{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T18:13:33Z","timestamp":1790100813978,"version":"4.0.1"},"reference-count":17,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Reg Anesth Pain Med"],"accepted":{"date-parts":[[2025,8,9]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This case series aims to assess the analgesic effectiveness and safety of percutaneous chemical denervation of the articular branches on anterior hip capsule in patients with refractory hip pain secondary to avascular necrosis (AVN).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Nine patients with refractory chronic hip pain secondary to AVN underwent image-guided chemical neurolysis with 100% ethanol. Average pain scores were recorded at baseline, 1, 3 and 6 months after chemical neurolysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The average baseline pain score was 6.7\u00b11.2 on the Numerical Rating Scale (NRS). Two out of the nine patients did not respond to chemical neurolysis. For the seven patients who responded, the average NRS decreased to (2.9\u00b11.2) at 1\u2009month and (3.0\u00b11.4) at 3\u2009months. Five out of these seven patients maintained 50% or greater pain relief at both 1 and 3\u2009months. For the five patients who completed the 6-month follow-up, the average NRS pain score was (3.0\u00b11.7), with three of these patients maintaining 50% or greater pain relief. No one reported side effects or complications during the follow-up period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In conclusion, alcohol neurolysis of the hip joint can be offered as an effective and safe modality for pain control in patients with AVN who failed conservative management. This small case series serves as a pilot for future large cohort studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/rapm-2025-106915","type":"journal-article","created":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T13:45:14Z","timestamp":1756388714000},"page":"823-826","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Image-guided alcohol neurolysis for treatment of chronic hip pain secondary to avascular necrosis"],"prefix":"10.1136","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5518-3797","authenticated-orcid":false,"given":"Abeer","family":"Alomari","sequence":"first","affiliation":[{"name":"Department of Anesthesia and Pain Medicine, University of Toronto, Toronto, Ontario, Canada"},{"name":"Department of Anesthesia and Pain Medicine, Toronto Western Hospital, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Napatpaphan","family":"Kanjanapanang","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Pain Medicine, University of Toronto, Toronto, Ontario, Canada"},{"name":"Department of Anesthesia and Pain Medicine, Toronto Western Hospital, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1704-7991","authenticated-orcid":false,"given":"Philip","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Pain Medicine, University of Toronto, Toronto, Ontario, Canada"},{"name":"Department of Anesthesia and Pain Medicine, Toronto Western Hospital, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6291-1956","authenticated-orcid":false,"given":"Nimish","family":"Mittal","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Pain Medicine, University of Toronto, Toronto, Ontario, Canada"},{"name":"Department of Anesthesia and Pain Medicine, Toronto Western Hospital, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,8,28]]},"reference":[{"key":"2026071002301579000_51.7.823.1","doi-asserted-by":"crossref","DOI":"10.3892\/etm.2022.11250","article-title":"Treatment of non\u2011traumatic avascular necrosis of the femoral head (Review)","volume":"23","author":"Liu","year":"2022","journal-title":"Exp Ther Med"},{"key":"2026071002301579000_51.7.823.