A critical overview of systematic reviews of radiofrequency ablation for knee osteoarthritis
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Jixin Chen1, Qinxin Zhou2, Weijie Yu1
1Department of Orthopaedic Surgery, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China.
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.
Insights
Systematic reviews on radiofrequency ablation (RFA) for knee osteoarthritis (KOA) show treatment efficacy but suffer from poor methodological quality. Further high-quality research is needed for reliable evidence-based medicine.
Area of Science:
- Orthopedics
- Pain Management
- Evidence-Based Medicine
Background:
- Knee osteoarthritis (KOA) is a prevalent degenerative joint disease.
- Radiofrequency ablation (RFA) is an emerging treatment modality for KOA pain.
- The quality of evidence supporting RFA for KOA requires critical evaluation.
Purpose of the Study:
- To assess the methodological rigor and evidence quality of existing systematic reviews on RFA for KOA.
- To identify limitations in the current body of systematic review literature for RFA in KOA.
Main Methods:
- A systematic literature search was performed across eight electronic databases.
- Methodological quality was evaluated using the Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR 2) tool.
- Evidence quality was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework.
Main Results:
- Eight systematic reviews met the inclusion criteria.
- The overall methodological quality of the included reviews was unsatisfactory, citing issues like lack of protocols and inadequate bias assessment.
- Evidence quality for RFA in KOA was predominantly rated as low or very low, with only one outcome rated as moderate.
Conclusions:
- Radiofrequency ablation demonstrates efficacy for treating knee osteoarthritis with acceptable side effects.
- The poor quality of current systematic reviews necessitates cautious interpretation of findings.
- Enhancing the quality of future systematic reviews is crucial for establishing robust evidence-based guidelines for RFA in KOA management.
