Avaliação da dor após radiofrequência pulsátil nos pacientes com osteoartrite do quadril

Resumo

Objetivo Avaliar o papel da radiofrequência pulsátil (RFP) no manejo álgico de pacientes com osteoartrite (OA) do quadril com indicação cirúrgica.

Métodos Foram selecionados 30 pacientes da fila de cirurgia para artroplastia total de quadril com tempo de espera de 1 a 3 anos. O grau de OA foi mensurado radiograficamente de acordo com a classificação de Tönnis. As RFPs foram realizadas no centro cirúrgico por dois cirurgiões seniores especialistas em quadril do hospital. O procedimento foi guiado por fluoroscopia e ocorreu sob sedação anestésica. Todos os pacientes foram avaliados no pré- e pós-procedimento através do questionário Short Form-36 por uma única enfermeira.

Resultados Dos 30 pacientes previamente selecionados, apenas 13 realizaram a RFP. Dentre eles, um era classificado como Tönnis tipo I, quatro como II e oito como III. Os resultados evidenciaram a melhora do quadro álgico em apenas 6 pacientes (46%), do estado geral de saúde em 9 (69%), dos aspectos sociais em 8 (62%) e da saúde mental em 3 (8%). Além disso, 2 pacientes (15%) chegaram a relatar piora do quadro álgico após a RFP e 3 (23%) relataram piora do estado de saúde geral.

Conclusão Em graus mais avançados de degeneração articular do quadril (Tönnis III) a técnica se mostrou falha, arriscada e insatisfatória. Os dados obtidos colocam em questão não só o custo-efetividade da técnica, mas sua indicação para os pacientes com OA do quadril como tratamento conservador alternativo seguro e eficaz.

Abstract

Objective To evaluate the role of pulsed radiofrequency (PRF) in the pain management of patients with hip osteoarthritis (OA) and surgical indication.

Methods We selected 30 patients from the waiting list for total hip arthroplasty, with wait time ranging from 1 to 3 years. The OA degree was measured radiographically according to the Tönnis classification. Patients underwent PRF in the surgical center, performed by two senior hip surgeons from the hospital. The procedure was fluoroscopy-guided and occurred under anesthetic sedation. One nurse assessed all patients before and after PRF using the short form-36 questionnaire.

Results From the initial sample of 30 patients, only 13 underwent PRF. Per the Tönnis classification, one subject was type I, four were type II, and eight were type III. The results showed an improvement in pain in 6 patients (46%), general health status in 9 (69%), social aspects in 8 (62%), and mental health in 3 (8%). Furthermore, 2 subjects (15%) reported pain worsening after PRF, and 3 (23%) reported general health status worsening.

Conclusion In more advanced degrees of hip joint degeneration (Tönnis III), the technique was flawed, risky, and unsatisfactory. The data obtained question PRF cost-effectiveness and its indication for patients with hip OA as a safe and effective alternative conservative treatment.

Palavras-chave

dor crônica - osteoartrite do quadril - quadril - tratamento por radiofrequência pulsada

Keywords

chronic pain - hip - osteoarthritis - hip - pulsed radiofrequency treatment

Contribuição dos Autores

Cada autor contribuiu individual e significativamente para o desenvolvimento do artigo: RRT coletou e organizou os dados. MICC, PVS e RRT escreveram o manuscrito. LP e MFA revisaram e editaram o texto, aprovando sua versão final, e CTL fez a análise estatística dos dados coletados.

Trabalho desenvolvido no Instituto Nacional de Traumatologia e Ortopedia Jamil Haddad, Rio de Janeiro, RJ, Brasil.

Publication History

Received: 11 June 2024

Accepted: 15 September 2024

Article published online:
23 June 2025

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