AOCPMR 2024 Mid-Year Meeting-Knee, Hip, and Shoulder Radiofrequency Ablation: Application and Outcomes

Knee, Hip, and Shoulder Radiofrequency Ablation: Application and Outcomes - John Yarjanian, DO, MS

Video Transcription

Video Summary

This detailed presentation covers radiofrequency ablation (RFA) for treating peripheral joint pain, focusing on the knee, hip, and shoulder. Originating from spinal interventions, RFA uses thermal energy to disrupt pain signals in sensory nerves, providing relief for patients unsuitable for surgery or those with persistent post-operative pain. Two main RFA types are discussed: traditional continuous high-frequency and water-cooled RFA, with the latter creating larger lesions and potentially longer-lasting effects.<br /><br />The knee has the most established evidence, targeting specific genicular nerves to reduce osteoarthritis pain, including in post-total knee arthroplasty cases. Studies show RFA is often more effective and longer-lasting than corticosteroids or hyaluronic acid injections. Hip RFA targets the obturator and femoral accessory nerves; it’s more technically challenging due to complex anatomy and nearby vasculature but shows promise for various hip disorders including osteoarthritis and avascular necrosis. Shoulder RFA targets the suprascapular, axillary, and lateral pectoral nerves, with early data indicating significant pain and functional improvement.<br /><br />Key considerations include careful patient selection, understanding anatomy to avoid complications, use of imaging, local anesthesia for patient comfort, and insurance coverage challenges as many payers currently deny claims citing experimental status. Overall, RFA offers a promising non-surgical option to relieve chronic joint pain, especially in patients ineligible for surgery or seeking to delay joint replacement.

Keywords

shoulder pain diagnosis

imaging modalities

X-rays

CAT scans

MRIs

ultrasounds

rotator cuff tears

diagnostic accuracy

radiofrequency ablation

peripheral joint pain

knee osteoarthritis

hip pain treatment

shoulder pain management

genicular nerves

water-cooled RFA

non-surgical pain relief

post-operative pain