Find care now
If you are experiencing a medical emergency, please call 911 or seek care at an emergency room.
Hip replacement surgery is an important and necessary procedure to restore mobility—544,000 patients each year have one in the U.S.
But hip replacement isn’t right for everyone with hip pain.
For patients who don’t want or can’t have a hip replacement, those who don’t qualify because of other medical conditions such as obesity, heart disease, or diabetes, or patients with pain after a hip replacement, an innovative outpatient procedure to silence the nerves in the hip can provide relief from life-limiting pain.
A minimally invasive procedure, cooled radiofrequency hip nerve ablation can be an effective treatment for common causes of hip pain, including:
- Osteoarthritis: In this “wear and tear” arthritis, the cartilage in a joint breaks down over time, causing swelling, stiffness, and pain and limiting function. One in four people in the U.S. will be diagnosed with osteoarthritis by age 85
- Avascular necrosis: When blood supply to the hip bone is disrupted due to injury, disease, or medical treatment, the bone can die. Symptoms can include pain, trouble standing or walking. Ablation is an excellent choice for patients with avascular necrosis, because steroid-based medications are not an option. Each year 10,000-20,000 people are diagnosed with avascular necrosis
- Persistent pain after hip replacement
Studies have shown almost 70% of patients report ongoing pain relief six months after the ablation procedure, and these improvements can last up to two years in some patients.
Even the most advanced joint replacement is a significant procedure and a lengthy recovery. For patients who want an alternative treatment or who have lingering pain after surgery, hip nerve ablation can be an effective, lasting pain relief solution.
Hip nerve ablation: Safe, quick, and effective.
In our practice, hip nerve ablation is a quick outpatient procedure that prioritizes patient comfort and safety.
MedStar Washington Hospital Center Interventional Radiologists use the COOLIEF™ cooled radiofrequency ablation system, which uses salt water to cool a friction-heated probe, allowing us to be more flexible in how we approach the nerve. This system provides more ablating energy than standard radiofrequency ablation.
Under twilight sedation, we address two nerves that surround the front of the hip joint, the femoral articular nerve and the obturator articular nerve. Throughout the procedure, we’re guided by live x-ray imaging, called fluoroscopy, so we can see inside the patient’s joint.
To ensure we’ve found the nerves responsible for pain, we first perform a “prognostic block” or “test block.” We use a needle to inject numbing medicine and then ask the patient how they feel. If the patient reports feeling a pain reduction of 50% or more, we know we’ve found the source.
The ablation procedure takes about 15 minutes. First, we double check to ensure we’re targeting the nerve responsible for sensation, not controlling movement. Then we inject more numbing medication.
With a small probe cooled by saline, an interventional radiologist inserts a long, thin probe near the nerve. This probe uses heat to ablate, or destroy, the nerve that causes pain. When we remove the instruments, we use band aids to close the wound, not stitches and sutures.
Patients can go home after about 30 minutes of recovery following the procedure.
Recovery and lasting pain reduction.
There are no movement restrictions after ablation. Patients benefit from physical therapy to help build strength and flexibility in the muscles around their hip joint and increase mobility.
Typically patients take only over-the-counter medications such as Tylenol or Advil for mild discomfort after the procedure. There are few risks to the procedure, but sometimes temporary muscle weakness can result.
It can take up to six weeks for patients to feel maximum pain relief after an ablation procedure, and freedom from hip pain can last from six months to about two years. The ablation procedure can be repeated after six months and does not interfere with any future surgery.
About 70% of patients report at least a 50% reduction in pain six months after the procedure, and 52% said that relief continued at 12 months.
For many patients, hip nerve ablation does not mean they will never need hip replacement surgery. This much less invasive procedure can serve as an effective bridge to help relieve pain and reduce the use of pain medication, but it does not restore a damaged joint.
Expertise with an advanced procedure.
The interventional radiologists at MedStar Washington Hospital Center are especially well suited to perform hip nerve ablations. We’re intimately familiar with the blood vessels because we often perform angioplasty, embolization, and other procedures that require us to insert small tools through tiny spaces crowded with important anatomy.
Our experience with procedures in tight spaces helps us avoid important blood vessels near in the busy groin region and hip like the femoral artery. We’re comfortable and confident hip nerve ablation can safely and effectively help patients restore mobility without joint replacement surgery.
