Radiofrequency Neurotomy Hip (RFN)

Why am I having a Radiofrequency Neurotomy?

Radiofrequency neurotomy of the hip (RFN) is a needle-based treatment The procedure involves placing needles onto the sensory, articular branches of the femoral and obturator nerves, using high-frequency electrical energy to create a heat lesion. This reduces the transmission of pain signals from the hip joint.

RFN of the hip can be an option if you are not suitable for hip replacement surgery or are not keen to undergo hip replacement surgery. It can also be used to assist in the management of conditions such as iliopsoas tendinopathy.

How is the procedure performed and does it hurt?

During this procedure an Anaesthetist will be present to ensure you are you feel as comfortable as possible.

Before the procedure starts you will have a small needle (cannula) placed in a vein in your hand or arm so that sedation can be given as necessary. The RFN is performed while you are lying on your back and supports (such as pillows) will be used to support you for comfort. Once the area has been cleaned with antiseptic solution your hip area will be covered with sterile drapes. You may feel a sharp sting as local anaesthetic is injected to make the skin area numb. An x-ray machine is used to help guide the needle into the right place. Your Pain Specialist will finish the procedure by putting some local anaesthetic down the needle to the effected nerves.

After the procedure you will return to the recovery area where the nursing team will carry out observations, give you something to eat and drink and make sure you are safe to go home.

How long will the relief last?

With time the nerves will regain function, and your pain may recur. The average duration of benefit is 9 months, but this is variable. If the procedure needs to be repeated in the future, the success rate is closer to 90%.

What are the risks?

All procedures carry a risk of side effects and possible complications.

Common risks and complications:

• Bleeding or bruising
• Localised hip pain due to the muscle being aggravated by the needle
• Temporary leg weakness due to local anaesthetic
• A burning sensation in the overlying skin, similar to sunburn (sometimes lasting up to 6 weeks)
• At the site of the procedure the skin may feel extra sensitive to normal touch

Less common risks and complications:

• Not able to perform the procedure due to medical and/or technical reasons
• Infection requiring further medical treatment
• Allergies
• Damage to surrounding structure needing further treatment

Preparing for your procedure

Please advise your pain specialist at least two weeks before your procedure if you:

• Are taking blood thinners including fish oils or aspirin
• Are diabetic
• May possibly be pregnant
• Are allergic to iodine, betadine, chlorhexidine, shellfish, local anaesthetic or steroids
• Have a temperature, feel unwell or possibly have an infection

You must have a responsible adult (over the age of 18) to pick you up after the procedure and stay with you overnight.

Please make arrangements to ensure you do not drive or make important decisions for the first 24 hours following your procedure.

Day of procedure

• No food within 6 hours prior to your procedure. However, you may take water up to 2 hours prior, but no more that 200mls per hour.
• Take your regular medication with a small sip of water.
• Shower the morning or your procedure

What to do after the procedure

• Take it easy for 24 hours.
• Resume your usual diet and drink plenty of fluids
• For procedural pain use cold packs and simple analgesics such as paracetamol
• Gentle mobilisation is recommended
• You may recommence your usual activity the following day
• Avoid bathing/soaking until the injection sites have healed

It may take two to three weeks before you start to notice an improvement in your pain.

After discharge, if you notice:

• Swelling
• Bleeding from the site
• Changes in sensation
• Difficulty with movement of arms of legs
• New symptoms or difficulty passing urine

Please contact Interventus Pain Specialists during office hours, your general practitioner or your nearest Emergency Department.

What happens next?

You will need to return to the clinic to determine if the pain relief provided by the RFN was meaningful.

This information will help us to guide you with a comprehensive pain management plan and enhance the outcomes of the procedure.