Minimally invasive interventional procedures for osteoarthritis and inflammatory arthritis: A systematic review and meta-analysis

IF 4.6 2区医学 Q1 RHEUMATOLOGY Seminars in arthritis and rheumatism Pub Date : 2024-08-05 DOI:10.1016/j.semarthrit.2024.152525

Jacopo Ciaffi , Nicolas Papalexis , Elena Vanni , Marco Miceli , Cesare Faldini , Lorenza Scotti , Antonella Zambon , Carlo Salvarani , Roberto Caporali , Giancarlo Facchini , Francesco Ursini

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Abstract

Objective

to summarize the evidence on the efficacy of minimally invasive interventional procedures such as radiofrequency ablation (RFA) and transcatheter arterial embolization (TAE) in patients with osteoarthritis or inflammatory arthritis.

Methods

a literature search was conducted in PubMed and Web of Science databases. Both randomized controlled trials (RCTs) and non-randomized studies of interventions (NRSI) were included. The results were organized according to the treated anatomical site: knee, hip, foot and ankle, shoulder, hand and wrist, sacroiliac joints. Data about treatment efficacy were extracted. The main outcome was change in pain intensity using the 0–10 visual analog scale (VAS) from baseline to 1 month. Additional timepoints at 3, 6 and 12 months were assessed. Change in functional status was evaluated. Pooled estimates were calculated as the mean difference (MD) and 95 % confidence interval relative to baseline. The meta-analyses of RCTs and NRSI were conducted separately.

Results

of the 4599 retrieved articles, 164 were included in the review and, considering all the established timepoints, 111 (38 RCTs and 73 NRSI) were selected for the meta-analysis. Only one article described patients with inflammatory arthritis. In the meta-analysis of RCTs, one month after the procedure, MD in VAS was -3.98 (-4.41 to -3.55; k = 21) for knee RFA, and -3.18 (-3.96 to -2.39; k = 8) for sacroiliac joints RFA. In the meta-analysis of NRSI, MD in VAS was -4.12 (-4.63 to -3.61; k = 23) for knee RFA, -3.84 (-4.77 to -2.92; k = 7) for knee TAE, -4.34 (-4.96 to -3.71; k = 2) for hip RFA, -3.83 (-4.52 to -3.15; k = 3) for shoulder RFA and -4.93 (-5.58 to -4.28; k = 14) for sacroiliac joints RFA. Significant decrease in pain intensity was found also at 3, 6 and 12 months. Additionally, functional status improved at all the assessed timepoints.

Conclusion

minimally invasive interventional procedures can improve pain and functional status of patients affected by OA or chronic sacroiliac pain of degenerative origin. Further research is warranted in the field of inflammatory rheumatic diseases.

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治疗骨关节炎和炎症性关节炎的微创介入手术：系统回顾和荟萃分析。

目的：总结射频消融术（RFA）和经导管动脉栓塞术（TAE）等微创介入手术对骨关节炎或炎症性关节炎患者疗效的证据。方法：在 PubM 和 Web Science 数据库中进行了文献检索，纳入了随机对照试验 (RCT) 和非随机干预研究 (NRSI)。研究结果按照治疗的解剖部位进行分类：膝关节、髋关节、足踝关节、肩关节、手和腕关节、骶髂关节。提取了有关疗效的数据。主要结果是使用0-10视觉模拟量表（VAS）测量疼痛强度从基线到1个月的变化。此外，还对 3 个月、6 个月和 12 个月的时间点进行了评估。还评估了功能状态的变化。相对于基线的汇总估计值计算为平均差（MD）和 95% 的置信区间。结果：在检索到的 4599 篇文章中，164 篇被纳入综述，考虑到所有已确定的时间点，111 篇（38 篇 RCT 和 73 篇 NRSI）被选中进行荟萃分析。只有一篇文章描述了炎症性关节炎患者的情况。在 RCT 的荟萃分析中，膝关节 RFA 术后一个月的 VAS MD 为-3.98（-4.41 至-3.55；k = 21），骶髂关节 RFA 术后一个月的 VAS MD 为-3.18（-3.96 至-2.39；k = 8）。在 NRSI 的荟萃分析中，膝关节 RFA 的 VAS MD 为 -4.12 (-4.63 to -3.61; k = 23)，膝关节 TAE 为 -3.84 (-4.77 to -2.92; k = 7)，骶髂关节 RFA 为 -4.34 (-4. 96 to -3.71; k = 8)。96至-3.71；k=2），肩关节RFA为-3.83（-4.52至-3.15；k=3），骶髂关节RFA为-4.93（-5.58至-4.28；k=14）。在 3 个月、6 个月和 12 个月时，疼痛强度也明显降低。结论：微创介入治疗可改善OA或慢性骶髂关节退行性疼痛患者的疼痛和功能状态。在炎症性风湿病领域还需要进一步研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Seminars in arthritis and rheumatism 医学-风湿病学

CiteScore

9.20

自引率

4.00%

发文量

176

审稿时长

46 days

期刊介绍： Seminars in Arthritis and Rheumatism provides access to the highest-quality clinical, therapeutic and translational research about arthritis, rheumatology and musculoskeletal disorders that affect the joints and connective tissue. Each bimonthly issue includes articles giving you the latest diagnostic criteria, consensus statements, systematic reviews and meta-analyses as well as clinical and translational research studies. Read this journal for the latest groundbreaking research and to gain insights from scientists and clinicians on the management and treatment of musculoskeletal and autoimmune rheumatologic diseases. The journal is of interest to rheumatologists, orthopedic surgeons, internal medicine physicians, immunologists and specialists in bone and mineral metabolism.