“…A recent systematic review of 11 studies of people undergoing TAE for OA-related knee pain determined that participants demonstrated a mean improvement at two years of 54% to 80% compared to baseline pain scores. 16 However, none of the studies except Bagla et al 17 included a comparison group, such that treatment-specific effects of TAE were unknown. Bagla et al 17 randomized 21 people to either TAE (n = 14) or a sham procedure (n = 7).…”
AimsThis study investigated the effects of transcatheter arterial embolization (TAE) on pain, function, and quality of life in people with early-stage symptomatic knee osteoarthritis (OA) compared to a sham procedure.MethodsA total of 59 participants with symptomatic Kellgren-Lawrence grade 2 knee OA were randomly allocated to TAE or a sham procedure. The intervention group underwent TAE of one or more genicular arteries. The control group received a blinded sham procedure. The primary outcome was knee pain at 12 months according to the Knee injury and Osteoarthritis Outcome Score (KOOS) pain scale. Secondary outcomes included self-reported function and quality of life (KOOS, EuroQol five-dimension five-level questionnaire (EQ-5D-5L)), self-reported Global Change, six-minute walk test, 30-second chair stand test, and adverse events. Subgroup analyses compared participants who received complete embolization of all genicular arteries (as distinct from embolization of some arteries) (n = 17) with the control group (n = 29) for KOOS and Global Change scores at 12 months. Continuous variables were analyzed with quantile regression, adjusting for baseline scores. Dichotomized variables were analyzed with chi-squared tests.ResultsOverall, 58 participants provided questionnaire data at 12 months. No significant differences were found for the primary and secondary outcomes, with both groups improving following the procedure. At 12 months, KOOS pain scores improved by 41.3% and 29.4% in the intervention and control groups, respectively. No adverse events occurred. Subgroup analysis indicated that the complete embolization group had significantly better KOOS Sports and Recreation, KOOS Quality of Life, and Global Change scores than the control group; 76.5% of participants who received complete embolization reporting being moderately or much better compared to 37.9% of the control group.ConclusionTAE might produce benefits above placebo, but only when complete embolization of all genicular arteries is performed. Further comparative studies are required before definitive conclusions regarding the effectiveness of TAE can be made.Level of evidence: ICite this article: Bone Jt Open 2023;4(3):158–167.
“…A recent systematic review of 11 studies of people undergoing TAE for OA-related knee pain determined that participants demonstrated a mean improvement at two years of 54% to 80% compared to baseline pain scores. 16 However, none of the studies except Bagla et al 17 included a comparison group, such that treatment-specific effects of TAE were unknown. Bagla et al 17 randomized 21 people to either TAE (n = 14) or a sham procedure (n = 7).…”
AimsThis study investigated the effects of transcatheter arterial embolization (TAE) on pain, function, and quality of life in people with early-stage symptomatic knee osteoarthritis (OA) compared to a sham procedure.MethodsA total of 59 participants with symptomatic Kellgren-Lawrence grade 2 knee OA were randomly allocated to TAE or a sham procedure. The intervention group underwent TAE of one or more genicular arteries. The control group received a blinded sham procedure. The primary outcome was knee pain at 12 months according to the Knee injury and Osteoarthritis Outcome Score (KOOS) pain scale. Secondary outcomes included self-reported function and quality of life (KOOS, EuroQol five-dimension five-level questionnaire (EQ-5D-5L)), self-reported Global Change, six-minute walk test, 30-second chair stand test, and adverse events. Subgroup analyses compared participants who received complete embolization of all genicular arteries (as distinct from embolization of some arteries) (n = 17) with the control group (n = 29) for KOOS and Global Change scores at 12 months. Continuous variables were analyzed with quantile regression, adjusting for baseline scores. Dichotomized variables were analyzed with chi-squared tests.ResultsOverall, 58 participants provided questionnaire data at 12 months. No significant differences were found for the primary and secondary outcomes, with both groups improving following the procedure. At 12 months, KOOS pain scores improved by 41.3% and 29.4% in the intervention and control groups, respectively. No adverse events occurred. Subgroup analysis indicated that the complete embolization group had significantly better KOOS Sports and Recreation, KOOS Quality of Life, and Global Change scores than the control group; 76.5% of participants who received complete embolization reporting being moderately or much better compared to 37.9% of the control group.ConclusionTAE might produce benefits above placebo, but only when complete embolization of all genicular arteries is performed. Further comparative studies are required before definitive conclusions regarding the effectiveness of TAE can be made.Level of evidence: ICite this article: Bone Jt Open 2023;4(3):158–167.
“…Among 174 papers identified in the literature search, 9 studies of GAE for treatment of knee OA were included in the systematic review [ 17 , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] ]. Among the full-text papers that were reviewed, 46 were excluded, with hemarthrosis diagnosis (19) and inadequate sample size (10) as the most common reasons for exclusion ( Fig.…”
Section: Resultsmentioning
confidence: 99%
“…1 ). Only one study included a control group [ 33 ]; therefore, we extracted data only from the GAE arm of each study for the meta-analysis. Fig.…”
Section: Resultsmentioning
confidence: 99%
“… Study Study design Treatment dates Country (No. sites) Patients Knees Key eligibility criteria Follow-up (months) Bagla [2020] [ 32 ] P 2017–2018 US (2) 20 20 Age ≥40 yr 6 K-L grade 1-3 Knee pain ≥5/10 Conservative therapy failure Bagla [2022] [ 33 ] P 2018–2019 US (2) 14 14 Age >40 yr 1 K-L grade 1-3 Knee pain >5/10 Conservative therapy failure Choi [2020] [ 34 ] R 2019 Korea (1) 18 28 Intractable knee pain due to OA 3 Conservative therapy failure Landers [2020] [ 35 ] P 2016–2017 Australia (1) 10 10 Age 18–75 yr 24 K-L grade 1-2 Moderate or severe knee pain Conservative therapy failure Lee [2019] [ 36 ] R 2017–2018 Korea (1) 41 71 K-L grade 1-4 12 Knee pain ≥2/10 Conservative therapy failure Little [2021] [ 37 ] P 2018–2020 UK (1) 38 38 Age ≥45 yr 12 …”
Section: Resultsmentioning
confidence: 99%
“…Bagla et al. [ 33 ] conducted a small randomized trial in which 14 patients were randomized to GAE and 7 to a sham procedure. All patients assigned to the sham procedure crossed over to GAE at the 1-month follow-up visit.…”
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