炎和其他退行性疾病引起的慢性髋关节疼痛是一个常见问题。最近有一些出版物报道了射频(RF)手术对支配髋关节的神经的镇痛效果,但由于缺乏对适应证、临床方案、解剖靶点以及 RF 手术获益的持久性的明确性,导致其解释受到阻碍。
我们检索了以下医学文献数据库中关于髋关节慢性疼痛的 RF 手术的出版物:MEDLINE、EMBASE、Cochrane 对照试验中心注册库、Cochrane 系统评价数据库和 Google Scholar,检索截至 2017 年 2 月 28 日。综合了髋关节支配神经的现有知识。还收集了干预后任何时间点的镇痛和功能结果以及不良反应的数据,并在本叙述性综述中进行了分析和报告。
共确定了 14 篇关于髋关节支配神经的消融性 RF 治疗的出版物。这些手术在手术后 8 天至 36 个月缓解髋关节慢性疼痛的成功率很高,但没有一篇是随机对照试验。有证据表明功能得到了改善,而且 RF 治疗没有严重的不良事件。
RF 治疗髋关节感觉神经支配有潜力减轻退行性疾病引起的疼痛。关于该主题的出版物仍然存在对解剖靶点、质量、程序方面以及结果监测的持续关注。需要高质量的随机对照试验来进一步阐述这些干预措施在该人群中的作用。