PMID- 31578561
OWN - NLM
STAT- MEDLINE
DCOM- 20210122
LR  - 20210122
IS  - 1526-4637 (Electronic)
IS  - 1526-2375 (Linking)
VI  - 21
IP  - 2
DP  - 2020 Feb 1
TI  - Radiofrequency Procedures for the Treatment of Symptomatic Knee Osteoarthritis: A 
      Systematic Review.
PG  - 333-348
LID - 10.1093/pm/pnz241 [doi]
AB  - OBJECTIVE: To evaluate the effectiveness and safety of radiofrequency (RF) 
      ablation and neuromodulation modalities for knee osteoarthritis (OA). METHODS: 
      The Pubmed, Medline, Embase, and Cochrane Library databases were searched from 
      inception to August 2018. All comparative and noncomparative studies that 
      reported clinical outcome measures and adverse events related to RF modalities 
      for knee OA were included. Pain scores, physical function measures, quality of 
      life (QOL), patient satisfaction, and adverse events for three months and beyond 
      of postprocedure follow-up were analyzed qualitatively. RESULTS: Thirty-three 
      studies, including 13 randomized controlled trials (RCTs), two nonrandomized 
      comparative studies, and 18 noncomparative cohort studies, were identified, with 
      1,512 patients (mean age = 64.3 years, 32.5% males). All 33 studies were 
      considered to be of moderate or high methodological quality. All 33/33 (100%) 
      studies reported alleviation of OA-related knee pain from baseline until three to 
      12 months with RF modalities, with six comparative studies reporting 194/296 
      (65.5%) and 29/150 (19.3%) RF and control patients achieving >50% pain relief, 
      respectively. Three of the 33 studies reported QOL, with three of three studies 
      (100%) achieving improvements in disease-specific QOL from baseline until three 
      to 12 months. Twenty-eight of the 33 studies reported functional outcomes, with 
      27/28 (96%) studies obtaining enhanced functionality from baseline up until three 
      to 12 months. Ten of the 33 studies reported patient satisfaction, with eight of 
      10 studies (80%) indicating that patients were significantly satisfied after RF 
      procedures, and from these eight studies, four were comparative studies that 
      indicated that 86/154 (56%) and 33/104 (32%) RF and control patients were 
      extremely satisfied or satisfied, respectively. Regarding adverse events (AEs), 
      29 of the 33 studies reported AEs, with 20/29 (69%) studies indicating no AEs 
      related to the RF modalities and the remaining nine studies only indicating minor 
      localized AEs. Twenty-nine of the 33 studies indicated no serious knee-related 
      AEs pertaining to RF modalities. CONCLUSIONS: Current evidence substantiates that 
      RF modalities for knee OA potentially improve pain, functionality, and 
      disease-specific QOL for up to three to 12 months with minimal localized 
      complications. This suggests that RF modalities are perhaps an effective adjunct 
      therapy for patients with knee OA who are unresponsive to conservative therapies. 
      Further RCTs with larger sample sizes and long-term follow-up that directly 
      compare the three primary RF modalities are warranted to confirm the clinical 
      efficaciousness and superiority of these RF modalities for knee OA.
CI  - (c) 2019 American Academy of Pain Medicine. All rights reserved. For permissions, 
      please e-mail: journals.permissions@oup.com.
FAU - Ajrawat, Prabjit
AU  - Ajrawat P
AD  - Division of Orthopaedic Surgery, Toronto Western Hospital, University of Toronto, 
      Toronto, Ontario, Canada.
FAU - Radomski, Lenny
AU  - Radomski L
AD  - Division of Orthopaedic Surgery, Toronto Western Hospital, University of Toronto, 
      Toronto, Ontario, Canada.
FAU - Bhatia, Anuj
AU  - Bhatia A
AD  - Department of Anesthesia, University Health Network, University of Toronto, 
      Toronto, Ontario, Canada.
AD  - Department of Anesthesia and Pain Medicine, Toronto Western Hospital, Toronto, 
      Ontario, Canada.
AD  - Institute of Health Policy Management and Evaluation, University of Toronto, 
      Ontario, Canada.
FAU - Peng, Phillip
AU  - Peng P
AD  - Department of Anesthesia, University Health Network, University of Toronto, 
      Toronto, Ontario, Canada.
FAU - Nath, Nikhil
AU  - Nath N
AD  - Division of Orthopaedic Surgery, Toronto Western Hospital, University of Toronto, 
      Toronto, Ontario, Canada.
FAU - Gandhi, Rajiv
AU  - Gandhi R
AD  - Division of Orthopaedic Surgery, Toronto Western Hospital, University of Toronto, 
      Toronto, Ontario, Canada.
LA  - eng
PT  - Journal Article
PT  - Systematic Review
PL  - England
TA  - Pain Med
JT  - Pain medicine (Malden, Mass.)
JID - 100894201
SB  - IM
MH  - Aged
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Osteoarthritis, Knee/*therapy
MH  - Radiofrequency Ablation/*methods
OTO - NOTNLM
OT  - Denervation
OT  - Knee Osteoarthritis
OT  - Knee Pain
OT  - Nerve Ablation
OT  - Neuromodulation
OT  - Pain Management
OT  - Radiofrequency Ablation
EDAT- 2019/10/04 06:00
MHDA- 2021/01/23 06:00
CRDT- 2019/10/04 06:00
PHST- 2019/10/04 06:00 [pubmed]
PHST- 2021/01/23 06:00 [medline]
PHST- 2019/10/04 06:00 [entrez]
AID - 5580377 [pii]
AID - 10.1093/pm/pnz241 [doi]
PST - ppublish
SO  - Pain Med. 2020 Feb 1;21(2):333-348. doi: 10.1093/pm/pnz241.