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Genicular Artery embolisation in Patients with Osteoarthritis of the Knee (GENESIS) Using Permanent Microspheres: Long-Term Results.

Authors :
Little MW
O'Grady A
Briggs J
Gibson M
Speirs A
Al-Rekabi A
Yoong P
Ariyanayagam T
Davies N
Tayton E
Tavares S
MacGill S
McLaren C
Harrison R
Source :
Cardiovascular and interventional radiology [Cardiovasc Intervent Radiol] 2024 May 31. Date of Electronic Publication: 2024 May 31.
Publication Year :
2024
Publisher :
Ahead of Print

Abstract

Purpose: To report the 2-year follow-up of patients with mild-to-moderate knee osteoarthritis (OA) treated with genicular artery embolisation (GAE) as part of the GENESIS study.<br />Materials and Methods: Forty-six patients, median age = 60 (45-83) underwent GAE using permanent microspheres (100-300 μm). Technical success was defined as embolisation of the targeted genicular arteries. Knee Injury and Osteoarthritis Outcome Score (KOOS) and Visual Analogue Scale (VAS) (0-100 mm) were recorded at baseline, 6 weeks, 3 months, 1, 2 years. Contrast-enhanced MRI knee scans were acquired at baseline and 1 year, and evaluated with the Whole-Organ Magnetic Resonance Imaging Score (WORMS). Functional MRI brain imaging and psychometric assessments were undertaken to investigate correlation between neuropsychological phenotypes and clinical outcome. Adverse events were recorded prospectively.<br />Results: Technical success was achieved in forty patients (87%). Mean VAS improved from 58.63 (SD = 20.57, 95% CI 52.7-65.5) at baselines to 37.7 at 2-years (SD = 26.3, 95% CI 27.0-47.5). Whole and subgroup KOOS were significantly improved at each timepoint with associated reductions in analgesia usage. WORMS analysis demonstrated significant reduction in synovitis (p < 0.05) with no cases of osteonecrosis. Self-limiting skin discolouration occurred in four patients. A self-limiting groin haematoma and single case of deep-vein thrombosis due to immobilisation were also recorded. Nine patients subsequently underwent knee arthroplasty with no additional operational complexities identified. Neuropsychometric assessment elucidated a correlation between baseline catastrophising and greater reduction in pain post GAE.<br />Conclusion: GAE is a safe intervention for mild-moderate knee osteoarthritis, with sustained efficacy at 2 years. These results are promising and justify ongoing controlled trials.<br /> (© 2024. The Author(s).)

Details

Language :
English
ISSN :
1432-086X
Database :
MEDLINE
Journal :
Cardiovascular and interventional radiology
Publication Type :
Academic Journal
Accession number :
38819473
Full Text :
https://doi.org/10.1007/s00270-024-03752-7