Efficacy and safety of radiofrequency treatment for improving knee pain and function in knee osteoarthritis: a meta-analysis of randomized controlled trials

Jian Liu, Ting Wang, Zhen-Hua Zhu, Jian Liu, Ting Wang, Zhen-Hua Zhu

Abstract

Background: The clinical utility of radiofrequency (RF) in patients with knee osteoarthritis (OA) remains unclear. We conducted a meta-analysis to systematically evaluate the efficacy and safety of RF treatment in patients with knee OA.

Methods: Searches of the PubMed, Web of Science, EMBASE, Cochrane Library, China National Knowledge Infrastructure, and Wanfang Data databases were performed through August 30, 2021. The major outcomes from published randomized controlled trials (RCTs) involving patients with knee OA were compared between RF and control groups, including Visual Analogue Scale (VAS) or Numerical Rating Scale (NRS) scores, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Oxford Knee Score (OKS), Global Perceived Effect (GPE) scale, and adverse effects at available follow-up times.

Results: Fifteen RCTs involving 1009 patients were included in this meta-analysis, and the results demonstrated that RF treatment correlated with improvements in pain relief (VAS/NRS score, all P < 0.001) and knee function (WOMAC, all P < 0.001) at 1-2, 4, 12, and 24 weeks after treatment as well as patients' degree of satisfaction with treatment effectiveness (GPE scale, 12 weeks, P < 0.001). OKSs did not differ significantly between the two groups. Moreover, treatment with RF did not significantly increase adverse effects. Subgroup analysis of knee pain indicated that the efficacy of RF treatment targeting the genicular nerve was significantly better than intra-articular RF at 12 weeks after treatment (P = 0.03).

Conclusions: This meta-analysis showed that RF is an efficacious and safe treatment for relieving knee pain and improving knee function in patients with knee OA.

Keywords: Knee function; Knee osteoarthritis; Meta-analysis; Pain score; Radiofrequency ablation.

Conflict of interest statement

The authors declare that they have no competing interests.

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
Flowchart of study selection. RCTs = randomized controlled trials
Fig. 2
Fig. 2
Risk of bias summary
Fig. 3
Fig. 3
Risk of bias graph
Fig. 4
Fig. 4
Forest plots for the assessment of pain scores between the radiofrequency group and control group. At A 1–2 weeks, B 4 weeks, C 12 weeks, and D 24 weeks. SD, standard deviation; CI, confidence interval
Fig. 5
Fig. 5
Forest plots for the assessment of WOMAC index between the radiofrequency group and control group. At A 4 weeks, B 12 weeks, and C 24 weeks. WOMAC, Western Ontario and McMaster Universities Arthritis Osteoarthritis Index; SD, standard deviation; CI, confidence interval
Fig. 6
Fig. 6
Forest plots for the assessment of GPE scale between the radiofrequency group and control group. At A 4 weeks and B 12 weeks. GPE, Global Perceived Effect; SD, standard deviation; CI, confidence interval
Fig. 7
Fig. 7
Forest plots for the assessment of adverse effects between the radiofrequency group and control group. RD, risk difference; CI, confidence interval

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Source: PubMed

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