Genicular Artery Embolization for Knee Osteoarthritis

Abstract

» Genicular artery embolization (GAE) is a promising treatment option for patients with knee osteoarthritis who are unresponsive to nonsurgical treatments and not yet candidates for surgery.» Current evidence supports the effectiveness of GAE in reducing pain and synovitis, with few reported major adverse events.» The cost-effectiveness and long-term results of GAE compared with other treatment options require further investigation.» Limitations of existing studies include small sample sizes, single-center trials, and lack of comparison between embolic agents and other treatments.» Future research should focus on larger, multicenter trials with longer follow-up periods and head-to-head comparisons with alternative treatment modalities to establish the role of GAE in the management of knee osteoarthritis.

Selective Genicular Artery Embolization in the Management of Osteoarthritic Knee Pain—A Narrative Review

“…Patients excluded from studies were those with malignancy, significant ipsilateral prior knee surgery, rheumatoid arthritis, irreversible coagulopathy, renal impairment, local infection, and advanced atherosclerosis [ 5 ].…”

“…All were performed by an Interventional Radiologist who was familiar with the genicular arterial anatomy. The goal is to diminish hypervascularity while sustaining arterial flow [ 5 ]. Pre-procedure, the clinical localisation of pain was clearly examined and discussed with the patient.…”

“…The VAS is a graded scale with increasing numerical value indicating worsening pain. It is used to compare pain progression in a single subject, and is sensitive to changes in improvement [ 5 ].…”

“…WOMAC and Knee Injury and Osteoarthritis Outcome Score (KOOS) are questionnaires used to evaluate pain during activity, and help quantify stiffness [ 5 ].…”

“…Geniculate artery embolization (GAE) is a technique that was first introduced into routine practice for management of spontaneous recurrent hemarthrosis following total knee arthroplasty (TKA) [ 5 ]. The first reported documentation of GAE for symptomatic knee OA arises from a 2015 study, which showed a reduction in pain following embolization of the arterial supply to the inflamed synovium [ 4 ].…”