Genicular Artery Embolization Using Resorbable Gelatin Microspheres for Refractory Knee Pain: Technique, Safety and...

Area of Science:

• Interventional Radiology
• Orthopedic Surgery
• Pain Management

Background:

• Knee osteoarthritis (OA) and persistent pain after total knee replacement (TKR) significantly impact patient quality of life.
• Current treatment options for severe knee pain have limitations, necessitating novel therapeutic approaches.

Purpose of the Study:

• To assess the safety, technique, and clinical effectiveness of genicular artery embolization (GAE) using resorbable gelatin microspheres (RGM).
• To evaluate GAE in patients suffering from knee OA or chronic pain following TKR.

Main Methods:

• A prospective observational study included 45 patients with knee OA or post-TKR pain.
• GAE was performed using 100-300 µm RGM, with embolic volume and treated vessels documented.
• Clinical outcomes were measured using KOOS and NRS scores, alongside psychological screening (HADS) at multiple time points.

Main Results:

• Significant improvements in pain (NRS by 35%) and function (KOOS pain by 55%) were observed at 6 months (p < 0.001).
• Higher embolic volumes were required for advanced OA and post-TKR cases.
• Patients with elevated anxiety/depression scores (HADS ≥ 8) showed diminished clinical benefits.

Conclusions:

• GAE with RGM is a safe and effective short-term treatment for knee OA and post-TKR pain.
• Embolic volume correlates with OA severity and post-TKR status.
• Psychological comorbidities may influence treatment outcomes, warranting consideration in patient selection.