Objective - to compare the effectiveness of radiofrequency denervation (RFD) and conservative treatment of patients with hip degenerative diseases. Material and methods. 66 patients with various stages of hip degeneration were followed up for 12 months, including 36 patients who underwent RFD and 30 patients of control group with conservative treatment. Treatment results were assessed using Visual Analogue Scale (VAS) and Harris Hip Score before treatment, during the first day, 2 days later, as well as at 1, 6 and 12 months. Results: RFD patients demonstrated significantly better results compared with conservative group. Patients with coxarthrosis stage I and II, besides higher efficiency had prolonged period of remission, while patients with coxarthrosis stage III returned to the near-baseline level of pain only in 3-6 months. Conclusions: RFD is an effective treatment modality for patients with initial coxarthrosis stages, which helps to reduce significantly the disability period compared with conservative therapy. RFD is the only method of effective hip pain relieve in patients with severe comorbidities allowing to reduce analgesic consumption. This method is minimally invasive, has low cost, permits repeated procedures, making it attractive for both physicians and patients.
The scientific review presents the treatment of coxarthrosis of various stages by the method of radiofrequency denervation (RFD). The authors provide information about the state of the problem according to domestic and world literature, with special attention being paid to the characteristics of various denervation protocols and the justification of the choice of target points for exposure from the standpoint of anatomy and innervation of the hip joint. RCD is a modern, interventional and effective solution to the main symptom, which is pain according to the results of numerous studies. The introduction of targeted effects on the articular branches of the locking and femoral nerves by radiofrequency denervation into the work of a practitioner can increase the period of remission of exacerbation of coxarthrosis and shorten the period of disability with a high level of intervention safety for the patient.
Introduction. Clinical efficacy of radiofrequency destruction (RFD) for the treatment of vertebrogenic pain syndrome and pain in coxarthrosis is confirmed by multiple studies. However the matter on morphologic changes in the nerve and surrounding tissue after directed local radiofrequency effect. Materials and methods. The study was performed on autopsy material – fragments of tibial nerve from 6 patients with lethal outcomes. Radiofrequency destruction was performed according to a standard protocol: within 90 sec under 80 C°. The sections were stained with hematoxylin and eosin by Bilshowski-Gros method. Results. It was shown that RFD causes the coagulation lesions of the nerve tissue such as spiral deformation, axon fragmentation and nerve fibers dissociation. Conclusion. The data obtained may serve as a morphologic basis of RDF clinical efficacy. The presence of undamaged Schwann cells allows assuming the tropism of the effect upon the nerve tissue.
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