Radiofrequency Neurotomy

Radiofrequency neurotomy (RFN) is a non surgical method to assist in the management of moderate to established osteoarthritis. RF has been widely and sucessfully used in the management of spinal disorders for many years. With the more recent development of suitable probe technology, RFN is now also more applicable to other joints, including the hip and knee.

During the conduct of RFN, a fine needle probe is placed into specific locations about the hip, where sensory nerve fibres arise from the joint. RFN is conducted using both X-Ray and ultrasound guidance to ensure accurate and safe conduct of the procedure. An electric current is passed through the RFN probe, that in turn heats the tissue adjacent to the needle tip, disrupting signal transmission of sensory nerve branches arising from the joint. In this way, reduction of pain from the joint can be achieved for 12 months or greater. In the hip, typically the sensory branches of the femoral and obturator nerves are treated by RFN. RFN will not provide complete pain relief however, as other nerve branches (not suitable for RFN therapy) also provide sensation to the hip joint.

I recommend RFN of the hip joint is conducted in hospital under a general anaesthetic as a day procedure (go home same day). Typically the procedure will be combined with a viscosupplementation injection into the hip joint for additional symptom improvement.

Indications for radiofrequency ablation about the hip joint include

- Persistent symptoms from hip arthritis

- As part of an overall joint preserving strategy in combination with other non surgical methods

- Where the degree of arthritic wear is beyond that which can reliably be managed by hip arthroscopy

- People who are experiencing symptoms not considered severe enough to justify hip joint replacement

- People who are medically unfit for joint replacement

- Where a delay in undertaking hip replacement is desireable

- Some cases of residual pain after joint replacement procedures

- Adjunct to the arthroscopic management of iliopsoas tendinopathy

- Selected other hip joint conditions

This information has been provided by A/Prof Patrick Weinrauch for the purposes of patient education. The details provided are of general nature only and do not substitute for professional recommendations based on an individual clinical assessment. © A/Prof Patrick Weinrauch. Brisbane Hip Clinic.