Genicular Artery Embolization Brings Lasting Relief for Knee Osteoarthritis Pain

Medical Notice: Genicular artery embolization (GAE) is a minimally invasive procedure performed by interventional radiologists. Like any procedure, it carries risks, and it is not appropriate for everyone with knee pain. Its availability and regulatory status vary by country; in some places it is offered mainly through clinical studies. The results described here come from one center and one year of follow-up. This content is for general information only and is not medical advice. Discuss your treatment options with your physician, an orthopedic surgeon, and an interventional radiologist.

Dr. Flechenstein

Dr. Flechenstein

Dr. med. Florian Nima Fleckenstein, MD
Board Certified Radiologist | Specialist Interventional Radiology | BIH Clinician Scientist
Deputy Head of IR Campus Mitte
Coordinator IASIOS Accreditation
Department of Radiology
Berlin Institute of Health (BIH)
Charité – Universitätsmedizin Berlin

 

PainRelief.com: What is the background for this study? What are the main findings?

Response: Knee osteoarthritis, the most common form of knee arthritis, is a leading cause of chronic pain and loss of mobility worldwide. Many patients reach the point where painkillers, physical therapy and joint injections no longer bring enough relief, but knee replacement surgery still feels too early or just isn’t the right path for them. For this very large group, there have been few good options so far.

Genicular artery embolization, or GAE for short, is a minimally invasive, non-surgical procedure designed for exactly this situation. Through a very small puncture in the groin, we guide tiny catheters to the small arteries that feed the inflamed areas of the knee and block them. Reducing this abnormal blood flow calms the inflammation that drives osteoarthritis pain.

In our study, published in the journal Radiology, 194 patients were treated and followed for a full year. The results were very encouraging. On a scale from 0 to 10, average pain fell from 7 before treatment to 3 after one year. Between 55 and 80 percent of patients reported meaningful improvements not only in pain, but also in daily activities, sports and quality of life. Side effects were mild and short-lived in about 7 percent of cases, usually just some temporary skin discoloration. No serious complications occurred.

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Opioids Associated with Higher Risk of Mortality in Patients with Kidney Disease and Chronic Pain

PainRelief.com Interview with:
Satya Surbhi, PhD
Assistant Professor, Division of General Internal Medicine, Department of Medicine
and Center for Health System Improvement, College of Medicine
Director of Measurement and Reporting, Tennessee Population Health Consortium
University of Tennessee Health Science Center

PainRelief.com: What is the background for this study?

Response: Pain is highly prevalent among individuals with chronic kidney disease (CKD), in whom commonly utilized analgesics such as non-steroidal anti-inflammatory drugs (NSAIDs) are often contraindicated. Opioids can be an alternative means of analgesia in patients with CKD, but they are associated with numerous unwanted adverse effects and current efforts are aimed at curbing opioid use in general, which leaves patients with few choices for analgesia. Non-opioid non-NSAID analgesics (e.g., gabapentin, acetaminophen, antipyrine) represent potential alternative choices, but their long-term outcomes in CKD compared to opioids are unknown.    

The objectives of this study were to

1) compare the association of chronic opioid vs. non-opioid analgesics with end-stage kidney disease (ESKD) and all-cause mortality among patients with CKD and chronic pain and

2) to examine the heterogeneity of treatment effects on outcomes by factors including age, sex, race, smoking status, BMI, cancer, eGFR and UACR levels, benzodiazepine use, and opioid/non-opioid prescription year. 

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