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膝轻至中度骨关节炎的膝状动脉栓塞术的短期至中期疗效:一项系统评价

The short-to-midterm outcomes of geniculate artery embolization for mild-to-moderate osteoarthritis of the knee: a systematic review.

作者信息

Bhatia Ansh, Bhatia Shivank

机构信息

Seth GS Medical College and KEM Hospital, Mumbai, MH, India.

Department of Interventional Radiology, University of Miami, Miller School of Medicine, Miami, FL, USA.

出版信息

J Orthop. 2023 Apr 5;39:30-41. doi: 10.1016/j.jor.2023.03.009. eCollection 2023 May.

Abstract

BACKGROUND

Geniculate Artery Embolization (GAE) is a novel, minimally-invasive treatment for mild to moderate Osteoarthritis (OA) associated with musculoskeletal pain.

PURPOSE

To investigate the outcomes of GAE in patients with mild to moderate OA of the knee using a Quantitative-analysis of the available literature.

METHODS

The PubMed, EMBASE and Cochrane databases were searched for GAE-related studies. Qualitative and quantitative analyses were performed following PRISMA-guidelines. Quantitative-analysis was performed using windows based 'MedCalc-Statistical-Software version 19.6.1 (2020). Statistical analysis was performed in Stata-IC-13.1(Stata corp-USA). Quantitative-analysis was done using the random-effects model, and the Standardized-Mean-Differences (SMD) were calculated.

RESULTS

After a full-text review, 13 studies with 399 knees (345-patients) were included in the qualitative synthesis, 10 were included in the quantitative synthesis. The total WOMAC score improved by a [SMD (95% CI)] of 3.46 points (1.27, 5.65), 3.50 (1.28, 5.71), 3.77 (0.58, 6.96), 5.46 (1.59, 9.33), 2.96 (-0.93, 6.85) compared to baseline at 1, 3, 6, 12, 24 months respectively. The VAS score improved by 2.06 (1.35, 2.76), 2.13 (1.39, 2.87), 2.36 (1.85, 2.90), 2.09 (0.91, 3.28) compared to baseline at 1, 3, 6, 12 months respectively. The Pain WOMAC score improved by SMD 2.97 (0.51, 5.43), 3.77 (0.58, 6.96), 2.27 (0.31, 4.22), 2.27 (0.31, 4.22) compared to baseline at 1, 3, 12, 24 months, respectively.

CONCLUSION

There was a statistically significant change from baseline in all outcome measures after GAE. GAE is a safe and effective method for pain control in mild to moderate OA-associated knee pain in the short and medium term.

摘要

背景

膝状动脉栓塞术(GAE)是一种针对与肌肉骨骼疼痛相关的轻至中度骨关节炎(OA)的新型微创治疗方法。

目的

通过对现有文献的定量分析,研究GAE治疗膝轻至中度OA患者的疗效。

方法

在PubMed、EMBASE和Cochrane数据库中检索与GAE相关的研究。按照PRISMA指南进行定性和定量分析。使用基于Windows的“MedCalc统计软件版本19.6.1(2020)”进行定量分析。在Stata-IC-13.1(美国Stata公司)中进行统计分析。采用随机效应模型进行定量分析,并计算标准化均数差(SMD)。

结果

经过全文审查,13项研究共399个膝关节(345例患者)纳入定性分析,10项纳入定量分析。与基线相比,总WOMAC评分在1、3、6、12、24个月时分别改善了[SMD(95%CI)]:3.46分(1.27,5.65)、3.50(1.28,5.71)、3.77(0.58,6.96)、5.46(1.59,9.33)、2.96(-0.93,6.85)。VAS评分与基线相比,在1、3、6、12个月时分别改善了2.06(1.35,2.76)、2.13(1.39,2.87)、2.36(1.85,2.90)、2.09(0.91,3.28)。疼痛WOMAC评分与基线相比,在1、3、12、24个月时分别改善了SMD 2.97(0.51,5.43)、3.77(0.58,6.96)、2.27(0.31,4.22)、2.27(0.31,4.22)。

结论

GAE术后所有结局指标与基线相比均有统计学意义的变化。GAE是一种在短期和中期控制轻至中度OA相关性膝关节疼痛的安全有效方法。

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