Introduction
Osteoarthritis affecting the hip joint can cause significant ongoing pain. Many people with this condition choose to undergo a surgical procedure to replace the hip joint, however in some cases this is not recommended, where for example age and/or general health may adversely affect the outcome of the surgery, or where the person simply prefers not to undergo surgery.
Hip joint denervation is a relatively new approach to managing pain in the hip, where the nerves transmitting the pain signals back to the brain are located (these include the obturator and femoral nerves) and, using a special type of needle a probe is inserted to apply heat to the nerve, which prevents the pain signal being transmitted.
This technique is also referred to by a number of terms such as 'radiofrequency ablation' (RFA), 'radiofrequency denervation' (RFD), 'radiofrequency neurotomy' (RFN), or 'thermolysis'.
The procedure may result in significant pain relief for about twelve months on average, at which point the procedure can be repeated.
It is important to note that this procedure is generally reserved for those patients unable to tolerate hip replacement, and the procedure itself has a variable success rate.
Indications
Hip joint denervation is recommended where…
- The patient has chronic hip pain due to osteoarthritis.
- The patient has had a hip replacement failure.
- The patient is unsuited to hip replacement surgery.
- The patient wishes to avoid surgery or ongoing use of medication or other nerve blocks.
Procedure
A hip joint denervation procedure is carried out under either a local anaesthetic and mild sedation to alleviate pain, however the patient remains awake during the procedure. The whole procedure generally takes less than an hour.
Risks
As with all medical procedures, there is always a small risk that complication may develop afterwards. With a hip joint denervation procedure, there is a small risk of…
- Altered sensation or temporary increase in pain level.
- Infection at needle insertion site/s.
- Skin burn from electrode tip.
- Injury to other nerves, which may cause numbness or weakness, although this is generally only temporary.
- Allergic reaction to anaesthetic.
- Hip replacement being required.