SUPRASCAPULAR NERVE DENERVATION AS A METHOD OF SYMPTOMATIC TREATMENT FOR END-STAGE OMARTHROSIS

Karapetyan Grigory Sergeevich, Darchiya Levan Yuryevich, Shuysky Artem Anatolyevich, Vakhromeeva Polina Yuryevna

Objective. To evaluate the efficacy and safety of pulsed radiofrequency ablation (RFA) of the suprascapular nerve for the management of chronic pain in patients with omarthrosis of radiographic stage III-IV who have contraindications to shoulder arthroplasty. Materials and Methods. A prospective comparative study included 40 patients with severe omarthrosis contraindicated for arthroplasty. The patients were randomized into two groups: the main group (n=20) underwent suprascapular nerve RFA; the control group (n=20) received comprehensive conservative therapy (systemic NSAIDs, a course of intra- and periarticular injections, and physiotherapy). The follow-up period was 12 months. Prior to inclusion, all patients underwent clinical examination, radiography and computed tomography of the shoulder joint, ultrasound of the joint and the suprascapular nerve, and electromyography of the upper limbs. Outcomes were assessed using the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire and the Visual Analog Scale (VAS). Statistical analysis was performed using the Mann-Whitney U test in IBM SPSS Statistics. Results. Baseline VAS and DASH scores did not differ significantly between the groups (p>0.05). At the 12-month follow-up, the main group showed statistically significant improvements compared to the control group. The mean VAS score was 2.1 ± 0.8 in the main group versus 5.8 ± 1.6 in the control group (p<0.05). The mean DASH score was 30.5 ± 8.2 in the main group versus 55.4 ± 9.7 in the control group (p<0.05). A sustained positive effect was observed in 18 patients (90%) in the main group. Two patients required a repeat procedure at 8-9 months. No complications (infectious, neurological, or other disorders) were reported. Conclusion. Radiofrequency ablation of the suprascapular nerve is an effective and safe method for the symptomatic treatment of omarthrosis, providing significant and long-term pain reduction and improved limb function in patients contraindicated for arthroplasty. This technique should be considered an important alternative in the arsenal of palliative treatments for severe glenohumeral osteoarthritis.

Keywords:omarthrosis, glenohumeral osteoarthritis, radiofrequency ablation, suprascapular nerve, chronic pain, conservative management, symptomatic treatment.