Genicular Artery Embolization for Knee Joint Osteoarthritis: A Systematic Review

Purpose: The purpose of this study was to perform a systematic review of current literature depicting the safety and efficacy outcomes of genicular artery embolization (GAE) for knee joint osteoarthritis (OA).

Materials and Methods: A structured search was performed in the PubMed.gov, Cochrane Central Register of Controlled Trials (CENTRAL), and ScienceDirect databases. Demographic data, procedure data (including embolic agents used and adverse events), and technical and clinical success were recorded. Where available, Kellgren-Lawrence (KL) grade, Western Ontario and McMaster Universities Arthritis Index (WOMAC) score, and Visual Analogue Scale (VAS) score were extracted. This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines.

Results: Twelve studies (including one randomized clinical trial and two retrospective studies) were included with a total number of patients of 301. All included studies demonstrated 100% technical success, except one that showed 84% success. Clinical success was variable, ranging between 53- 100% at three to twelve months. Studies reported a decrease in most conservative options utilization post-procedure. The most common sequelae post-GAE were transient cutaneous erythema (n = 22, 7.3%) and access-site hematomas/subcutaneous hemorrhage (n = 22, 7.3%).

Conclusion:

GAE is a minimally invasive therapeutic option for refractory knee OA with the potential to be the future standard of care prior to TKA. Well-designed future studies will assist in identifying the population which would benefit the most from the procedure.