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Purpose <p>To develop expert-consensus recommendations for patient selection, technique and clinical management in genicular artery embolization (GAE) using a Delphi process.</p> Materials and Methods <p>A working group developed a 75-statement questionnaire. A panel of musculoskeletal and interventional radiologists (IRs), selected based on clinical experience, scientific expertise and geographic diversity, scored each response using a 10-point Likert-scale across three rounds. Consensus was predefined as ≥ 75% of ratings ≥ 7/10.</p> Results <p>Twenty-nine IRs completed all three rounds. Consensus inclusion criteria for GAE include knee pain refractory to conservative treatment for ≥ 3&#xa0;months due to osteoarthritis, tendinopathies or prior knee surgery and recurrent hemarthrosis (median 9[IQR 7–10]; 86% ≥ 7). Pre-procedural assessment should include standardized outcome measures, clinical examination and knee radiographs. Contrast-enhanced MRI is optional for osteoarthritis phenotyping and grading of synovitis, differential diagnosis and outcome prediction (8[7–10]; 79% ≥ 7). Via an ipsilateral antegrade transfemoral access, all visible genicular arteries should be catheterized and embolized upon detection of a hypervascular blush (9[7–10]; 76% ≥ 7). No evidence of superiority of either temporary or permanent embolic agents in terms of safety or efficacy has been demonstrated (10[8–10]; 86% ≥ 7). Structured long-term follow-up is recommended, with clinical success defined as achievement of the minimal clinically important difference or individual patient satisfaction (9[7–10]; 83% ≥ 7). Contralateral or repeat GAE may be considered for bilateral knee pain, insufficient response or pain recurrence (8[7–10]; 76% ≥ 7).</p> Conclusion <p>This Delphi study establishes expert-derived consensus recommendations for GAE, emphasizing broad indications, patient-tailored technique and an active role of the IR in multidisciplinary longitudinal care.</p> Graphic Abstract <p></p>

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Genicular Artery Embolization for Chronic Knee Pain: Expert Consensus Recommendations on Indications, Technique and Clinical Care Using a Delphi Process

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月22日

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  • A. Taheri Amin,
  • J. Golzarian,
  • K. Abd El Tawab,
  • L. Abu-Gharbieh,
  • O. Ahmed,
  • A. Assis,
  • S. A. Astani,
  • CA. Binkert,
  • F. Carnevale,
  • F. Cavalheiro,
  • F. Collettini,
  • M. P. Correa,
  • A. Dablan,
  • K. Damodharan,
  • Y. Epelboym,
  • A. M. Fernández,
  • D. Filippiadis,
  • G. S. Goh,
  • A. Guermazi,
  • Z. Haskal,
  • A. M. Ierardi,
  • M. Katoh,
  • M. Little,
  • Y. Okuno,
  • S. Padia,
  • N. Rostambeigi,
  • M. Sapoval,
  • B. Taslakian,
  • R. Uberoi,
  • H. Vieweg,
  • F. Ziayee,
  • P. Minko

摘要

Purpose

To develop expert-consensus recommendations for patient selection, technique and clinical management in genicular artery embolization (GAE) using a Delphi process.

Materials and Methods

A working group developed a 75-statement questionnaire. A panel of musculoskeletal and interventional radiologists (IRs), selected based on clinical experience, scientific expertise and geographic diversity, scored each response using a 10-point Likert-scale across three rounds. Consensus was predefined as ≥ 75% of ratings ≥ 7/10.

Results

Twenty-nine IRs completed all three rounds. Consensus inclusion criteria for GAE include knee pain refractory to conservative treatment for ≥ 3 months due to osteoarthritis, tendinopathies or prior knee surgery and recurrent hemarthrosis (median 9[IQR 7–10]; 86% ≥ 7). Pre-procedural assessment should include standardized outcome measures, clinical examination and knee radiographs. Contrast-enhanced MRI is optional for osteoarthritis phenotyping and grading of synovitis, differential diagnosis and outcome prediction (8[7–10]; 79% ≥ 7). Via an ipsilateral antegrade transfemoral access, all visible genicular arteries should be catheterized and embolized upon detection of a hypervascular blush (9[7–10]; 76% ≥ 7). No evidence of superiority of either temporary or permanent embolic agents in terms of safety or efficacy has been demonstrated (10[8–10]; 86% ≥ 7). Structured long-term follow-up is recommended, with clinical success defined as achievement of the minimal clinically important difference or individual patient satisfaction (9[7–10]; 83% ≥ 7). Contralateral or repeat GAE may be considered for bilateral knee pain, insufficient response or pain recurrence (8[7–10]; 76% ≥ 7).

Conclusion

This Delphi study establishes expert-derived consensus recommendations for GAE, emphasizing broad indications, patient-tailored technique and an active role of the IR in multidisciplinary longitudinal care.

Graphic Abstract