Knee osteoarthritis is one of the most common causes of pain and disability in older adults. It develops when the protective cartilage that cushions the ends of bones slowly wears away.
As the cartilage becomes thinner, bones rub against each other, causing pain, stiffness, swelling, and difficulty walking. Many people begin with exercise, weight management, pain medicines, or physical therapy.
Some receive steroid injections. When these treatments stop working, many patients eventually need a total knee replacement. However, not everyone is ready for major surgery or is healthy enough to have it.
Doctors at the University of Colorado Anschutz School of Medicine are highlighting a newer option called genicular artery embolization, or GAE. Although this report is not a clinical trial itself, it describes encouraging patient experiences and ongoing research into the procedure.
GAE has been studied in several research projects, and long-term findings from Japan together with newer U.S. studies suggest that pain relief may last for years in many patients.
GAE is performed by an interventional radiologist. Instead of replacing the knee joint, the procedure reduces blood flow to tiny abnormal blood vessels that develop around inflamed areas of the knee.
Researchers believe these blood vessels help maintain inflammation and pain. By blocking them with microscopic particles, inflammation may decrease and symptoms may improve.
The treatment usually takes one to two hours under conscious sedation. Doctors make a very small incision near the upper leg and guide a thin catheter through the femoral artery using X-ray imaging.
Once the catheter reaches the small arteries supplying the inflamed parts of the knee, tiny beads are released to block selected blood vessels. Patients are monitored for several hours before returning home the same day.
According to Dr. Leigh Casadaban, many of the best results are seen in people with mild to moderate osteoarthritis who have not found relief from conservative treatments but are not yet ready for knee replacement. About seventy percent of patients experience major pain improvement, with some reporting little or no pain after treatment.
The procedure began in Japan a little over ten years ago and has expanded internationally. Studies from Japan suggest pain relief can last up to four years after a single procedure, while U.S. research has reported benefits lasting at least two years in patients who respond well.
Researchers continue to study exactly how GAE works and which patients benefit the most. Clinical trials at the University of Colorado are investigating changes inside the knee after treatment and testing new temporary embolization devices.
Although these early findings are encouraging, GAE is not suitable for everyone. The evidence continues to grow, but larger long-term studies comparing GAE directly with standard treatments are still needed.
Patients should discuss all treatment options with their healthcare providers. Overall, GAE appears to offer an important middle option between conservative care and knee replacement for selected patients.
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Source: University of Colorado Anschutz School of Medicine.
