Transarterial Embolization for the Treatment of Symptomatic Hip Osteoarthritis

To evaluate the safety and clinical effectiveness of transarterial embolization (TAE) using temporary embolic agents in patients with symptomatic hip osteoarthritis (OA) refractory to conservative treatment.

This single-centre retrospective analysis included patients undergoing TAE between January 2023 and April 2025. Eligibility required ≥ 3 months of clinically and radiographically confirmed hip OA unresponsive to conservative therapy. Embolization was performed using rapidly resorbable gelatin microspheres or imipenem/cilastatin. Outcomes included technical success, adverse events, and patient-reported outcomes (numeric rating scale [NRS] pain; Hip Disability and Osteoarthritis Outcome Score [HOOS]) assessed at baseline and up to 12 months. Clinically meaningful improvement was defined using minimum clinically important difference (MCID) thresholds (≥ 2 points for NRS; ≥ 10 points for HOOS).

Forty-one patients (median age 65 years) underwent TAE with a technical success rate of 97.5% (40/41). The lateral circumflex femoral artery was embolized in all cases, with additional internal iliac branches treated in 27.5% (11/40). No major or moderate adverse events occurred; minor transient skin discoloration was observed in 7.3% (all after imipenem/cilastatin). Median NRS decreased from 7 to 4 at 12 months (p < .001), with significant improvement across all HOOS domains. MCID was achieved in 64.3% for NRS and 85-92% for HOOS. Two patients (4.9%) underwent total hip replacement.

TAE using temporary embolic agents was associated with sustained pain reduction and functional improvement at 12 months with a favourable safety profile.