Article Text

Download PDFPDF

B11 Pong, the posterior (pericapsular) nerve group radiofrequency as possible adjunct to treat chronic hip pain
  1. R Del Buono1,
  2. G Terranova1,
  3. G Pascarella2,
  4. F Costa2,
  5. D Genco1,
  6. S Roli3 and
  7. PA Grossi1
  1. 1Istituto ortopedico Pini, Milano, Italy
  2. 2Università campus biomedico di Roma, Roma, Italy
  3. 3Università degli studi di Milano, Milano, Italy


Background and Aims Chronic hip pain is a cause of disability and costs. There are some available options to threat this condition, such as radiofrequency ablation or chemical denervation. An innovative approach to treat posterior hip pain due to inoperable femur fracture has recently been described [1].

We share a strategy to manage severe chronic hip pain in an old patient unwilling to undergo hip surgery.

Methods Firstly, a test with a PENG block combined a posterior approach (PONG) has been performed. The PONG was administered with the same technique described for hip surgery [2,3]. After the positive test response, the patient underwent anterior and posterior hip radiofrequency (RF) ablation/neuromodulation.

Anterior RF ablation has been performed under ultrasound and fluoroscopic guidance as per current recommendations.

Posteriorly, a variant of the Kwung-Tung approach was used under RF stimulus guide, locating two different spots. Under ultrasound, the inferior spot corresponded to the capsule deep to the quadratus femoris, while the superior spot corresponded to the superior-posterior border of the acetabulum. Pulsed RF until 42°C for 5 minutes was performed posteriorly on each spot.

NRS was registered before the procedure, and after a one-month follow-up.

Results Previous patient’s NRS score was 7 for static pain in sitting position, and 9 for dynamic pain. After one month, static NRS decreased to 2, while dynamic pain was 6. No adverse effects were reported.

Conclusions The combination of anterior and posterior RF intervention on chronic hip pain provided a viable alternative in a patient unwilling to undergo hip surgery.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.