- A small meta-analysis finds that denervation therapy for refractory knee osteoarthritis (KOA) shows short-term (up to 6 months) improvements in pain and functional recovery but the long-term benefits remain controversial.
Why this matters
- There are few treatment options for refractory KOA.
- Denervation therapy is promising.
- Meta-analysis of 6 randomized controlled trials (n=408) after search of Medline, EMBASE, and the Cochrane Library.
- Pain intensity was rated by visual analog scale or numeric rating scale; functional improvement was rated by total Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC).
- Funding: None disclosed.
- Efficacy at 4 weeks favored denervation therapy (vs controls):
- Pain standardized mean difference (SMD), −1.17; P=.04.
- Functional recovery SMD, −0.75; P=.0002.
- Efficacy at 12 weeks favored denervation therapy (vs controls):
- Pain SMD, −1.24; P<.00001.>
- Functional recovery SMD, −0.42; P=.007.
- Pain SMD, −1.25; P=.0002.
- Functional recovery SMD, −0.39; P=.06.
- Small number of trials; most with small sample sizes.
- Most studies open-label.