Endoscopic obturator nerve radiofrequency ablation for femoral head necrosis: a case series.

Background: This pilot case series evaluated the feasibility and effectiveness of using endoscopic radiofrequency ablation (RFA) of the articular branch of the anterior obturator nerve under endoscopic and fluoroscopic guidance for controlling pain in patients with osteonecrosis of the femoral head (ONFH).

Methods: Data on 11 consecutive patients were collected with ONFH underwent endoscopic RFA of the anterior obturator nerve. Electromyography (EMG) examination was performed preoperatively and postoperatively. Visual Analogue Scale (VAS) scores, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores, and analgesic usage were recorded preoperatively, on the day of surgery, and at 1, 3, and 6 months postoperatively.

Results: The study included 5 males and 6 females, aged 45 to 91 years (mean age: 70.4 ± 14.6 years), with an average BMI of 29.5. All patients completed a minimum of 6 months of follow-up. Postoperative EMG showed no muscle damage. VAS and WOMAC scores demonstrated significant improvement, with reduced pain, stiffness, and improved hip function. Oral analgesic use also decreased.

Conclusion: Endoscopic RFA of the anterior obturator nerve effectively reduces pain and improves function in ONFH patients over 6 months. Further studies are needed to confirm long-term outcomes.