Keywords
knee joint
transcatheter arterial embolization
WOMAC
pain
Categories
How to Cite
Abstract
Objectives: To evaluate the effectiveness of our first experience in employing transcathether arterial embolization (TAE) of popliteal artery branches in patients with knee osteoarthritis (OA). Materials and methods: The research included 80 people with knee OA grades 1-2, resistant to standard conservative treatment and without indications for surgical intervention. The patients were divided into 2 groups of 40 people each; in group 1, intra-articular injection of sodium hyaluronate (synovial fluid prosthesis) was chosen as minimally invasive therapy; in group 2, TAE of popliteal artery branches was performed. Clinical and functional characteristics of joints were assessed using WOMAC and Lysholm scales at baseline and 3 months after intervention. Results: Before surgery, in both groups 1 and 2, high levels of WOMAC scale (150 [138-184] and 162 [140-190] points, respectively) and low levels of Lysholm scale (42 [35-54] and 40 [38- 60] points, respectively) were recorded. At 3 months after treatment, patients of both groups demonstrated significant improvement in clinical and functional results in the form of decrease in WOMAC scale to 94 [84-120] for group 1, p<0.001; and 52 [40-79] points for group 2, p< 0.001. According to Lysholm scale, satisfactory results were obtained in group 1 (68 [60-85] points, p = 0.001) and good results in group 2 (91 [85-95] points, p < 0.001). On comparison of both groups, patients with TAE achieved lower values of WOMAC (p = 0.023) and higher values of Lysholm scale (p = 0.06). No complications were recorded in both groups. Conclusion: TAE of popliteal artery branches is an effective minimally invasive intervention that significantly reduces severity of pain and improves the function of knee joints. This method requires more studies with larger number of patients, development of selection criteria in order to increase accessibility in practical healthcare.
References
1. GBD 2021 Osteoarthritis Collaborators. Global, regional, and national burden of osteoarthritis, 1990-2020 and projections to 2050: a systematic analysis for the Global Burden of Disease Study 2021. Lancet Rheumatol. 2023 Aug 21;5(9):e508-e522. doi: 10.1016/S2665-9913(23)00163-7.
2. Driban JB, Harkey MS, Liu SH, et al. Osteoarthritis and aging: young adults with osteoarthritis. Curr Epidemiol Rep. 2020; 7(1):9–15.
3. Moseng T, Vliet Vlieland TPM, Battista S, et al. EULAR recommendations for the non-pharmacological core management of hip and knee osteoarthritis: 2023 update. Ann Rheum Dis. 2024 Jan 11:ard-2023-225041. doi: 10.1136/ard-2023-225041.
4. Bannuru RR, Osani MC, Vaysbrot EE, et al. OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis Cartilage. 2019 Nov;27(11):1578-1589. doi: 10.1016/j.joca.2019.06.011.
5. Taskina EA, Alekseeva LI, Kashevarova NG, et al. Multimorbidity in osteoarthritis. Nauchno-Prakticheskaya Revmatologia = Rheumatology Science and Practice. 2022;60(3):306–313 (In Russ.). doi: 10.47360/1995-4484-2022-306-313
6. Filippiadis D, Charalampopoulos G, Mazioti A, et al. Interventional radiology techniques for pain reduction and mobility improvement in patients with knee osteoarthritis. Diagn Interv Imaging. 2019 Jul-Aug;100(7-8):391-400. doi: 10.1016/j.diii.2019.02.011.
7. Goldring MB, Otero M. Inflammation in osteoarthritis. Curr Opin Rheumatol. 2011;23(5):471-478. doi:10.1097/BOR.0b013e328349c2b1
8. Mapp, P., Walsh, D. Mechanisms and targets of angiogenesis and nerve growth in osteoarthritis. Nat Rev Rheumatol 2012; 8: 390–398. https://doi.org/10.1038/nrrheum.2012.80
9. Walsh DA, Bonnet CS, Turner EL, et al. Angiogenesis in the synovium and at the osteochondral junction in osteoarthritis. Osteoarthritis Cartilage. 2007;15(7):743-751. doi:10.1016/j.joca.2007.01.020
10. Mapp PI, Avery PS, McWilliams DF, et al. Angiogenesis in two animal models of osteoarthritis. Osteoarthritis Cartilage. 2008; 16(1): 61-69. doi:10.1016/j.joca.2007.05.017
11. Okuno Y, Korchi AM, Shinjo T, et al. Transcatheter Arterial Embolization as a Treatment for Medial Knee Pain in Patients with Mild to Moderate Osteoarthritis. Cardiovasc Intervent Radiol. 2015; 38: 336–343. doi:10.1007/s00270-014-0944-8
12. Bagla S, Piechowiak R, Hartman T, et al. Genicular Artery Embolization for the Treatment of Knee Pain Secondary to Osteoarthritis. J Vasc Interv Radiol. 2020 Jul;31(7):1096-1102, doi: 10.1016/j.jvir.2019.09.018
13. Landers S, Hely R, Page R, et al. Genicular Artery Embolization to Improve Pain and Function in Early-Stage Knee Osteoarthritis-24-Month Pilot Study Results. J Vasc Interv Radiol. 2020; 31(9): 1453-1458. doi:10.1016/j.jvir.2020.05.007
14. Lauko K, Tangchaiburana S, Padia S. Transarterial genicular artery embolization as treatment of painful knee osteoarthritis in a 64-year-old woman. J Radiol Nurs. 2020; 39: 89–91. doi: 10.1016/j.jradnu.2020.02.002
15. Little MW, Gibson M, Briggs J, et al. Genicular artery embolization in patients with osteoarthritis of the knee (GENESIS) Using Permanent Microspheres: Interim Analysis. Cardiovasc Intervent Radiol 2021; 44: 931–940. doi:10.1007/s00270-020-02764-3
16. Casadaban LC, Mandell JC, Epelboym Y. Genicular Artery Embolization for Osteoarthritis Related Knee Pain: A Systematic Review and Qualitative Analysis of Clinical Outcomes. Cardiovascular and interventional radiology. 2021; 44(1): 1-9. doi:10.1007/s00270-020-02687-z
17. Kozadaev MN., Shchanitsyn IN., Girkalo MV, et al. [Management of Chronic Pain Syndrome in Knee Osteoarthritis with Selective Embolization of Popliteal Artery Branches: Review]. Travmatologiya i ortopediya Rossii [Traumatology and Orthopedics of Russia]. 2020;26(4):163-174. (In Russian). doi: 10.21823/2311-2905-2020-26-4-163-174
This work is licensed under a Creative Commons Attribution 4.0 International License.