冷冻神经松解治疗膝骨关节炎的疗效：一项系统综述

Q2 Medicine

Journal of Clinical Orthopaedics and Trauma Pub Date : 2025-05-15 DOI:10.1016/j.jcot.2025.103056

Kee Jin Loh , Yeow Leng Tan , Joon Sin Ser , Youyi Huang

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引用次数: 0

摘要

研究背景：确定冷冻神经松解术用于减轻膝关节骨关节炎（KOA）患者的疼痛、改善身体功能和生活质量，以及冷冻神经松解治疗的安全性。该系统综述按照PRISMA指南进行，注册号为PROSPERO ID: CRD42024581457，评估了从开始到2024年10月2日冷冻解液治疗KOA的有效性、安全性和治疗结果。对PubMed、Embase和CINHAL进行了全面的检索。使用国家心肺血液研究所（NIH）研究质量评估工具对研究的质量和潜在偏倚风险进行评估。结果5项研究（2项随机对照试验和3项非随机试验）符合纳入标准。这些研究（n = 1064例患者）被认为具有良好的质量。研究结果显示，冷冻神经溶解显著改善了疼痛缓解、功能结局（由WOMAC和kos测量）和生活质量，效果持续长达6个月。总的来说，该手术耐受性良好，只有轻微的不良反应。然而，这五项纳入的研究在研究设计、神经靶点和结果测量方面的异质性限制了荟萃分析的可行性，这表明需要进一步研究标准化冷冻神经溶解方案，探索图像引导技术，并确定最有可能受益的患者亚组。结论有相当高质量的证据表明，冷冻松解术是一种安全有效的治疗KOA的方法，为目前的治疗库提供了有价值的补充。

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Outcome of cryoneurolysis treatment in knee osteoarthritis: A systematic review

Background

To determine the use of Cryoneurolysis for pain reduction, improvement of physical function and quality of life in knee osteoarthritis (KOA), and the safety profile from cryoneurolysis treatment.

Method

This systematic review, conducted in accordance with PRISMA guidelines and registered under PROSPERO ID: CRD42024581457, evaluated the effectiveness, safety, and therapeutic outcomes of cryoneurolysis for KOA from inception to 2 October 2024. A comprehensive search of PubMed, Embase, and CINHAL was conducted. The qualities and risk of potential bias of the studies were appraised using the National Heart, Lung and Blood Institute (NIH) Study Quality Assessment tools.

Results

Five studies (two randomized controlled trials and three non-randomized studies) meet the inclusion criteria. These studies (n = 1064 patients) were found to be of fair to good quality. Findings revealed that cryoneurolysis significantly improved pain relief, functional outcomes (measured by WOMAC and KOOS), and quality of life, with effects lasting up to 6 months. The procedure was well-tolerated overall, with only mild adverse effects reported. However, heterogeneity in study designs, nerve targets, and outcome measures in these five included studies limited the feasibility of meta-analysis, indicating the need for future research on standardizing cryoneurolysis protocols, exploring image-guided techniques, and identifying patient subgroups most likely to benefit.

Conclusion

There are fair to good quality of evidence to suggest cryoneurolysis as a safe and effective treatment for KOA, offering a valuable addition to the current therapeutic arsenal.

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来源期刊

Journal of Clinical Orthopaedics and Trauma Medicine-Orthopedics and Sports Medicine

CiteScore

4.30

自引率

0.00%

发文量

181

审稿时长

92 days

期刊介绍： Journal of Clinical Orthopaedics and Trauma (JCOT) aims to provide its readers with the latest clinical and basic research, and informed opinions that shape today''s orthopedic practice, thereby providing an opportunity to practice evidence-based medicine. With contributions from leading clinicians and researchers around the world, we aim to be the premier journal providing an international perspective advancing knowledge of the musculoskeletal system. JCOT publishes content of value to both general orthopedic practitioners and specialists on all aspects of musculoskeletal research, diagnoses, and treatment. We accept following types of articles: • Original articles focusing on current clinical issues. • Review articles with learning value for professionals as well as students. • Research articles providing the latest in basic biological or engineering research on musculoskeletal diseases. • Regular columns by experts discussing issues affecting the field of orthopedics. • "Symposia" devoted to a single topic offering the general reader an overview of a field, but providing the specialist current in-depth information. • Video of any orthopedic surgery which is innovative and adds to present concepts. • Articles emphasizing or demonstrating a new clinical sign in the art of patient examination is also considered for publication. Contributions from anywhere in the world are welcome and considered on their merits.