Genicular Artery Embolization using an Ethiodized Oil-based Emulsion in Fifty Knees: 12-Month Results

The purpose of the study was to evaluate the mid-term efficacy of genicular artery embolization (GAE) using an ethiodized oil-based emulsion for the treatment of symptomatic knee osteoarthritis.

This was a single-arm, open-label, single-center, prospective cohort study. Inclusion criteria were GAE using an ethiodized oil-based emulsion for primary knee osteoarthritis. Exclusion criteria were absence of available follow-up longer than 3 months. Clinical efficacy was assessed using the Visual Analog Scale (VAS) pain score and the Western Ontario & McMaster Universities Osteoarthritis Index (WOMAC) scores.

Fifty consecutive GAEs in 46 patients (mean age, 67.4 years ± 9.8) with Kellgren-Lawrence grade from 2 to 4 knee osteoarthritis were included between March 2021 and November 2023. Technical success rate was 100%. No patient experienced complication in the target knee. Mean VAS pain score improved significantly from 71.8 mm ± 16.6 (Standard Deviation [SD]) at baseline to 36.8 mm ± 25.9 at 6 months (n = 41; p < 0.001) and to 37.8 mm ± 26.7 at 12 months (n = 37; p < 0.01). Mean WOMAC index score decreased significantly from 52.7 ± 17.6 at baseline to 30.9 ± 21.8 at 6 months (n = 37; p < 0.001) and to 29.0 ± 20.5 at 12 months (n = 33; p < 0.001). At 12 months, 45.9% (17/37) of the participants reached an acceptable symptom state defined by a VAS pain score < 32.3 mm.

Genicular artery embolization for symptomatic knee osteoarthritis using an ethiodized oil-based emulsion is safe and improves pain and function with a sustained efficacy at 12 months.