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbspin.2006.01.025"},{"key":"2026071002301579000_51.7.823.3","doi-asserted-by":"crossref","first-page":"864","DOI":"10.3904\/kjim.2020.098","article-title":"Epidemiology and risk factors associated with avascular necrosis in patients with autoimmune diseases: a nationwide study","volume":"37","author":"Tsai","year":"2022","journal-title":"Korean J Intern Med"},{"key":"2026071002301579000_51.7.823.4","first-page":"e178","article-title":"Non-modifiable Risk Factors Associated with Avascular Necrosis in the US Military","volume":"185","author":"Gun","year":"2020","journal-title":"Mil Med"},{"key":"2026071002301579000_51.7.823.5","article-title":"Treatment for avascular necrosis of bone in people with sickle cell disease","volume":"12","author":"Mart\u00ed-Carvajal","year":"2019","journal-title":"Cochrane Database Syst Rev"},{"key":"2026071002301579000_51.7.823.6","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0214355","article-title":"Sickle cell disease complications: Prevalence and resource utilization","volume":"14","author":"Shah","year":"2019","journal-title":"PLoS ONE"},{"key":"2026071002301579000_51.7.823.7","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0000000000000847"},{"key":"2026071002301579000_51.7.823.8","unstructured":"Ficat RP , Arlet J . Ischemia and necrosis of bone. Baltimore: Williams and Wilkins, 1980."},{"key":"2026071002301579000_51.7.823.9","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1007\/s12630-023-02664-3","article-title":"Hip fracture analgesia: how far ahead are we?","volume":"71","author":"Ramlogan","year":"2024","journal-title":"Can J Anaesth"},{"key":"2026071002301579000_51.7.823.10","doi-asserted-by":"publisher","DOI":"10.1136\/rapm-2024-105427"},{"key":"2026071002301579000_51.7.823.11","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1213\/ANE.0000000000004172","article-title":"Chemical Hip Denervation for Inoperable Hip Fracture","volume":"130","author":"Kwun-Tung Ng","year":"2020","journal-title":"Anesth Analg"},{"key":"2026071002301579000_51.7.823.12","doi-asserted-by":"crossref","first-page":"111872","DOI":"10.1016\/j.jclinane.2025.111872","article-title":"Chemical hip denervation using phenol via Pericapsular Nerve Group (PENG) block in palliative non-operative management for frail older hip fracture patients: A multicenter retrospective cohort study","volume":"105","author":"Kroes","year":"2025","journal-title":"J Clin Anesth"},{"key":"2026071002301579000_51.7.823.13","doi-asserted-by":"crossref","first-page":"195","DOI":"10.3344\/kjp.22325","article-title":"Ultrasound-guided PENG block versus intraarticular corticosteroid injection in hip osteoarthritis: a randomised controlled study","volume":"36","author":"Kose","year":"2023","journal-title":"Korean J Pain"},{"key":"2026071002301579000_51.7.823.14","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1016\/j.bja.2025.04.045","article-title":"Chemical ablation of pericapsular nerve group with 95% ethanol for pain relief and quality of life in patients with hip osteoarthritis: a prospective, double-blinded, randomised, controlled trial","volume":"135","author":"Reysner","year":"2025","journal-title":"Br J Anaesth"},{"key":"2026071002301579000_51.7.823.15","doi-asserted-by":"crossref","unstructured":"Ferreira-Silva N , Ferreira-Dos-Santos G , Cu\u00f1at T , et al . Navigating current controversies in radiofrequency ablation of the genicular nerves for chronic knee pain in osteoarthritis: a daring discourse. Reg Anesth Pain Med 2025. doi:10.1136\/rapm-2025-106518. [Epub ahead of print: 15 Jul 2025].","DOI":"10.1136\/rapm-2025-106518"},{"key":"2026071002301579000_51.7.823.16","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1007\/s40477-024-00871-2","article-title":"Hip chronic pain: ultrasound guided ablation of anterior articular branches plus posterior neurolysis of the nerve to the quadratus femoris versus the alone anterior approach-a retrospective observational study","volume":"27","author":"Petroni","year":"2024","journal-title":"J Ultrasound"},{"key":"2026071002301579000_51.7.823.17","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0000000000000694"}],"container-title":["Regional Anesthesia &amp; Pain Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/rapm-2025-106915","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T09:30:34Z","timestamp":1783675834000},"score":1,"resource":{"primary":{"URL":"https:\/\/rapm.bmj.com\/lookup\/doi\/10.1136\/rapm-2025-106915"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,28]]},"references-count":17,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7,6]]},"published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1136\/rapm-2025-106915"],"URL":"https:\/\/doi.org\/10.1136\/rapm-2025-106915","relation":{},"ISSN":["1098-7339","1532-8651"],"issn-type":[{"value":"1098-7339","type":"print"},{"value":"1532-8651","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,28]]}}}