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P276 Thermal bipolar radiofrequency for refractory severe coxalgia: a case report
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P276 Thermal bipolar radiofrequency for refractory severe coxalgia: a case report
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P276 Thermal bipolar radiofrequency for refractory severe coxalgia: a case report
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Journal Article
P276 Thermal bipolar radiofrequency for refractory severe coxalgia: a case report
2025
Overview
Application for ESRA Abstract Prizes:Background and AimsCoxalgia is a common condition in patients over 45, prevalence increasing with age. Its etiology is diverse, including degenerative, inflammatory, infectious, or neoplastic causes. Radiofrequency (RF) targets the sensory innervation of the anterior hip capsule, particularly the articular branches of the obturator, accessory obturator, and femoral nerves. We present a case of severe coxalgia successfully managed with bipolar thermal RF after failure of conservative treatments.MethodsA 68-year-old woman presented with progressive right-sided mechanical groin pain (VAS 8) of several years’ duration. Radiographic evaluation confirmed severe coxarthrosis. The patient had completed rehabilitation and first-line analgesic therapy. Despite orthopedic consultation, she declined surgical intervention and was referred to the Pain Unit for palliative management. A diagnostic block of the femoral, accessory obturator, and obturator nerves was performed under fluoroscopic and ultrasound guidance using 0.5% bupivacaine, resulting in complete pain relief for 36 hours. Bipolar thermal radiofrequency ablation was then scheduled. Under ultrasound guidance, the femoral neurovascular bundle was identified. Then RF needles (22G) were placed at the target sites under fluoroscopy. Thermal RF was applied for 2 minutes at 80°C after test stimulation.ResultsThe patient reported complete pain relief lasting 6 months. Upon symptom recurrence (VAS 6), the procedure was repeated one month later, achieving sustained improvement lasting at least one year.ConclusionsBipolar thermal radiofrequency is a safe and promising technique for the management of chronic coxalgia. Further studies are needed to compare its long-term efficacy versus monopolar RF approaches.
Publisher
BMJ Publishing Group LTD
Subject
