PDF(Pubmed)
Abstract：
BACKGROUND: Greater trochanteric pain syndrome (GTPS) is a prevalent cause of lateral hip pain that often leads to significant functional limitations. Conservative treatment options include physical therapy, pharmacological treatment, and more invasive techniques such as corticosteroid injections. However, despite the high success rates reported with corticosteroid injections, a significant number of patients have their symptoms persist or recur.
OBJECTIVE: In this case series, we present the outcomes of nine patients with GTPS who underwent ultrasound-guided bipolar pulsed radiofrequency targeting the trochanteric branches of the femoral nerve. We aim to discuss the effectiveness and safety of this approach.
METHODS: Eligible patients referred to our centre underwent ultrasound-guided bipolar pulsed radiofrequency aimed at the trochanteric branches of the femoral nerve. The procedure consisted of one cycle at 42°C for six minutes, followed by the injection of ropivacaine (0.2%, 3 mL) and dexamethasone (12 mg). The Brief Pain Inventory - Short Form (BPI-sf) and Lequesne Algofunctional Index (LAI) were used before the procedure and at the third and sixth months post-procedure. We monitored immediate and late complications, as well as adverse effects.
CONCLUSIONS: Our results indicate a favourable outcome for most patients, with an average pain reduction of 76.51% according to their report of the BPI-sf. Additionally, eight out of nine patients experienced at least 50% relief. These findings align with a previous case series, which reported a similar average pain reduction. Before the procedure, most patients were classified as \"extremely severe\" in the LAI, with an average score of 18.17. Although there was only a slight reduction of 16.84% at the six-month follow-up, this suggests a potential improvement in their functional status. We did not observe any immediate complications or adverse effects after the procedure, nor were any reported at the subsequent follow-ups, which is consistent with existing literature.
CONCLUSIONS: Our study suggests that ultrasound-guided bipolar pulsed radiofrequency treatment is a promising minimally invasive technique for GPTS, especially for patients who do not respond to conservative treatments. Although our case series provides some evidence of effectiveness and safety, further controlled studies on a larger scale are necessary, particularly to compare this intervention with the use of corticosteroid injections alone.
OBJECTIVE: In this case series, we present the outcomes of nine patients with GTPS who underwent ultrasound-guided bipolar pulsed radiofrequency targeting the trochanteric branches of the femoral nerve. We aim to discuss the effectiveness and safety of this approach.
METHODS: Eligible patients referred to our centre underwent ultrasound-guided bipolar pulsed radiofrequency aimed at the trochanteric branches of the femoral nerve. The procedure consisted of one cycle at 42°C for six minutes, followed by the injection of ropivacaine (0.2%, 3 mL) and dexamethasone (12 mg). The Brief Pain Inventory - Short Form (BPI-sf) and Lequesne Algofunctional Index (LAI) were used before the procedure and at the third and sixth months post-procedure. We monitored immediate and late complications, as well as adverse effects.
CONCLUSIONS: Our results indicate a favourable outcome for most patients, with an average pain reduction of 76.51% according to their report of the BPI-sf. Additionally, eight out of nine patients experienced at least 50% relief. These findings align with a previous case series, which reported a similar average pain reduction. Before the procedure, most patients were classified as \"extremely severe\" in the LAI, with an average score of 18.17. Although there was only a slight reduction of 16.84% at the six-month follow-up, this suggests a potential improvement in their functional status. We did not observe any immediate complications or adverse effects after the procedure, nor were any reported at the subsequent follow-ups, which is consistent with existing literature.
CONCLUSIONS: Our study suggests that ultrasound-guided bipolar pulsed radiofrequency treatment is a promising minimally invasive technique for GPTS, especially for patients who do not respond to conservative treatments. Although our case series provides some evidence of effectiveness and safety, further controlled studies on a larger scale are necessary, particularly to compare this intervention with the use of corticosteroid injections alone.
摘要：
背景：大转子疼痛综合征（GTPS）是髋关节外侧疼痛的常见原因，通常会导致明显的功能限制。保守治疗方案包括物理治疗,药物治疗,和更具侵入性的技术，如皮质类固醇注射。然而,尽管据报道皮质类固醇注射的成功率很高，相当数量的患者症状持续或复发.
目的：在本系列中，我们介绍了9例GTP患者的结局,这些患者接受了针对股神经转子分支的超声引导双极脉冲射频治疗.我们的目标是讨论这种方法的有效性和安全性。
方法：我们中心的符合条件的患者接受了针对股神经股骨粗隆支的超声引导双极脉冲射频治疗。该程序包括在42°C下进行6分钟的一个循环，然后注射罗哌卡因(0.2%，3mL）和地塞米松（12mg）。术前以及术后第3个月和第6个月使用简短疼痛量表（BPI-sf）和LequesneAlgofunctionalIndex（LAI）。我们监测了即时和晚期并发症，以及不利影响。
结论：我们的结果表明大多数患者的预后良好，根据BPI-sf的报告，平均疼痛减少76.51％。此外,九分之八的患者至少有50%的缓解.这些发现与之前的案例系列一致，报告了类似的平均疼痛减轻。在程序之前，大多数患者在LAI中被归类为“极其严重”，平均得分为18.17。尽管在六个月的随访中只有16.84％的轻微下降，这表明他们的功能状态有潜在的改善.手术后我们没有观察到任何立即的并发症或不良反应，在随后的随访中也没有任何报告，这与现有文献一致。
结论：我们的研究表明，超声引导双极脉冲射频治疗是一种有前途的GPTS微创技术，尤其是对保守治疗无反应的患者。尽管我们的病例系列提供了一些有效性和安全性的证据，有必要进行更大规模的进一步对照研究，特别是将这种干预措施与单独使用皮质类固醇注射进行比较。
目的：在本系列中，我们介绍了9例GTP患者的结局,这些患者接受了针对股神经转子分支的超声引导双极脉冲射频治疗.我们的目标是讨论这种方法的有效性和安全性。
方法：我们中心的符合条件的患者接受了针对股神经股骨粗隆支的超声引导双极脉冲射频治疗。该程序包括在42°C下进行6分钟的一个循环，然后注射罗哌卡因(0.2%，3mL）和地塞米松（12mg）。术前以及术后第3个月和第6个月使用简短疼痛量表（BPI-sf）和LequesneAlgofunctionalIndex（LAI）。我们监测了即时和晚期并发症，以及不利影响。
结论：我们的结果表明大多数患者的预后良好，根据BPI-sf的报告，平均疼痛减少76.51％。此外,九分之八的患者至少有50%的缓解.这些发现与之前的案例系列一致，报告了类似的平均疼痛减轻。在程序之前，大多数患者在LAI中被归类为“极其严重”，平均得分为18.17。尽管在六个月的随访中只有16.84％的轻微下降，这表明他们的功能状态有潜在的改善.手术后我们没有观察到任何立即的并发症或不良反应，在随后的随访中也没有任何报告，这与现有文献一致。
结论：我们的研究表明，超声引导双极脉冲射频治疗是一种有前途的GPTS微创技术，尤其是对保守治疗无反应的患者。尽管我们的病例系列提供了一些有效性和安全性的证据，有必要进行更大规模的进一步对照研究，特别是将这种干预措施与单独使用皮质类固醇注射进行比较。
