Comparison of Femoral and Obturatory Nerve Joint Branches Conventional Radiofrequency Thermocoagulation ,Intraarticular Steroid Injection and Pericapsular Nerve Group (PENG) Block in Chronic Hip Pain

In this study ,the investigators aimed to show the decrease in pain levels and the effect on quality of life of patients who underwent chronic hip painRFT , intraartıcular steroid injection and Peng block.

Study Overview

• Status: Recruiting
• Conditions: Chronic Hip Pain
• Intervention / Treatment: Procedure: radiofrequency thermocoagulation to the articular branches of the femoral and obturatory nerves; Procedure: intraairticular steroid injection; Procedure: pericapsular nerve group (PENG) block

Detailed Description

Hip pain is a common medical condition with increasing age.The effectiveness of conservative methods used in hip pain is limited.Since the lifespan of prostheses used in hip surgery is limited, new methods are needed in the treatment of pain.The anterior sensory innervation of the hip joint is provided by the articular branches of the femoral and obturatory nerve. Today, the most commonly used techniques for hip pain are corticosteroid administration into the hip joint, pericapsular nerve group (PENG) block application, and radiofrequency thermocoagulation to the articular branches of the femoral and obturatory nerves. The aim of this study is to compare the effects of these three procedures in hip pain.

• Study Type: Interventional
• Enrollment (Anticipated): 60
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: BİLGENUR ERGÜN DEMİRÖZ, RESİDENT DOCTOR; Phone Number: +902564441256; Email: bilgenurergunn@gmail.com
• Study Contact Backup: Name: Sinem Sarı Öztürk, Associate professor; Phone Number: +902564441256; Email: sinemsari@yahoo.com

Study Locations

• Turkey
  • Aydın, Turkey, 09010
    • Recruiting
    • Adnan Menderes University Faculty of Medicine

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

1. be over 18 years old
2. Written consent has been obtained
3. Those with chronic hip pain for more than 3 weeks

Exclusion Criteria:

1. Major psychiatric illness
2. The patient has lumbar compression pain or referred pain
3. Patients using anticoagulant agents
4. Patients with infection in the area to be treated
5. Those who are allergic to local anesthetics
6. Those who are allergic to betamethasone
7. Pregnancy
8. Patients who underwent hip surgery during the 3-month follow-up period during the study

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Crossover Assignment
• Masking: None (Open Label)

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: radiofrequency thermocoagulation to the articular branches of the femoral and obturatory nerves; radiofrequency thermocoagulation to the articular branches of the femoral and obturatory nerves applied	Procedure: radiofrequency thermocoagulation to the articular branches of the femoral and obturatory nerves; Patients are operated under sedation in the operating room. C-arm fluoroscopy device is used for imaging purposes for radiofrequency thermocoagulation process. In order to prevent vascular injury, the needle is advanced under the guidance of ultrasonography. There are target points determined in fluoroscopy for the femoral nerve and the obturatory nerve. Before the thermocoagulation procedure, local anesthetic and steroid are injected into each of the target points.
Active Comparator: intraairticular steroid injection; intraairticular steroid injection applied	Procedure: intraairticular steroid injection; The patients were placed in the supine position in the operating room. The patient was stained sterile with povidone iodide. The femoral neck was detected under ultrasonography and the joint capsule was entered with a 22G 9 cm spinal needle. Then, 5 cc bupivacaine and 5 mg betamethasone were given and the procedure was terminated.
Active Comparator: pericapsular nerve group (PENG) block; pericapsular nerve group (PENG) block applied	Procedure: pericapsular nerve group (PENG) block; The patients were placed in the supine position in the operating room. The patient was stained sterile with povidone iodide. The high-frequency linear ultrasonography probe was placed on the anterior superior iliacspina (ASIS). Later, the anterior inferior iliac spine (AIIS) was detected by descending caudally. Afterwards, the probe was brought to the oblique position and AIIS, iliopubikeminence, psoas muscle and tendon were seen. Using a 22G 90-mm Quinckespinal needle, the tendon of the iliopsoas muscle was entered in the lateral-medial direction in the in-plane plane and bone contact was achieved. After negative aspiration, 15 ml of 0.5% bupivacaine were administered by seeing the appropriate drug distribution.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
NRS(Numerating Rating Scale) for chronic pain	İt is a pain intensity determination system based on the system where there person tells a point between 0=(no pain) 10=( unbearable pain) and to describe their pain	preoperative
NRS(Numerating Rating Scale) for chronic pain	İt is a pain intensity determination system based on the system where there person tells a point between 0=(no pain) 10=( unbearable pain) and to describe their pain	Postoperative first month
NRS(Numerating Rating Scale) for chronic pain	İt is a pain intensity determination system based on the system where there person tells a point between 0=(no pain) 10=( unbearable pain) and to describe their pain	Postoperative third month

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
WOMAC (Western OntarioandMcMasterUniversitiesArthritisIndex )	It includes 24 questions under three sub-headings as pain, stiffness and physical function. Each question was scored according to the Likert scale as 0=absent, 1=mild, 2=moderate, 3=severe, 4=very severe.minimum score is 0=good maximum score is 96 = bad functional capacity	Preoperative
WOMAC (Western OntarioandMcMasterUniversitiesArthritisIndex )	It includes 24 questions under three sub-headings as pain, stiffness and physical function. Each question was scored according to the Likert scale as 0=absent, 1=mild, 2=moderate, 3=severe, 4=very severe.minimum score is 0=good maximum score is 96 = bad functional capacity	Postoperative first month
WOMAC (Western OntarioandMcMasterUniversitiesArthritisIndex )	It includes 24 questions under three sub-headings as pain, stiffness and physical function. Each question was scored according to the Likert scale as 0=absent, 1=mild, 2=moderate, 3=severe, 4=very severe.minimum score is 0=good maximum score is 96 = bad functional capacity	Postoperative third month

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
NRS(Numerating Rating Scale) for acute pain	İt is a pain intensity determination system based on the system where there person tells a point between 0=(no pain) 10=( unbearable pain) and to describe their pain	postoperative second hour

Collaborators and Investigators

• Sponsor: Aydin Adnan Menderes University

Study record dates

Study Major Dates

• Study Start (Actual): April 15, 2023
• Primary Completion (Anticipated): April 1, 2024
• Study Completion (Anticipated): April 1, 2024

Study Registration Dates

• First Submitted: January 19, 2023
• First Submitted That Met QC Criteria: April 19, 2023
• First Posted (Actual): April 20, 2023

Study Record Updates

• Last Update Posted (Actual): April 20, 2023
• Last Update Submitted That Met QC Criteria: April 19, 2023
• Last Verified: April 1, 2023

More Information

Terms related to this study

• Keywords: chronic hip pain; Radiofrequency thermocoagulation; femoral and obturatuar nerve; intraartıcular steroid injection; pericapsular nerve group (PENG) block
• Other Study ID Numbers: 2022/07

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No