Radiologists as clinicians: Radiological interventions for knee osteoarthritis.

Knee osteoarthritis is often treated surgically (knee joint replacement) or non-surgically (physiotherapy, pharmacological treatment). However, interventional radiologists can also offer a number of image-guided percutaneous therapies, including pharmacological treatments (intra-articular steroid, local anesthetic, and hyaluronic acid injections), biological options (platelet-rich plasma or mesenchymal stem cell injections), and newer nonpharmacological therapies (neuroablation, neuromodulation, and genicular artery embolization). Intra-articular steroid injection is the most widely used radiologically guided therapy; it provides pain relief and can help confirm the joint as the source of pain. However, platelet-rich plasma injection may provide greater pain relief and functional improvement compared with other intra-articular injections. Mesenchymal stem cell injections may improve pain, function, and cartilage volume, but the therapy is still under clinical investigation. Neuroablation and neuromodulation achieve pain reduction by targeting the sensory nerves of the knee joint. Radiofrequency ablation has been shown to be more effective than intraarticular steroid injections at treating knee osteoarthritis pain and function. Potential advantages of neuromodulation over conventional radiofrequency ablation include less intraprocedural pain and lower risk of thermal damage to adjacent structures. Genicular artery embolization aims to downregulate inflammation and its downstream effects by altering synovial blood flow; it is considered a promising therapy for osteoarthritis-associated knee pain. [ABSTRACT FROM AUTHOR]