Early data show arterial embolization reduces knee pain and disability from osteoarthritis

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Sandeep Bagla

Geniculate artery embolization could improve quality of life for patients with knee pain due to osteoarthritis, according to new research presented at the Society of Interventional Radiology’s 2018 Annual Scientific Meeting (SIR; 17–22 March, Los Angeles, USA).

In the first US clinical trial involving geniculate artery embolization, a minimally invasive procedure that blocks key arteries in the knee to reduce inflammation and pain, a majority of study participants achieved significant pain reduction and improvements in range of motion, avoiding more invasive measures.

“A majority of our patients with osteoarthritis of the knee saw significant pain reduction, not only just a few days after the procedure, but a month after as well, making this an accessible treatment for patients looking to improve their quality of life without surgery,” said Sandeep Bagla, director of interventional radiology at the Vascular Institute of Virginia and lead author of the study. “We are very encouraged by the results and the implications for the millions suffering from this common, yet debilitating condition.”

This prospective, multicentre clinical trial evaluated 13 patients with severe osteoarthritis pain. Each patient’s pain and disability were measured along two scales, with evaluations before and after the treatment. The treatment was successfully completed in all 13 patients, with no adverse events. One month later, researchers followed the progress of eight patients and found that embolization significantly decreased pain (-58mm on the Visual Analog Scale), reduced stiffness and increased physical function (-36.3 on the Western Ontario and McMaster University Osteoarthritis Index). Together the scales represent an 80% improvement in function compared with preprocedure conditions.

“This procedure could have a significant impact in the treatment of osteoarthritis pain as a whole,” said Bagla. “The current mainstay of treatment in patients who have arthritis is pain medication, which comes with significant side-effects and risks. But geniculate artery embolization provides another option for patients struggling with pain and may even allow patients to avoid the painful recovery of knee surgery and the need for the kind of opioid pain medications associated with the dangerous epidemic in the USA.”

This study builds on the growing international research around geniculate artery embolization and osteoarthritis. While preliminary data shows that the treatment does work and is feasible, it has only been used in a clinical trial setting. The study has completed enrolment of 20 patients and final results are expected in summer 2018. A second randomised controlled clinical trial began in February 2018 and will provide further data on what types of patients are the best candidates for this treatment and how it could move toward clinical practice.

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