The Analgesic Effectiveness of Genicular Nerve-targeted Cooled and Pulsed Radiofrequency Ablation for Osteoarthritis Knee Pain: A Systematic Review and Meta-analysis
Notice bibliographique
Résumé
BACKGROUND: Radiofrequency ablation (RFA) is a form of therapy for knee osteoarthritis (OA) pain that has become more popular in recent years. In addition to standard RF approaches, there are cooled and pulsed options. RFA could be used to treat the superolateral, superomedial, and inferomedial branches of the genicular nerves. Pulsed and cooled RF ablation on the genicular nerve to treat knee OA pain, however, has not yet been shown to be effective. OBJECTIVES: We conducted a meta-analysis to assess nonconventional, pulsed or cooled, RFA on the genicular nerve to treat knee OA pain; intended our study to provide useful information in deciding whether to use nonconventional RFA because of its effectiveness. STUDY DESIGN: Meta-analysis study of nonconventional, pulsed or cooled, RFA on the genicular nerve to treat knee OA pain. METHODS: PubMed, Ovid MEDLINE, Scopus, and Cochrane Central were searched for eligible papers. In our literature review, procedures, posttreatment outcomes, follow-up data, and adverse events were compiled and analyzed from the selected studies. The National Heart, Lung, and Blood Institute Quality Assessment tool was used to assess therapeutic relevance and evidence strength. Our meta-analysis analyzed pre- and posttreatment pain and physical function scores. The primary outcome was pain measured with either the Visual Analog Scale or the Numeric Rating Scale. The secondary outcome was physical function measured with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score. RESULTS: Our systematic review and meta-analysis includes 11 eligible publications (604 patients). Both cooled and pulsed RFA procedures targeting the genicular nerve resulted in considerable pain reduction at post one, 3, 6, and 12 months (P < 0.005). There was no significant improvement in physical function outcome for the cooled RFA technique in all follow-up visits. There was a significant improvement in physical function outcome for the pulsed RFA technique at the one-month and 3-month follow-up visits. LIMITATIONS: Limitations include that there are a limited number of randomized controlled trials available, the methodology utilized for comparison is based on the change in outcome between baseline and follow-up visits. There are only a few papers that have reported physical function outcomes in complete WOMAC rating data. CONCLUSION: At the 6-month follow-up, both cooled and pulsed RFA targeting the genicular nerve provided significant osteoarthritic pain alleviation. There is no different in pain relief between cooled and pulsed RFA targeting the genicular nerve for treating knee osteoarthritis. There was no significant functional improvement of cooled RFA in all follow-ups, but there was a significant functional improvement of pulsed RFA up to 3-month follow-up. According to our study, knee osteoarthritis pain can be efficiently treated with pulsed and cooled radiofrequency with few adverse effects.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,009 | 0,021 |
| Méta-épidémiologie (sens strict) | 0,002 | 0,001 |
| Méta-épidémiologie (sens large) | 0,017 | 0,033 |
| Bibliométrie | 0,007 | 0,007 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,003 | 0,002 |
| Science ouverte | 0,002 | 0,001 |
| Intégrité de la recherche | 0,002 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».