Key Osteoarthritis Biomarkers: What Interventional Radiologists Performing Genicular Artery Embolization Need to...

Area of Science:

• Orthopedics and Sports Medicine
• Interventional Radiology
• Rheumatology

Background:

• Knee osteoarthritis (OA) is a leading cause of pain and disability.
• Genicular artery embolization (GAE) is an emerging treatment for knee OA refractory to conservative management.
• GAE's efficacy is linked to reduced synovitis and nerve ischemia, but patient selection remains a challenge due to variable outcomes.

Purpose of the Study:

• To review the pathophysiology of knee OA.
• To explore the role of radiographic, biochemical, and imaging biomarkers in evaluating GAE for knee OA.
• To discuss how novel OA phenotypes can aid in patient selection for GAE.

Main Methods:

• Literature review focusing on knee OA pathophysiology.
• Analysis of studies investigating genicular artery embolization (GAE) for knee OA.
• Examination of imaging modalities (MRI, radiography) and biomarkers for predicting GAE outcomes.

Main Results:

• Reduction in synovitis on contrast-enhanced MRI correlates with pain relief after GAE.
• Imaging features like cartilage defects, bone marrow lesions, and synovitis can predict symptomatic outcomes.
• Novel OA phenotypes (inflammatory, cartilage, bone, atrophic) show promise for optimizing patient selection.

Conclusions:

• GAE is a viable option for select knee OA patients.
• Biomarkers, particularly imaging-based ones and OA phenotypes, are crucial for improving patient selection and predicting GAE success.
• Further research into imaging and molecular biomarkers will refine GAE treatment strategies for knee OA.