Radiofrequency ablation in acute post-operative orthopedic trauma pain: A prospective cohort study from India

Abstract

Background: Post-operative pain management in orthopedic trauma remains challenging. Conventional reliance on opioids and NSAIDs is limited by side effects, risk of dependence, and delayed rehabilitation. Radiofrequency ablation (RFA), traditionally used in chronic musculoskeletal pain, has recently emerged as a potential modality in acute post-surgical settings. This study evaluates the effectiveness of thermal continuous-mode RFA in reducing pain and facilitating early recovery in patients with peri-articular and periprosthetic fractures. Methods: A prospective cohort study was conducted at Amandeep Hospital, Amritsar (March 2024-March 2025). A total of 754 adult patients with peri-articular or periprosthetic fractures underwent ultrasound or fluoroscopy-guided thermal RFA at 48 hours post-surgery. Pain relief was assessed using the Numerical Rating Scale (NRS). Secondary outcomes included opioid consumption, time to physiotherapy initiation, ambulation milestones, and hospital stay duration. Results: The mean age was 36 years, with 56% males. Fracture distribution included knee (27%), elbow (21%), and periprosthetic fractures (9%). Mean pre-RFA NRS was 8.2, reduced significantly to 3.1 at 48 hours (p