A critical overview of systematic reviews of radiofrequency ablation for knee osteoarthritis.

Abstract

Purpose: This overview aims to assess the methodological and evidence quality of systematic reviews related to radiofrequency ablation (RFA) for knee osteoarthritis (KOA).

Methods: A comprehensive search strategy was conducted through two independent researchers in eight electronic databases from the inception to September 1, 2024. The methodological quality of the included systematic reviews was assessed by the Assessing the Methodological Quality of Systematic Reviews 2 tool. The Grading of Recommendations Assessment, Development, and Evaluation tool assessed the evidence quality.

Results: Eight systematic reviews were finally included. The results of the methodological quality of the included systematic reviews were generally unsatisfactory. The limitations were a lack of pre-designed protocols, reasons for the inclusion of study types, a list of excluded studies, the consideration of the single study risk of bias, and management of conflicts of interest. A total of 56 outcome indicators were evaluated, with one item receiving a moderate quality rating, while the rest were classified as low or very low. Limitations were identified as the primary factors leading to the downgrade.

Conclusions: RFA shows efficacy in treating KOA, with tolerable side effects. However, systematic reviews' poor quality indicates cautious interpretation needed. Future studies must enhance quality for robust EBM.