Transcatheter Arterial Embolization Studied as a Treatment for Knee Osteoarthritis

July 14, 2014—Transcatheter arterial embolization as a treatment for mild to moderate knee osteoarthritis was feasible, rapidly relieved resistant pain, and restored knee function, according to a study published by Yuji Okuno, MD, et al online ahead of print in Cardiovascular and Interventional Radiology. Dr. Okuno is from the Department of Orthopedic Surgery at Edogawa Hospital in Tokyo, Japan. 

According to the investigators, the background of the study is that osteoarthritis is a common cause of pain and disability. Mild to moderate knee osteoarthritis that is resistant to nonsurgical options and not severe enough to warrant joint replacement represents a challenge in its management. On the basis of the hypothesis that neovessels and accompanying nerves are possible sources of pain, previous work demonstrated that transcatheter arterial embolization for chronic painful conditions resulted in excellent pain relief.

In this study, the investigators hypothesized that transcatheter arterial embolization can relieve pain associated with knee osteoarthritis.

As summarized in Cardiovascular and Interventional Radiology, transcatheter arterial embolization for mild to moderate knee osteoarthritis was performed in 11 patients using imipenem/cilastatin sodium as an embolic agent and in three patients using 75-μm calibrated Embozene microspheres (CeloNova BioSciences) as an embolic agent. The investigators assessed adverse events and changes in Western Ontario and McMaster University Osteoarthritis Index (WOMAC) scores.

The investigators found that abnormal neovessels were identified within soft tissue surrounding the knee joint in all cases by arteriography. No major adverse events were reported in relation to the procedures. Transcatheter arterial embolization rapidly improved WOMAC pain scores from 12.2 ± 1.9 to 3.3 ± 2.1 at 1 month after the procedure, with further improvement at 4 months (1.7 ± 2.2) and WOMAC total scores from 47.3 ± 5.8 to 11.6 ± 5.4 at 1 month and to 6.3 ± 6 at 4 months. These improvements were maintained in most cases at the final follow-up examination at a mean of 12 ± 5 months (range, 4–19 months), reported the investigators in Cardiovascular and Interventional Radiology.