The first geniculate artery embolization (GAE) to take place in Europe to treat osteoarthritis pain in the knee has been performed by Mark Little at the Royal Berkshire Hospital in Reading, UK. Little is the lead investigator in the GENESIS study, investigating the use of GAE in UK patients.
A previous Japanese study found a 75% reduction in pain over a four-year period.
Currently in Europe, osteoarthritic patients are given painkillers, and knee-replacement surgery is conducted in severe cases. GAE is therefore posited as a potential minimally invasive alternative for patients with mild-to-moderate osteoarthritis pain for whom painkillers have not worked.
Little, who is leading the study, comments: “If the results of this study and future studies confirm the Japanese data, then geniculate artery embolisation is a potential game changer for the treatment of osteoarthritis. Performed under only local anaesthetic, the procedure takes about one hour and patients go home the same day. It is truly minimally invasive.
“If you can get patients off high-dose painkillers who are struggling with mobility and unable to work, it has a massive impact on their health and quality of life.”
The GENESIS study has funding from Merit Medical and support from the National Institute for Health Research (NIHR).
The patient response
The 65-year-old patient, Linda Skilton, underwent the procedure on 29 January, and reported positive results. Quoted in a press release from the Royal Berkshire NHS Foundation Trust, she says that before the procedure “I was having problems with my left knee; a lot of swelling, a lot of fluid, limited mobility.
“I was given cortisone injections, which made it settle for a while, but it flared up again a year later when I was using some equipment in the gym. For the past couple of years, I have not been able stand for too long because it got so sore and swollen and I could not keep it bent or straight for any length of time either, which made sleeping difficult.
She continues to describe the procedure: “I only felt the initial cut to get to the artery, which was no worse than a paper cut. I was expecting some feeling of pushing and pulling, but I did not feel anything at all.
“Since the procedure, I can feel day-to-day that my knee is improving. I can easily walk up the stairs for the first time in years. I am delighted with the outcome.”
Commenting specifically on this patient’s response to the procedure, Little says “Linda is clearly very active and if we can keep her playing golf, then that will have a profound impact on her social interactions with friends, improve her happiness, and wellbeing, and give her back her independence.”
You can read an article on this topic authored by Sandeep Bagla (The Vascular Institute of Virginia, Woodbridge, USA), the first to perform this procedure in the USA, here.