Short-term effects of genicular artery embolization on symptoms and bone marrow abnormalities in patients with refractory knee osteoarthritis.

PURPOSE: To evaluate the short-term outcomes of genicular artery embolization (GAE) for knee osteoarthritis (OA) with and without bone marrow lesion (BML) and/or subchondral insufficiency fracture of the knee (SIFK).

METHODS: This single-institution prospective observational pilot study analyzed 24 knees in 22 patients with mild to moderate knee OA, including 8 knees without BML, 13 knees with BML, and 3 knees with both BML and SIFK. The area and volume of BMLs on MRI images were measured before and after GAE. Baseline and postoperative pain and physical function were assessed using the Visual Analog Scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC).

RESULTS: GAE significantly reduced BML area and volume 3 months after embolization in knees with BML (both P < 0.0005). GAE significantly decreased VAS scores at 3 and 6 months after embolization in patients without BML (both P = 0.04) and in those with BML (both P = 0.01). GAE also lowered WOMAC scores 3 months after embolization in patients without and with BML (P = 0.02 and 0.0002, respectively). However, GAE did not significantly alter BML area and volume (both P = 0.25), VAS score (P = 1.00) and WOMAC scores (P = 0.08) in patients with BML and SIFK at 3 months after GAE.

CONCLUSIONS: This observational pilot study suggested that GAE may effectively reduce BML and improve pain and physical function in patients with knee OA accompanied by BML, but may be inefficacious in those with both BML and SIFK.