Genicular Artery Embolization as a Treatment Option for Refractory Knee Pain Post Total Knee Arthroplasty: A Prospective Series
摘要
This study examines the efficacy of genicular artery embolization (GAE) as a treatment to reduce chronic knee pain in patients who have previously undergone total knee arthroplasty (TKA).
Materials and MethodsThirty-seven consecutive patients (13 men and 24 women) with a history of persistent pain for at least one year after TKA underwent GAE at a single center. The mean age across all patients was 72.8 ± 9.7 years, and the mean BMI was 29.3 ± 6.1 kg/m2. Imipenem cilastatin particles and/or microspheres were delivered through a microcatheter to the targeted arteries by a board-certified interventional cardiologist. Clinical success was determined by degree of improvement in patient response to the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Visual Analog Scale (VAS) pain questionnaires at one-month and three-month intervals following successful embolization of targeted arteries.
ResultsAmong 37 patients, WOMAC scores at the preliminary, one-month, and three-month follow-up appointments were 64% ± 6%, 39% ± 8%, and 36% ± 8%, respectively (95% CI). VAS scores were 8.1 ± 0.6, 3.2 ± 1.1, and 3.1 ± 1.0 (95% CI). A paired t-test showed a statistically significant improvement at both one-month and three-month post-procedure evaluations. (p < 0.05). Overall, 64.9% (n = 24) of patients achieved at least a 50% improvement in pain scores by the end of the study term.
ConclusionGAE shows efficacy as an adjunct treatment in patients with TKA and long-standing pain (> 1 year). Further research is needed to assess long-term outcomes and broader applicability.
Graphical Abstract