Outcome and Safety of Genicular Artery Embolization for Knee Osteoarthritis: A Systematic Review and Meta-Analysis

This systematic review and meta-analysis evaluated pain and functional outcomes, safety, and differences between embolic agents in genicular artery embolization (GAE) for knee osteoarthritis. Forty-five studies including 2205 patients were analyzed. Across predominantly uncontrolled studies, clinically relevant improvements were observed, with pooled Visual Analogue Scale reductions of - 37.5 points at 1 month and - 37.1 at 12 months. Western Ontario and McMaster Universities Osteoarthritis Index improved by - 28.9 at 1 month, and Knee Injury and Osteoarthritis Outcome Score-Pain by + 23.6 at 6 months. Mean changes exceeded clinically important thresholds. No significant subgroup interaction between permanent and temporary embolic agents was observed. The most frequent adverse events were transient skin discoloration (11%) and hematoma (3%). Overall, the certainty of evidence ranged from very low to low.Graphical Abstract.