Genicular Artery Embolization Evaluated to Treat Arthritis in the Knee

March 16, 2021—Nonsurgical genicular artery embolization (GAE) to treat arthritis in the knee is safe and effective in providing immediate and long-term pain relief, according to a new study presented at the Society of Interventional Radiology (SIR) annual scientific meeting.

GAE was shown to reduce inflammation in the knee to improve function and quality of life for people with moderate to severe knee pain. In addition, GAE quickly improves patients’ pain and the pain relief is durable, lasting for at least 12 months.

As noted in the SIR announcement, arthritis pain was regarded until recently as a wear-and-tear disease, but as the cartilage breaks down it releases enzymes that can cause inflammation and pain, and limit functioning. The GAE treatment cuts down the abnormal blood flow to reduce inflammation.

The study is being presented as part of the the SIR meeting, the sessions for which will be held virtually on March 20-26, 2021. The study can be found as abstract 16 at sirmeeting.org. Siddharth A. Padia, MD, who is Professor of Radiology, UCLA Health in Los Angeles, California, served as the lead investigator of the study.

Dr. Padia commented in the SIR announcement, “Prior to treatment, patients’ knee pain had taken over their whole life. But after treatment, patients who initially could walk only three or four blocks were walking three miles. Some were able to do away with walking aids, such as canes, while others reported being in a better mood now that they were living without pain.”

According to SIR, this prospective, single-center, open-label FDA-approved study is the largest in the United States to evaluate the safety and efficacy of GAE for the treatment of osteoarthritis in the knee. The study included 40 patients who were not candidates for total knee replacement but had failed to benefit from more conservative treatments, such as nonsteroidal anti-inflammatory drugs, joint injections, and physical therapy.

Interventional radiologists navigated a catheter through a pinhole incision in the hip into the arteries in the arthritic knee. They then injected tiny particles to control the blood supply to inflamed and painful areas of the knee. The outpatient procedure took approximately 1 to 2 hours, followed by a 2-hour recovery period. Each patient was evaluated for adverse events and pain scores at 1 week; 1, 3, and 6 months; and 1 year after the treatment.

SIR reported that patients saw benefits as soon as 3 days after the procedure. Average pain scores decreased from 8 out of 10 before GAE to 3 out of 10 within the first week. Additionally, seven in 10 patients reported > 50% reduction in pain scores at the 1-year follow-up.

Additionally, minor temporary adverse events, such as transient skin discoloration and small bone infarct were reported in 10 patients, but resolved without treatment within days.

The investigators plan to conduct a randomized trial with a larger patient population to determine which patients may benefit most from the treatment, as well as the impact it has on slowing the progression of arthritis, advised SIR.