Article Text

Download PDFPDF
Radiofrequency ablation versus intra-articular mesenchymal stem cell injection for knee osteoarthritis: a systematic review and network meta-analysis
  1. Sukhee Park1,
  2. Soyoon Park2,
  3. Jae Ni Jang2,
  4. Young-Soon Choi2,
  5. Dong Seong Kim3,
  6. Jeong Eun Sohn3 and
  7. Ji-Hoon Park4
  1. 1Catholic Kwandong University College of Medicine, Gangneung, Republic of Korea
  2. 2Catholic Kwandong University College of Medicine, Gangneung, Gangwon-do, Republic of Korea
  3. 3Jeju Halla Byeongwon, Jeju, Jeju-do, Republic of Korea
  4. 4Department of Anesthesiology and Pain Medicine, Keimyung University College of Medicine, Daegu, Republic of Korea
  1. Correspondence to Professor Ji-Hoon Park, Department of Anesthesiology and Pain Medicine, Keimyung University College of Medicine, Daegu, Daegu, Korea (the Republic of); cmjihoon{at}


Background Knee osteoarthritis (OA) is a prevalent degenerative disease and causes disability, pain and imposes a substantial burden on patients. Conventional treatments for knee OA show limited effectiveness. Consequently, innovative treatments, such as radiofrequency ablation (RFA) and intra-articular mesenchymal stem cells (IA MSC), have gained attention for addressing these limitations.

Objective We compared the efficacy of RFA and IA MSC for knee OA through a network meta-analysis (NMA).

Evidence review A literature search was conducted using PubMed, MEDLINE, Embase, Cochrane Library, Web of Science and handsearching. Randomized controlled trials (RCTs) comparing RFA or IA MSC to conventional treatments for knee OA were included. The primary outcomes comprised the pain score and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). The clinical outcomes were compared using a frequentist approach, and the treatments were ranked using the surface under the cumulative ranking curve (SUCRA) values.

Findings We included 34 RCTs (n=2371). Our NMA revealed that RFA and IA MSC were significantly more effective than conventional treatments in managing pain at both 3 and 6 months with moderate certainty. Specifically, RFA demonstrated the highest SUCRA values, indicating its superior efficacy. For WOMAC scores, both RFA and MSC showed significant improvements at 3 months, with RFA maintaining its lead at 6 months, although MSC did not display significant superiority at this stage.

Conclusions This analysis suggests that RFA and MSC are resilient treatment options in knee OA. Despite some study heterogeneity, these treatments consistently outperformed conventional treatments, particularly in the short to mid-term, although with varying levels of certainty in their efficacy.

PROSPERO registration number CRD42023492299.

  • Radiofrequency Ablation
  • Treatment Outcome
  • Pain Management

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors SuP: study design, protocol registration, screening, data extraction, data analysis/interpretation, drafting the manuscript, funding acquisition. SoP, JNJ, Y-SC: screening, data extraction, drafting manuscript. DSK, JES: data analysis/interpretation, final manuscript approval. J-HP: study design, protocol registration, data analysis/interpretation, drafting the manuscript, final manuscript approval.

  • Funding This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government Ministry of Science and ICT (grant number: 2022R1F1A1068925).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer-reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.