Thursday, 13 Dec 2018

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Novel Approach to Knee Osteoarthritis Pain

Geniculate artery embolization was found to dampen knee pain arising from osteoarthritis, according to interim study results presented at the 2018 annual meeting of the Society of Interventional Radiology.

One month after the catheter-based procedure, patients reported having less intense knee pain on a visual analog scale (VAS; baseline 75 mm, average decrease of 53 mm, P<0.01).

Patients also reported decreased pain and stiffness but improved physical function per the total Western Ontario and McMaster University Osteoarthritis Index (WOMAC; baseline score 61, mean decrease of 37 points, P<0.01), according to a poster at the annual Society of Interventional Radiology conference.

"We believe that the decreases in both the VAS and the WOMAC speak directly to the effectiveness of the procedure," investigator Julie Orlando, RT(R)(CV), of Vascular Institute of Virginia, told MedPage Today. "Another finding, not specifically addressed in the poster, was the decrease in the amount of pain medications that patients reported taking after the procedure."

Geniculate artery embolization is a minimally invasive attempt to reduce pain in the long term. The theory is that it resolves the formation of new blood vessels growing in the cartilage, synovium and adjacent bone, which is thought to accompany inflammation -- bringing new sensory nerve fibers and thus knee pain.

Orlando noted that patients do not typically emerge from the procedure with absolutely zero pain, "as there can be many contributing factors to a patient's knee pain besides osteoarthritis alone."

The researchers enrolled 20 patients for this study, 19 of whom had the geniculate artery embolization procedure and completed follow-up. Participants were eligible if they had moderate-to-severe knee pain that was refractory to conservative therapy, namely chronic pain medications and joint injections, for at least 3 months prior to enrollment.

Geniculate artery embolization was technically successful in all patients, and operators observed no major adverse events.

Median baseline osteoarthritis among patients in the study was Kellgren and Lawrence stage III. Arteriography confirmed that all areas of knee pain had been accompanied by new blood vessels.

Final results of the study are expected in July. For now, "interim results are promising for geniculate artery embolization to safely reduce pain and disability for mild to moderate knee osteoarthritis," the investigators concluded.

Disclosures: 
The author has no conflicts of interest to disclose related to this subject

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