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[脉冲射频治疗后髋骨关节炎患者的疼痛评估]

[Pain Evaluation after Pulsed Radiofrequency in Patients with Osteoarthritis of the Hip].

作者信息

Torrealba Rafaela Reis, Veiga-Santos Phercyles, Castro Maria Isabella Cruz de, Peixoto Lourenço, Almeida Marcelo Felipe, Laett Conrado Torres

机构信息

Instituto Nacional de Traumatologia e Ortopedia Jamil Haddad, Rio de Janeiro, RJ, Brasil.

出版信息

Rev Bras Ortop (Sao Paulo). 2025 Jun 23;60(2):1-6. doi: 10.1055/s-0045-1809516. eCollection 2025 Apr.

DOI:10.1055/s-0045-1809516
PMID:40552004
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12185192/
Abstract

To evaluate the role of pulsed radiofrequency (PRF) in the pain management of patients with hip osteoarthritis (OA) and surgical indication.  We selected 30 patients from the waiting list for total hip arthroplasty, with wait time ranging from 1 to 3 years. The OA degree was measured radiographically according to the Tönnis classification. Patients underwent PRF in the surgical center, performed by two senior hip surgeons from the hospital. The procedure was fluoroscopy-guided and occurred under anesthetic sedation. One nurse assessed all patients before and after PRF using the short form-36 questionnaire.  From the initial sample of 30 patients, only 13 underwent PRF. Per the Tönnis classification, one subject was type I, four were type II, and eight were type III. The results showed an improvement in pain in 6 patients (46%), general health status in 9 (69%), social aspects in 8 (62%), and mental health in 3 (8%). Furthermore, 2 subjects (15%) reported pain worsening after PRF, and 3 (23%) reported general health status worsening.  In more advanced degrees of hip joint degeneration (Tönnis III), the technique was flawed, risky, and unsatisfactory. The data obtained question PRF cost-effectiveness and its indication for patients with hip OA as a safe and effective alternative conservative treatment.

摘要

评估脉冲射频(PRF)在髋关节骨关节炎(OA)患者疼痛管理及手术指征中的作用。

我们从等待全髋关节置换术的患者名单中选取了30例患者,等待时间为1至3年。根据Tönnis分类法通过影像学测量OA程度。患者在手术中心接受由医院两名资深髋关节外科医生实施的PRF治疗。该操作在荧光镜引导下进行,且在麻醉镇静状态下完成。一名护士使用简明健康状况调查问卷(Short Form-36)对所有患者在PRF治疗前后进行评估。

在最初的30例患者样本中,只有13例接受了PRF治疗。根据Tönnis分类,1例为I型,4例为II型,8例为III型。结果显示,6例患者(46%)疼痛改善,9例(69%)总体健康状况改善,8例(62%)社会方面改善,3例(8%)心理健康改善。此外,2例患者(15%)报告PRF治疗后疼痛加重,3例(23%)报告总体健康状况恶化。

在髋关节退变程度更严重(Tönnis III型)的情况下,该技术存在缺陷、有风险且效果不佳。所获得的数据对PRF作为髋关节OA患者安全有效的替代保守治疗的成本效益及其指征提出了质疑。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/38b3/12185192/85a1c8ae83dc/10-1055-s-0045-1809516-i2400196pt-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/38b3/12185192/5b964c605bd6/10-1055-s-0045-1809516-i2400196pt-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/38b3/12185192/f83c8aff0c34/10-1055-s-0045-1809516-i2400196pt-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/38b3/12185192/85a1c8ae83dc/10-1055-s-0045-1809516-i2400196pt-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/38b3/12185192/5b964c605bd6/10-1055-s-0045-1809516-i2400196pt-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/38b3/12185192/f83c8aff0c34/10-1055-s-0045-1809516-i2400196pt-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/38b3/12185192/85a1c8ae83dc/10-1055-s-0045-1809516-i2400196pt-3.jpg

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本文引用的文献

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Measurement Error, Minimal Detectable Change, and Minimal Clinically Important Difference of the Short Form-36 Health Survey, Hospital Anxiety and Depression Scale, and Pain Numeric Rating Scale in Patients With Chronic Pain.慢性疼痛患者的简明健康调查问卷、医院焦虑抑郁量表和疼痛数字评分量表的测量误差、最小可检测变化和最小临床重要差异。
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Pulsed Radiofrequency and Platelet Rich Plasma in Degenerative Joint Arthritis: Two Case Reports and Literature Analyses.脉冲射频和富血小板血浆治疗退行性关节关节炎:两例病例报告及文献分析
Life (Basel). 2023 Jun 7;13(6):1334. doi: 10.3390/life13061334.
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Regional and Multimodal Analgesia to Reduce Opioid Use After Total Joint Arthroplasty: A Narrative Review.区域和多模式镇痛以减少全关节置换术后阿片类药物的使用:一项叙述性综述
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Classifications in Brief: Tönnis Classification of Hip Osteoarthritis.简要分类:髋关节骨关节炎的托尼分类法。
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