Periarticular artery embolization as a minimally invasive treatment for pain in osteoarthritis

Osteoarthritis (OA) is a leading cause of chronic pain and disability worldwide, affecting approximately 607 million people in 2021, with projections exceeding 1.1 billion by 2050. The knee is the most commonly affected joint and many patients experience inadequate symptom relief with conservative management or are not candidates for total knee arthroplasty. Periarticular arterial embolization, particularly genicular artery embolization (GAE), has emerged as a minimally invasive treatment targeting pathological neovascularization and synovial inflammation in OA pathogenesis. This review aims to synthesize current evidence on the use of periarticular embolization in the treatment of OA across multiple joints including the knee, hip, shoulder, hand and temporomandibular joint (TMJ). A comprehensive literature review was conducted examining clinical studies, systematic reviews and meta-analyses evaluating periarticular artery embolization for OA treatment. Periarticular artery embolization represents a promising minimally invasive treatment option for patients with mild-to-moderate OA who have failed conservative therapy. It demonstrates high technical success rates (approaching 100%) with favourable safety profiles for knee OA, with emerging applications in other joints. However, standardized procedural protocols, long-term outcome data and multicenter randomized control trials are needed to definitively establish its role in OA treatment and optimize patient selection criteria.