Genicular Artery Embolization to Treat Osteoarthritis Knee Pain Save

A study from the Journal of Vascular and Interventional Radiology has shown that  knee pain secondary to osteoarthritis (OA) may be effectively treated by selective vascular interruption (embolization) showing efficacy and safety in a small pilot trial. 

In an uncontrolled 20 patient observational study, adults with radiographic knee OA and moderate-to-severe pain refractory to conservative therapy were enlisted to study the effects of  embolization of hyperemic synovial tissue for the treatment of knee pain secondary to osteoarthritis (OA). Genicular artery embolization (GAE) was performed with 75- or 100-μm spherical particles. Patients were assessed magnetic resonance imaging at baseline and at 1 month and also with the Visual Analogue Scale (VAS)  and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) at baseline and at 1, 3, and 6 months.

Embolization of at least 1 genicular artery was achieved in all patients. The mean VAS improved from 76 mm ± 14 (baseline) to 29 mm ± 27 at 6-months (P <.01). WOMAC scores also dropped by more than 50% (61 ± 12 to 29 ± 27) at 6-months

Adverse events were limited to short-lived skin discoloration (65%) and 2 patients (10%) developed plantar sensory paresthesia that resolved within 14 days.

While OA has long been considered a degenerative disorder with a minor inflammatory component, research has suggested a prominent role for vascular ischemia and that OA "pain" may reflect "osteo-angina". Selective embolization may be a means of approaching problematic, painful OA of the knee in the future, but more studies are needed.