Department of Radiology, Columbia University Irving Medical Center, New York, New York.
Department of Radiology, Johns Hopkins Hospital, Baltimore, Maryland.
J Vasc Interv Radiol. 2022 Mar;33(3):238-248.e4. doi: 10.1016/j.jvir.2021.11.004. Epub 2021 Nov 22.
To review and indirectly compare the outcomes of genicular artery embolization (GAE), radiofrequency (RF) ablation, and intra-articular (IA) injection for the treatment of knee pain secondary to osteoarthritis (OA).
A literature review of the MEDLINE and Cochrane databases was conducted with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement in June 2020. The visual analog scale (VAS) was recorded at baseline and at all available time points for each therapy. Standard mean differences were calculated at each time point and compared between treatments to assess the magnitude of the treatment effect.
All 3 treatments demonstrated significant differences in VAS scores after therapy. RF ablation produced the greatest significant mean reduction in relative VAS score from baseline at 1 year of follow-up (mean, 0.49; 95% confidence interval, 0.4-0.59; P = .03). GAE reported the most significant reductions in VAS scores across all measured time points. Overall, the comparison did not demonstrate a significant difference in VAS scores among patients receiving IA injections, RF ablation, and GAE.
The current evidence does not suggest a significant difference in outcomes among IA injection, RF ablation, and GAE for knee pain secondary to OA.
回顾并间接比较膝关节内动脉栓塞术（GAE）、射频消融术（RF）和关节内注射治疗骨关节炎（OA）继发膝关节痛的疗效。
本研究于 2020 年 6 月按照系统评价和荟萃分析的首选报告项目对 MEDLINE 和 Cochrane 数据库进行了文献回顾。基线和每种治疗方法所有可获得的时间点均记录视觉模拟量表（VAS）评分。计算各时间点的标准均数差值，并比较治疗之间的治疗效果大小。
所有 3 种治疗方法在治疗后 VAS 评分均有显著差异。在 1 年随访时，RF 消融术在相对 VAS 评分方面产生了最大的显著平均降低（均值，0.49；95%置信区间，0.4-0.59；P =.03）。GAE 在所有测量的时间点均报告了 VAS 评分的最大降低。总体而言，接受关节内注射、RF 消融术和 GAE 的患者之间 VAS 评分的比较没有显著差异。
目前的证据表明，关节内注射、RF 消融术和 GAE 治疗 OA 继发膝关节痛的疗效没有显著差异。
