To determine the role of pulse-dose radiofrequency (PDRF) in athletes with chronic pubalgia and investigate the causes with imaging.
Prospective nonrandomized single-group study.
PDRF was performed on 32 patients with a chronic pain that had been refractory to conservative therapies during the last 3 mo.
The genital branches of the genitofemoral, ilioinguinal, and iliohypogastric nerves and the obturator nerve were the goals of treatment. A 10-cm, 20-gauge cannula was inserted with a percutaneous access on the upper and lower edges of the iliopubic branch. After the spindle was removed, a radiofrequency needle with a 10-mm “active tip” was inserted. The radiofrequency technique was performed with 1200 pulses at 45 V and 20-ms duration, followed by a 480-ms silent phase.
Main Outcome Measures:
The follow-up with a clinical examination was performed at 1, 3, 6, and 9 mo after the procedure. During the follow-up visits, the patients were asked to rate their pain on a 0–10 VAS scale.
All of the enrolled patients completed the study. Mean VAS score before the treatment was 8.4 ± 0.6. Twenty-four patients had a reduction of pain VAS scores more than 50% during all follow-up visits and started training and physiotherapy in the days after the radiofrequency procedure. Six patients, each treated 2 times, had a reduction more than 50% of VAS scores and could start training and physiotherapy only after the 2nd procedure. One patient had no pain relief with 2 treatments. Pain intensity decreased up to 9 mo in 31 patients (mean VAS scores 3.4 ± 0.5 at 6 mo and 3.8 ± 0.9 at 9 mo). No complications were observed.
PDRF is an effective and safe technique in management of chronic pubalgia in athletes.
The authors are with the Dept of Diagnostic and Molecular Imaging, Interventional Radiology and Radiation Therapy, University of Rome “Tor Vergata,” Rome, Italy.