Transcatheter arterial tendinopathy embolization as a treatment for painful and refractory tendinopathy: a systematic review and meta-analysis.

IF 1.9 3区医学 Q2 ORTHOPEDICS

Skeletal Radiology Pub Date : 2024-11-01 Epub Date: 2024-03-27 DOI:10.1007/s00256-024-04649-9

Yan Epelboym, Colette Glaser, Zhou Lan, Jacob C Mandell, Ezra Burch, Timothy Killoran, Ali Guermazi

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Abstract

Objective: Transcatheter arterial embolization (TAE) is a novel minimally invasive therapy for painful tendinopathy in patients with pain refractory to conservative management. The purpose of this study was to evaluate evidence on the efficacy of TAE for tendinopathy related pain.

Materials and methods: Using Embase, PubMed, and Web of Science, a systematic review and meta-analysis was performed to identify studies evaluating TAE for painful tendinopathy. The primary outcome measure was change in pain scale score at 6 months. A Ratio of Means (ROM) was used to compare the effect size post treatment as compared to baseline. The Visual Analog Scale (VAS) was used as the metric for comparison.

Results: After screening titles, abstracts, and the full text, 5 studies met inclusion criteria. A total of 97 tendinopathy embolization procedures performed in 74 patients were included. Patients who underwent TAE demonstrated declines in VAS ROM at 1 day 0.53 [95% CI 0.31,0.88], 1 week (0.51 [95% CI 0.32,0.79]), 1 month (0.45 [95% CI 0.29, 0.71]), 3-4 months (0.33 [95% CI 0.22,0.48]), and 6 months following embolization (0.18[95% CI 0.13,0.26]), respectively.

Discussion: TAE provides substantial short-term reductions in pain scores for patients suffering with refractory tendinopathy related pain of the rotator cuff, elbow extensor and flexor, Achilles, and patellar tendons.

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经导管动脉腱鞘炎栓塞术治疗疼痛难忍的腱鞘炎：系统回顾和荟萃分析。

目的：经导管动脉栓塞术（TAE）是一种新型微创疗法，可治疗保守治疗无效的腱鞘炎疼痛患者。本研究旨在评估经导管动脉栓塞治疗腱鞘炎相关疼痛的疗效证据：利用Embase、PubMed和Web of Science进行了系统回顾和荟萃分析，以确定评估TAE治疗肌腱痛的研究。主要结果指标是6个月时疼痛量表评分的变化。平均值比（ROM）用于比较治疗后与基线相比的效果大小。结果：经过对标题、摘要和全文的筛选，5 项研究符合纳入标准。共纳入了为 74 名患者实施的 97 例腱鞘炎栓塞手术。接受 TAE 的患者在栓塞后 1 天（0.53 [95% CI 0.31,0.88]）、1 周（0.51 [95% CI 0.32,0.79]）、1 个月（0.45 [95% CI 0.29,0.71]）、3-4 个月（0.33 [95% CI 0.22,0.48]）和 6 个月（0.18 [95% CI 0.13,0.26]）的 VAS ROM 分别有所下降：讨论：对于肩袖、肘关节伸屈肌腱、跟腱和髌腱等难治性肌腱病相关疼痛的患者，TAE可在短期内显著降低疼痛评分。

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来源期刊

Skeletal Radiology 医学-核医学

CiteScore

4.40

自引率

9.50%

发文量

253

审稿时长

3-8 weeks

期刊介绍： Skeletal Radiology provides a forum for the dissemination of current knowledge and information dealing with disorders of the musculoskeletal system including the spine. While emphasizing the radiological aspects of the many varied skeletal abnormalities, the journal also adopts an interdisciplinary approach, reflecting the membership of the International Skeletal Society. Thus, the anatomical, pathological, physiological, clinical, metabolic and epidemiological aspects of the many entities affecting the skeleton receive appropriate consideration. This is the Journal of the International Skeletal Society and the Official Journal of the Society of Skeletal Radiology and the Australasian Musculoskelelal Imaging Group.