Minimally Invasive Procedures Effective in Reducing Pain and Improving Function in Osteoarthritis Patients: Study
Researchers have found that minimally invasive interventional procedures, namely radiofrequency ablation (RFA) and transcatheter arterial embolization (TAE), did reduce the levels of pain and improve the functionality of patients with osteoarthritis (OA) and chronic sacroiliac pain of degenerative origin. A comprehensive meta-analysis was conducted to evaluate the efficacy of such treatments on various anatomical locations by comparing RCTs and NRSI. The study was recently published in the journal Seminars in Arthritis and Rheumatism by Jacopo C. and colleagues.
PubMed and Web of Science databases were searched systematically for both RCTs and NRSI. The searched studies included patients with osteoarthritis or chronic sacroiliac pain treated with RFA or TAE. Findings were summarized according to anatomical treatment site: knee, hip, foot and ankle, shoulder, hand and wrist, and sacroiliac joints. The primary outcome assessed was the change in pain intensity score as measured by the 0–10 VAS, comparing baseline with one month, and follow-up assessments at three, six, and twelve months. Assessments of improvements in functional status were also conducted. Pooled estimates were estimated as the mean difference (MD) versus baseline, along with 95% confidence intervals (CI). For added strength, the analyses were performed separately for RCTs and NRSI.
Results
From 4,599 articles obtained, 164 met the inclusion criteria and were reviewed, and of these, 111 studies (38 RCTs and 73 NRSI) were included in the meta-analysis. Of these, one article was specific to patients with inflammatory arthritis. Significant decreases in pain intensity were seen for both RFA and TAE at all post-procedure timepoints by comparison in meta-analysis.
RCT meta-analysis: At one month post procedure:
• Knee RFA: MD in VAS was -3.98 (-4.41 to -3.55; 21 studies).
• Sacroiliac joints RFA: MD in VAS was -3.18 (-3.96 to -2.39; 8 studies).
NRSI meta-analysis:
• Knee RFA: MD in VAS was -4.12 (-4.63 to -3.61; 23 studies).
• Knee TAE: MD in VAS was -3.84 (-4.77 to -2.92; 7 studies).
• Hip RFA: MD in VAS was -4.34 (-4.96 to -3.71; 2 studies).
• Shoulder RFA: MD in VAS was -3.83 (-4.52 to -3.15; 3 studies).
• Sacroiliac joints RFA: MD in VAS was -4.93 (-5.58 to -4.28; 14 studies).
Pain reduction was additional at the three, six, and twelve-month mark post-intervention. The functional status of the patients also improved at all time points assessed, thus complementing the clinical and treatment indications of these interventions.
Minimally invasive interventional procedures, like RFA and TAE, will bestow many benefits in reducing pain and improvement of the patients' functional status with OA or chronic sacroiliac joint pain. Such findings would justify the integration of such treatments into clinical practice, especially for patients who are searching for non-surgical alternatives. Further studies would be necessary to affirm the effectiveness of such procedures within the management of inflammatory arthritis.
Reference:
Ciaffi, J., Papalexis, N., Vanni, E., Miceli, M., Faldini, C., Scotti, L., Zambon, A., Salvarani, C., Caporali, R., Facchini, G., & Ursini, F. (2024). Minimally invasive interventional procedures for osteoarthritis and inflammatory arthritis: A systematic review and meta-analysis. Seminars in Arthritis and Rheumatism, 68(152525), 152525. https://doi.org/10.1016/j.semarthrit.2024.152525
