A Minimally Invasive Treatment Reduces Knee Pain and Disability from OA, Study Finds
A non-surgical treatment could improve quality of life for patients with knee pain due to osteoarthritis, according to the preliminary results of a small study presented at the Society of Interventional Radiology’s 2018 Annual Scientific Meeting.
In the first US clinical trial, use of geniculate artery embolization (GAE) resulted in most study participants achieving significant pain reduction and improvements in range of motion and avoiding more-invasive measures. GAE is a minimally invasive, image-guided treatment that blocks key arteries in the knee to reduce inflammation and pain.
“A majority of our patients with osteoarthritis of the knee saw 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,” said Sandeep Bagla, MD, director of interventional radiology at the Vascular Institute of Virginia and lead author of the study.
“We are very encouraged by the results and the implications for the millions suffering from this common, yet debilitating condition.”
Interventional radiologists perform GAE for knee pain by inserting catheters through a pinhole-sized incision, blocking the very small arteries or capillaries within the lining of the knee and reducing the inflammation caused by osteoarthritis. As an outpatient treatment, GAE does not require open surgery or physical therapy, and it takes 45 to 90 minutes to perform.
This prospective, multicenter clinical trial evaluated 13 patients with severe osteoarthritis pain. Pain and disability were measured along 2 scales, with evaluations before and after the treatment. The treatment was successfully completed in all 13 patients, with no adverse events.
One month later, researchers followed the progress of 8 patients and found that GAE significantly decreased pain (-58 mm on the Visual Analog Scale), reduced stiffness, and increased physical function (-36.3 on the Western Ontario and McMaster University Osteoarthritis Index). Together, the scales represented an 80% improvement in function compared with pre-procedure conditions.
“This procedure could have a significant impact in the treatment of osteoarthritis pain as a whole,” Dr. Bagla said. “The current mainstay of treatment in patients who have arthritis are pain medications, which come with significant side effects and risks.
“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 medications associated with the dangerous epidemic in the United States.”
This study builds on the growing international research around GAE and osteoarthritis. Although preliminary data show that the treatment works and is feasible, it has only been used in a clinical trial setting.
The study presented at the Society of Interventional Radiology meeting has completed enrollment of 20 patients, with final results expected in summer 2018.
A second randomized controlled clinical trial began in February 2018 and will provide further data on what types of patients are the best candidates for this treatment and how it could move toward clinical practice.
Bagla S, Piechowiak R, Hartman T, Orlando J, Isaacson A. Geniculate Artery Embolization (GAE) for Osteoarthritis (OA)-related Knee Pain: Interim Results from a Multicenter US Trial (Abstract 210. Presented at the 2018 Annual Scientific Meeting of the Society of Interventional Radiology, March 17-22, 2018, Los Angeles, California.