膝动脉栓塞治疗膝骨关节炎：假对照随机试验的系统回顾

IF 1.5 Q3 ORTHOPEDICS

Journal of orthopaedics Pub Date : 2025-07-25 DOI:10.1016/j.jor.2025.07.022

Fathi Milhem , Muhammad Takhman , Mohamed S. Elgendy , Anas Abu Zahra , Sarah Saife , Sakeena Saife , Waseem Shehadeh , Mohammad Bdair , Omar Abu-Khazneh , Yazan Hamdan , Qutayba Z. Ayaseh , Orabi Hajjeh , Ayesha Younas , Walaa Abu Alya , Ahmad Mohammad , Anwar Zaitoun

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引用次数: 0

摘要

膝骨关节炎（KOA）是一种与慢性疼痛和功能下降相关的退行性关节疾病。膝动脉栓塞（GAE）是一种针对异常滑膜新生血管的微创干预。本系统综述评价了GAE与假手术在有症状KOA患者中的疗效和安全性。方法系统检索到2025年3月为止的PubMed、EMBASE、Scopus、Web of Science数据库。仅纳入有症状KOA的成人的假对照随机对照试验（rct）。收集了有关研究设计、患者特征、干预措施、结局和不良事件的数据。使用Cochrane RoB 2.0工具评估偏倚风险。结果共纳入3组假对照rct，共138例患者。GAE显示出短期疼痛减轻，特别是VAS评分，一项试验显示1个月时显着改善（- 50.8 vs - 0.5）。kos疼痛评分在研究中略有改善，但缺乏统计学意义。功能结果混杂；一项试验报告了WOMAC功能的显著改善，另一项试验发现，完全栓塞患者的生活质量得到了提高。未发生严重不良事件；导管部位擦伤等轻微并发症并不常见，而且是自限性的。结论gae是一种安全、微创的治疗方法，可在短期内缓解部分KOA患者的症状。然而，有限的样本量、方法的可变性和较短的随访期限制了明确的结论。为了确认疗效和优化患者选择，需要更大规模、更长期随访的标准化试验。

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Genicular artery embolization for knee osteoarthritis: A systematic review of sham-controlled randomized trials

Background

Knee osteoarthritis (KOA) is a degenerative joint disease associated with chronic pain and functional decline. Genicular artery embolization (GAE) is a minimally invasive intervention that targets abnormal synovial neovascularization. This systematic review evaluates the efficacy and safety of GAE compared with sham procedures in patients with symptomatic KOA.

Methods

A systematic search of PubMed, EMBASE, Scopus, and Web of Science was conducted through March 2025. Only sham-controlled randomized controlled trials (RCTs) enrolling adults with symptomatic KOA were included. Data were extracted on study design, patient characteristics, interventions, outcomes, and adverse events. Risk of bias was assessed using the Cochrane RoB 2.0 tool.

Results

Three sham-controlled RCTs with a total of 138 patients were included. GAE demonstrated short-term pain reduction, particularly in VAS scores, with one trial showing a significant improvement at 1 month (−50.8 vs −0.5). KOOS pain scores improved modestly across studies but lacked statistical significance. Functional outcomes were mixed; one trial reported significant improvement in WOMAC function, and another found enhanced quality of life in patients undergoing complete embolization. No serious adverse events occurred; minor complications such as catheter-site bruising were infrequent and self-limited.

Conclusions

GAE appears to be a safe and minimally invasive treatment that may provide short-term symptomatic relief in select KOA patients. However, limited sample sizes, methodological variability, and short follow-up periods constrain definitive conclusions. Larger, standardized trials with longer follow-up are necessary to confirm efficacy and optimize patient selection.

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来源期刊

Journal of orthopaedics ORTHOPEDICS-

CiteScore

3.50

自引率

6.70%

发文量

202

审稿时长

56 days

期刊介绍： Journal of Orthopaedics aims to be a leading journal in orthopaedics and contribute towards the improvement of quality of orthopedic health care. The journal publishes original research work and review articles related to different aspects of orthopaedics including Arthroplasty, Arthroscopy, Sports Medicine, Trauma, Spine and Spinal deformities, Pediatric orthopaedics, limb reconstruction procedures, hand surgery, and orthopaedic oncology. It also publishes articles on continuing education, health-related information, case reports and letters to the editor. It is requested to note that the journal has an international readership and all submissions should be aimed at specifying something about the setting in which the work was conducted. Authors must also provide any specific reasons for the research and also provide an elaborate description of the results.