Knee Pain Relief by Emoblization of Joint Synovial Tissue What are the main findings?

Response: The main finding is that embolization or stopping blood flow to inflamed synovial tissue in the knee joint can significantly reduce knee pain due to osteoarthritis for at least 6 months. Embolization is a minimally invasive outpatient procedure performed through a catheter similar to heart catheterization. What should readers take away from your report?

Response: There is now evidence from US patients that reaffirms what we have already seen from Japanese and Korean populations—that embolization can reduce knee pain from osteoarthritis and is safe to perform. Additionally, this procedure can reduce the amount of daily medications that patients require—an important finding during the opioid crisis that we are now going through. What recommendations do you have for future research as a result of this work?

Response: With any new pain therapy, it will be important to determine if the therapy actually reduces pain, or we are just seeing a placebo effect. We are currently performing a study to examine this. It involves patients being randomized to receive the embolization procedure or a “sham” procedure. If the patient is assigned to the sham group, a procedure very similar to embolization is carried out, but no blood vessels are actually blocked. The patient does not know if they received the embolization or the sham. In this way, we are able to tease out how much of the improvement in pain is due to the therapy itself and how much is do to placebo effect. Is there anything else you would like to add?

Response: This type of treatment, embolization to treat joint pain, may be effective in other locations as well, such as the shoulder and elbow. There are currently trials ongoing looking at this.

My disclosures include being a speaker and consultant for Boston Scientific who sponsored the recently published study.


J Vasc Interv Radiol. 2019 Dec 11. pii: S1051-0443(19)30821-8. doi: 10.1016/j.jvir.2019.09.018. [Epub ahead of print]

Genicular Artery Embolization for the Treatment of Knee Pain Secondary to Osteoarthritis.
Bagla S1, Piechowiak R2, Hartman T3, Orlando J2, Del Gaizo D4, Isaacson A3.

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