Genicular artery embolization for the treatment of knee pain secondary to mild to severe knee osteoarthritis: One year clinical outcomes

Sun, Changhao; Chen, Yuxin; Gao, Zhiling; Wu, Longyun; Lu, Rong; Zhao, Chaoyun; Yang, Hao; Chen, Yong

doi:10.1016/j.ejrad.2024.111443

European Journal of Radiology

2024

DOI: 10.1016/j.ejrad.2024.111443

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Genicular artery embolization for the treatment of knee pain secondary to mild to severe knee osteoarthritis: One year clinical outcomes

Changhao Sun,

Yuxin Chen,

Zhiling Gao

et al.

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2024

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Cited by 3 publications

References 27 publications

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How Arterial Embolization Is Transforming Treatment of Oncologic and Degenerative Musculoskeletal Disease

Papalexis,

Peta,

Carta

et al. 2024

Current Oncology

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Background: Arterial embolization is a minimally invasive treatment that occludes blood vessels supplying pathological tissue. Developed to control bleeding without surgery, it has evolved over decades and is now applied in musculoskeletal oncology as a preoperative treatment, palliative care, or standalone therapy for select tumors. Recently, its use has expanded globally in treating chronic pain syndromes and osteoarthritis. Materials and Methods: We reviewed the literature on arterial embolization in various musculoskeletal conditions. The focus was on established oncologic indications for primary and metastatic bone or soft tissue tumors, and emerging evidence on degenerative diseases like osteoarthritis, inflammatory musculoskeletal pathology, and intractable pain. Emphasis was placed on leading studies regarding efficacy, complications, and recurrence rates. Discussion: Arterial embolization has progressed from bleeding control to a versatile therapeutic option in musculoskeletal medicine. It offers symptom relief, reduces tumor size, and improves quality of life. Applications include oncologic interventions and management of degenerative and inflammatory conditions. Despite its benefits, variations in complications and recurrence rates highlight the need for standardized protocols and further research. Conclusions: Arterial embolization is a safe and effective minimally invasive tool in the multidisciplinary management of a wide range of musculoskeletal pathologies. Ongoing research is crucial to understand long-term efficacy, optimize protocols, and broaden its applications.

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How Arterial Embolization Is Transforming Treatment of Oncologic and Degenerative Musculoskeletal Disease

Papalexis,

Peta,

Carta

et al. 2024

Current Oncology

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show abstract

Transarterial Embolization of Geniculate Arteries Reduces Pain and Improves Physical Function in Knee Osteoarthritis—A Prospective Cohort Study

Hindsø,

Hölmich,

Petersen

et al. 2024

Diagnostics

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Knee osteoarthritis (OA) affects millions worldwide, leading to pain and reduced quality of life. Conventional treatments often fail to provide adequate relief, necessitating new therapeutic approaches. This study evaluated the efficacy and safety of genicular artery embolization (GAE) using permanent microspheres in patients with mild-to-moderate knee OA. In this prospective, single-center study, 17 participants underwent GAE. KOOS (Knee injury and Osteoarthritis Outcome Score), WOMAC (The Western Ontario and McMaster Universities Arthritis Index), and IPAQ (International Physical Activity Questionnaire) scores, along with physical performance tests, medication use, and dual-energy X-ray absorptiometry (DEXA) scans, were assessed at baseline and at multiple follow-up points over six months. The primary endpoint, VAS at six months, showed significant improvement (median reduction from 66 mm to 40 mm, p = 0.0004). All pain and function scores, as well as physical performance tests, improved significantly. No clinically relevant changes in medication use or DEXA parameters were observed after six months. Only minor, self-limiting adverse events occurred. This study indicates that GAE is a promising minimally invasive treatment for knee OA, providing significant pain relief and functional improvement. However, further long-term, randomized trials are needed to confirm these findings and establish optimal patient selection criteria.

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Reduction in Synovitis Following Genicular Artery Embolization in Knee Osteoarthritis: A Prospective Ultrasound and MRI Study

Hindsø,

Hölmich,

Petersen

et al. 2024

Diagnostics

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Background/Objectives: Genicular artery embolization (GAE) has demonstrated potential as a treatment for knee osteoarthritis by targeting inflammation and pain, although current evidence remains limited. This study used imaging biomarkers to objectively assess synovitis and possible ischemic complications following GAE. Methods: This was a prospective, single-center trial including participants with mild-to-moderate knee osteoarthritis. Ultrasound, contrast-enhanced (CE), and non-CE-MRI were performed two days before and one and six months after GAE. Ultrasound biomarkers included synovial hypertrophy, effusion, and Doppler activity. A combined effusion-synovitis score was assessed on non-CE-MRI, while CE-MRI allowed differentiation between synovium and effusion and was used to calculate whole-joint and local synovitis scores. The post-GAE MRIs were reviewed for ischemic complications.Results: Seventeen participants (aged 43–71) were treated. Significant reductions were observed in ultrasound-assessed synovial hypertrophy and Doppler activity, as well as in CE-MRI local and whole-joint synovitis scores. While reductions in effusion were noted in both ultrasound and MRI, these changes did not reach statistical significance. At one month, MRI revealed three cases of nonspecific osteonecrosis-like areas, which resolved completely by six months.Conclusions: This study demonstrated a reduction in synovitis and no permanent ischemic complication following GAE in knee osteoarthritis. Larger studies with longer follow-up are needed to confirm the long-term efficacy and safety of the procedure.

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Genicular artery embolization for the treatment of knee pain secondary to mild to severe knee osteoarthritis: One year clinical outcomes

Cited by 3 publications

References 27 publications

How Arterial Embolization Is Transforming Treatment of Oncologic and Degenerative Musculoskeletal Disease

How Arterial Embolization Is Transforming Treatment of Oncologic and Degenerative Musculoskeletal Disease

Transarterial Embolization of Geniculate Arteries Reduces Pain and Improves Physical Function in Knee Osteoarthritis—A Prospective Cohort Study

Reduction in Synovitis Following Genicular Artery Embolization in Knee Osteoarthritis: A Prospective Ultrasound and MRI Study

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