Reuters Health – 03/12/2020 – Cooled radiofrequency ablation (c-RFA) appears to provide lasting pain relief for patients with moderate to severe osteoarthritis in the hip or shoulder, according to a new study.
Standard RFA covers a very narrow treatment area, while c-RFA covers an area five times larger, Dr. Felix M. Gonzalez with Emory University School of Medicine in Atlanta, Georgia, explained in a presentation of the findings at the Radiological Society of North American (RSNA) virtual annual meeting.
The study included 23 patients with pain from moderate to severe shoulder (12 patients; mean age, 61 years) and hip (11 patients; mean age, 62) osteoarthritis that did not respond adequately to anti-inflammatory pain control and intra-articular lidocaine-steroid injections.
The c-RFA protocol is a two-step process. Patients with shoulder joint pain are given fluoroscopically guided anesthetic blocks of the suprascapular, lateral pectoral and axillary sensory articular nerves while the patients with hip pain have obturator and femoral sensory articular nerve blocks.
In patients with a positive response (at least 50% pain reduction post-block), c-RFA of the same nerve branches is performed one to two weeks later. All 23 patients underwent c-RFA.
There were no procedure-related complications in study patients. Roughly three months after the procedure, patients in both groups reported a statistically significant decrease in the degree of pain with a corresponding increase in dynamic function after the treatment, Dr. Gonzalez reported.
In shoulder pain patients, “we observed approximately 83% pain reduction and 74% overall improvement,” and in the hip pain patients, “we observed approximately 70% pain reduction and 66% overall improvement,” Dr. Gonzalez told the conference.
“This procedure is a last resort for patients who are unable to be physically active and may develop a narcotic addiction,” Dr. Gonzalez added in a news release. “Until recently, there was no other alternative for the treatment of patients at the end of the arthritis pathway who do not qualify for surgery or are unwilling to undergo a surgical procedure.”
At last year’s RSNA annual meeting, Dr. Gonzalez presented similarly promising results using c-RFA in patients with knee osteoarthritis.
“We think that we are only scratching the surface with this technology. We would like to further advance it by applying it in other areas” of pain, such as trauma, amputations and cancer patients with metastatic disease, he added in his presentation.
The study had no commercial funding and the authors have no relevant financial disclosures.
SOURCE: https://bit.ly/36uXH1i Radiological Society of North American Annual Meeting, presented November 29, 2020.
By Megan Brooks
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