Purpose: Knee OA is a common cause of pain and disability, with many patients relying on chronic pain medications and/or joint injections. These options unfortunately result in short-Term relief, or have associated increased morbidity, and knee replacement surgery may ultimately be performed. Researchers have postulated that synovial neovascularity develops as a result of inflammation and subsequently leads to knee pain. While previous overseas reports of success with GAE have been published, we present our interim results from a prospective US multicenter clinical trial. Materials: 20 subjects with OA with pain greater than 50 mm (Visual Analog Scale 100 mm) refractory to conservative therapy are being recruited for the study (clinicaltrials.gov NCT02850068). Subjects were excluded for: Kellgren Lawrence (KL) Stage 4, rheumatoid arthritis, infection, previous athroplasty, renal insufficiency, or uncorrectable coagulopathy. GAE was performed using 75 or 100 um microspheres in 13 subjects at 2 US centers. Subjects were assessed with MRI, Visual Analog (VAS) and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) pain and disability scales before and after the procedure. Adverse events were also recorded at all time points. Results: Median baseline OA was KL stage III. Neovascularity was identified in the area of pain in all cases by arteriography (n = 13) and GAE was technically successful in all subjects (n = 13). 8/ 13 subjects were eligible for clinical follow-up at present. GAE significantly improved pain at 1 month as measured by VAS (n = 8, mean-58 mm, p = 0.016). Global WOMAC score also decreased (n = 8 mean-36.3, p = 0.0008). No major adverse events were seen related to the procedure. Conclusions: Interim results are promising for GAE to safely reduce pain and disability for mild to moderate knee osteoarthritis.
Bagla, S., Piechowiak, R., Hartman, T., Orlando, J., & Isaacson, A. (2018). 4:21 PM Abstract No. 210 Geniculate artery embolization for osteoarthritis-related knee pain: interim results from a multicenter U.S. trial. Journal of Vascular and Interventional Radiology, 29(4), S91. https://doi.org/10.1016/j.jvir.2018.01.235