Selective Sensory Denervation by Means of Radiofrequency (RF) Ablation: a Novel Non-surgical Treatment Approach in Chronic Joint Pain: a Narrative Review on Its Application on Knee Hip and Shoulder

Chronic joint pain has a major negative impact on the quality of life of patients. A large percentage of patients does not respond to conservative treatments and is not candidates for joint replacement surgery. Thanks to focused anatomical studies, the major sensory nerves could be identified in the main joints. This led to the emergence of novel treatment option consisting in selective denervation of sensory nerves, by means of radiofrequency. The purpose of this review is to discuss the efficacy of radiofrequency denervation of the hip, knee, and shoulder and to define its role in the management of chronic joint pain. Narrative review. The main targets for the denervation of the hip are branches of the femoral and obturator nerves. Pain relief for 6 months has been demonstrated in multiple studies. Radiofrequency may be applied to sensory branches of the lateral pectoral, axillary, and suprascapular nerves to treat shoulder pain. A significant reduction in pain lasting for 3–6 months has been found in 50–85% of patients. The genicular nerves and the suprapatellar plexus are mainly responsible of the innervation of the knee and they can be located by bony landmarks. Studies on the knee joint suggest that radiofrequency can be more efficient than steroid and hyaluronic acid injections. A growing number of studies suggests that radiofrequency denervation is effective in reducing chronic joint pain, particularly in the knee joint. Positive outcome predictors and precise inclusion criteria are still lacking as well as indication for the best denervation modality.