Nonsurgical treatment could safely alleviate OA knee pain, rigidity
Geniculate artery embolization resulted in significant knee-osteoarthritis pain reduction and improvements in patients’ range of motion, according to interim results presented at the 2018 Society of Interventional Radiology annual meeting in Los Angeles.
“A majority of our patients with osteoarthritis (OA) of the knee saw a significant pain reduction, not only just a few days after the procedure, but a month after as well, making this an accessible treatment for patients looking to improve their quality of life without surgery,” Sandeep Bagla, MD, of the Vascular Institute of Virginia, who presented the findings, said in a press release. “We are very encouraged by the results and the implications for the millions suffering from this common, yet debilitating, condition.”
In geniculate artery embolization (GAE), an interventional radiologist inserts catheter through a small incision, which blocks the arteries within the knee lining and reduces inflammation caused by OA. According to the release, the procedure takes 45 to 90 minutes to perform and does not require any physical therapy. It has so far only been used in clinical trial settings.
Following reports of the success of GAE in international settings, Bagla and colleagues evaluated the treatment’s efficacy and safety in a prospective, multicenter trial based in the United States. The researchers recruited 13 patients with severe OA knee pain, defined as pain greater than 50 mm on the Visual Analog Scale (VAS), who had not responded to conservative treatment.
Each of the 13 patients underwent GAE with 75 or 100 microspheres at one of two centers. The researchers assessed patients using MRI and two disability scales — the VAS and the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) — both before and after the procedure. The researchers also recorded adverse events throughout the study. Among the participants, eight were eligible for the 1-month clinical follow-up.
According to the researchers, GAE was successfully performed in all 13 patients with no adverse events. Among the eight participants who were eligible for the 1-month follow-up, GAE significantly improved pain, as measured by VAS, in all cases (mean –58 mm; P = .016). WOMAC scores also decreased in all eight follow-up participants (mean –36.3; P = .0008).
According to the press release, the researchers’ final results are expected this summer. A second randomized, controlled clinical trial determining which patients make the best candidates for GAE, and how it could move toward clinical practice, began in February.
“This procedure could have a significant impact in the treatment of osteoarthritis pain as a whole,” Bagla said in the release. “The current mainstay of treatment in patients who have arthritis are pain medications, which come with significant side effects and risks. But GAE provides another option for patients struggling with pain and may even allow patients to avoid the painful recovery of knee surgery and the need for the kind of opioid pain medication associated with the dangerous epidemic in the United States.” – by Jason Laday
Disclosure: Bagla reports receiving consulting fees from Medtronic, Boston Scientific, Teleflex, Terumo and Merit, as well as research grants from Medtronic, Boston Scientific, Terumo, BTG and Renovo.
Bagla S, et al. Abstract 210, “Geniculate artery embolization (GAE) for osteoarthritis (OA)-related knee pain: interim results from a multicenter US trial.” Presented at: Society of Interventional Radiology annual meeting; March 19, 2018; Los Angeles.