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Genicular Artery Embolization as a Treatment for Osteoarthritis Related Knee Pain: A Systematic Review and Meta-analysis

  • Scientific Paper (Other)
  • Musculoskeletal Interventions
  • Published:
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Abstract

Objective

Genicular artery embolization (GAE) is a minimally invasive therapy for symptomatic osteoarthritis (OA) in patients with knee pain refractory to conservative management. The purpose of this study was to evaluate evidence on the effectiveness of GAE for OA related knee pain as part of a systematic review and meta-analysis.

Materials and Methods

Using Embase, PubMed, and Web of Science, a systematic review was performed to identify studies evaluating treatment of knee OA with GAE. The primary outcome measure was change in pain scale score at 6 months. A Hedge’s g was computed as a measure of effect size, selecting Visual Analog Scale (VAS) first if available and Knee Injury and Osteoarthritis Outcome Score and Western Ontario and McMaster Universities Osteoarthritis Index if VAS was not available.

Results

After screening titles, abstracts, and the full text, 10 studies met inclusion criteria. A total of 351 treated knees were included. Patients who underwent GAE demonstrated declines in VAS pain scores at 1 month {− 34 points [95% CI (− 43.8, − 24.6)], 3 months {− 30 points [95% CI (− 41.7, − 19.2)], 6 months {− 41 points [95% CI (− 54.0, − 27.2)], and 12 months {− 37 points [95% CI (− 55.0, − 18.1)]. Hedges’ g from baseline to 1, 3, 6, and 12 months, was {− 1.3 [95% CI (− 1.6, − 0.97)]}, {− 1.2 [95% CI (− 1.54, − 0.84)]}, {− 1.4 [95% CI (− 2.1, − 0.8)]}, and {− 1.25 [95% CI (− 2.0, − 0.6)]}, respectively.

Conclusion

GAE provides durable reductions in pain scores for patients suffering with mild, moderate, and severe OA.

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Funding

This study was not supported by any funding.

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Authors and Affiliations

  1. Division of Angiography and Interventional Radiology, Department of Radiology, Brigham and Women’s Hospital, Boston, MA, 02115, USA

    Yan Epelboym, Ezra Burch & Timothy Killoran

  2. Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Jacob C. Mandell & Tina Shiang

  3. Department of Orthopaedic Surgery, Brigham and Women’s Hospital, Boston, MA, USA

    Jamie E. Collins

  4. Division of Rheumatology, Inflammation, and Immunity, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, 02115, USA

    Lindsey Macfarlane

  5. Department of Radiology, Boston University School of Medicine, 820 Harrison Avenue, FGH Building, 3rd Floor, Boston, MA, 02118, USA

    Ali Guermazi

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Correspondence to Yan Epelboym.

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Conflict of interest

Y.E. has received consultancies from Boston Imaging Core Lab (BICL). A.G. has received consultancies, speaking fees, and/or honoraria from Novartis, Pfizer, AstraZeneca, Regeneron, Merck Serono, and is a shareholder of BICL. None of the other authors have declared any competing interests.

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Epelboym, Y., Mandell, J.C., Collins, J.E. et al. Genicular Artery Embolization as a Treatment for Osteoarthritis Related Knee Pain: A Systematic Review and Meta-analysis. Cardiovasc Intervent Radiol 46, 760–769 (2023). https://doi.org/10.1007/s00270-023-03422-0

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