Radiofrequency ablation reduces pain for knee osteoarthritis: A meta-analysis of randomized controlled trials

Abstract

Background: Currently, there is poor evidence on the effect of radiofrequency ablation (RFA) on pain and knee function in patients with knee osteoarthritis (OA). We performed a meta-analysis on randomized controlled trials (RCTs) to determine the effectiveness and safety of RFA on pain and knee function in individuals with knee OA.

Methods: PubMed, EMBASE, Web of Science, Cochrane, Ovid and MEDLINE were systematically searched (up to March 20, 2021) to obtain literature focusing on the impact of RFA on knee OA, using the following keywords and their synonyms: "radiofrequency ablation", "neurotomy", "knee" and "osteoarthritis". Two authors independently evaluated the quality of the RCTs according to the Cochrane Handbook for Systematic Reviews of Interventions version. Pooled effects of this meta-analysis were calculated using STATA version 13.0.

Results: Eight RCTs were included for data extraction and meta-analysis. The present study indicated that there were significant differences between the two groups of patients who were treated or not treated with RFA on the pain intensity at 4 week (WMD = -0.504; 95% CI: 0.708 to -0.300; P < 0.001), 12 week (WMD = -0.280; 95% CI: 0.476 to -0.084; P = 0.005) and 24 week (WMD = -2.437; 95% CI: 4.742 to -0.132; P = 0.038). Furthermore, RFA was associated with improved outcome of the Western Ontario and McMaster Universities Arthritis index at 4 week (WMD = -3.189; 95% CI: 5.996 to -0.382, P = 0.026), 12 week (WMD = -3.706; 95% CI:-6.584 to -0.828, P = 0.012) and 24 week (WMD = -2.437; 95% CI: 4.742 to -0.132). No serious adverse events were observed in all patients who received RFA (RD = -0.019; 95% CI: 0.053 to 0.016; P = 0.294).

Conclusion: RFA showed better effectiveness in relieving pain and promoting function recovery in patients with knee OA. Considering the small sample size of the included studies, the results should be treated with caution.

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