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

NCT ID: NCT05822310

Last Updated: 2023-04-20

Basic Information

• Recruitment Status: UNKNOWN
• Clinical Phase: NA
• Total Enrollment: 60 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2023-04-15
• Study Completion Date: 2024-04-01

Brief Summary

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.

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.

Conditions

Chronic Hip Pain

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: CROSSOVER
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

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

Group Type: EXPERIMENTAL

radiofrequency thermocoagulation to the articular branches of the femoral and obturatory nerves

Intervention Type: PROCEDURE

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.

intraairticular steroid injection

intraairticular steroid injection applied

Group Type: ACTIVE_COMPARATOR

intraairticular steroid injection

Intervention Type: PROCEDURE

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.

pericapsular nerve group (PENG) block

pericapsular nerve group (PENG) block applied

Group Type: ACTIVE_COMPARATOR

pericapsular nerve group (PENG) block

Intervention Type: PROCEDURE

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.

Interventions

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.

Intervention Type: 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.

Intervention Type: 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.

Intervention Type: PROCEDURE

Eligibility Criteria

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

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Aydin Adnan Menderes University

OTHER

Sponsor Role: lead

Responsible Party

SINEM SARI

Associate professor

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

Adnan Menderes University Faculty of Medicine

Aydin, , Turkey (Türkiye)

Site Status: RECRUITING

Countries

Turkey (Türkiye)

Central Contacts

BİLGENUR ERGÜN DEMİRÖZ, RESİDENT DOCTOR

Role: CONTACT

bilgenurergunn@gmail.com

+902564441256

Sinem Sarı Öztürk, Associate professor

Role: CONTACT

sinemsari@yahoo.com

+902564441256

Other Identifiers

2022/07

Identifier Type: -

Identifier Source: org_study_id