Efficacy of Pulse Radiofrequency Treatment in Patients With Coxarthrosis
Condition: Coxarthrosis; Primary
MeSH terms: Osteoarthritis, Hip
Study type: Interventional

Summary: 
      Our aim in this interventional study is to investigate the effectiveness of pulsed
      radiofrequency (PRF) treatment applied to the articular branches of the femoral and obturator
      nerves on pain, functional level, functional capacity and quality of life in patients with
      coxarthrosis. We will compare the effects of PRF treatment added to nerve block compared to
      nerve block alone.
    

Detailed description: 
      Hip pain caused by coxarthrosis is common in the general population and is one of the leading
      causes of disability in the aging population. Conservative treatments may fail due to side
      effects or ineffectiveness. Surgery is generally recommended for patients who do not respond
      to conservative treatment. Surgery is not always an appropriate option for elderly patients
      and patients with multiple comorbidities. For this reason, nerve block may be an appropriate
      treatment option for patients who do not respond to conservative treatment, who are not
      suitable for surgery or who do not want surgery. Pulsed radiofrequency (PRF) is a method of
      temporarily preventing pain transmission through heat increase in the tissue with the help of
      an electrode placed near the target nerve. Most of the pain sensation in the hip joint is
      received by the articular branches of the femoral and obturator nerves. The application of
      PRF to the nerves innervating the hip joint may be an effective method to reduce pain and
      disability in these patients.

      This study was designed as a prospective, randomized, controlled trial. According to the
      statistical analysis, 28 patients who met the eligibility criteria were planned to be
      included in the study. The patients will be divided into 2 groups as the block group (n=14)
      and the PRF group (n=14). In procedures performed under fluoroscopy, vascular structures will
      be detected primarily by ultrasonography for safety purposes. Nerve block and PRF procedures
      will be performed in sterile conditions according to their protocols. Patients will be
      evaluated about pain, functional level, functional capacity and quality of life before
      treatment, at week 2, week 4, and week 12. If complications develop, they will be recorded.
    

Intervention name(s): Pulse radiofrequency treatment; Nerve block with 1 cc betamethasone and 1 cc 1% lidocaine
Intervention type(s): Device; Drug
Intervention description(s): In the procedures to be performed under fluoroscopy, vascular structures will be detected primarily by ultrasonography for safety purposes. A standard RF device will be used for the process. A 22-gauge and 10 cm straight radiofrequency cannula with 1 cm active tip will be used. For each nerve, sensory stimulation will be performed at 50 Hz and the patient will be expected to feel numbness and tingling with a maximum 0.7 V. Motor stimulation will be at 2 Hz and no muscle contraction up to 2 V is expected. Following the appropriate cannula placement, pulse radiofrequency will be applied to each nerve in 2 cycles of 120 seconds for the patients in this group. The pulse radiofrequency current will be 20 milliseconds wide and 45 volts in size. The tip temperature shall not be more than 42℃.; In the procedures to be performed under fluoroscopy, vascular structures will be detected primarily by ultrasonography for safety purposes. A standard RF device will be used for the process. A 22-gauge and 10 cm straight radiofrequency cannula with 1 cm active tip will be used. For each nerve, sensory stimulation will be performed at 50 Hz and the patient will be expected to feel numbness and tingling with a maximum 0.7 V. Motor stimulation will be at 2 Hz and no muscle contraction up to 2 V is expected. Following the appropriate cannula placement, patients will be injected with 1 cc betamethasone and 1 cc 1% lidocaine for each nerve. A total of 2 cc volume will be injected for each nerve.
Intervention MeSH terms: Betamethasone; Lidocaine
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: coxarthrosis; pain; pulse radiofrequency; nerve block