A Novel Single-Puncture Ultrasound-Guided Approach for Radiofrequency Treatment of the Articular Branches of Femoral and Obturator Nerves

Purpose: Current management of hip pain primarily involves pharmacotherapy, conservative treatment, and surgical intervention, with pulsed radiofrequency (PRF) treatment of articular branches gaining increasing attention. Previous PRF treatments have radiation risk and poor vascular visibility. This study introduces a novel single-puncture combined ultrasound-guided PRF technique targeting the articular branches of both the obturator and femoral nerves and evaluates its efficacy and safety in patients with chronic hip pain. Patients and Methods: A retrospective analysis was conducted on six patients with chronic hip pain treated at the Pain Department of Taihe Hospital, Shiyan, Hubei Province, between January 2024 and August 2025. All patients underwent the single-puncture combined ultrasound-guided PRF procedure. The position of the needle tip relative to the articular branches was verified using C-arm fluoroscopy. Pain intensity was assessed before and after the procedure using the Numerical Rating Scale (NRS). Results: Under ultrasound guidance, the target anatomy was clearly visualized, and successful needle placement was achieved in all six patients. No serious complications occurred during the procedure. The median NRS score decreased from 8.0 (IQR 7.0– 8.0) at baseline to 1.5 (IQR 1.0– 2.0) at 8 weeks post‑procedure (Friedman test, χ 2 = 15.95, df = 3, p = 0.0012). Following treatment, all patients showed varying degrees of improvement, as reflected by reduced NRS scores. Limitations: Retrospective study, small sample size. Conclusion: The single-puncture combined ultrasound-guided PRF technique targeting the articular branches of the obturator and femoral nerves is a safe and effective short-term treatment for chronic hip pain.