Our first paper looks at the intersection between musculoskeletal radiology and interventional (1).
Background:
This study looked to evaluate the effectiveness of genicular artery embolisation (GAE) in reducing synovitis in patients with knee osteoarthritis (OA). GAE is a minimally invasive procedure targeting arteries, aiming to decrease flow of pro-inflammatory mediators (2). These mediators can propagate further cartilage destruction leading to OA-related pain (3).
Methodology:
This was a retrospective, single-center observational study. The study included 33 patients who underwent GAE for knee osteoarthritis. The patients were selected based on specific criteria, including persistent knee pain despite conservative treatments and adequate imaging quality. The effectiveness of GAE was assessed using contrast-enhanced MRI to measure synovitis before the procedure and three months post-procedure. Pain and functional outcomes were measured using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and a visual analog scale (VAS).
Results:
Reduction in Synovitis: The study found a significant reduction in synovitis scores after GAE. The synovial contrast enhancement scores decreased significantly from a mean of 5.1 to 2.9 three months post-procedure.
Pain Relief Correlation: There was a moderate negative correlation between the reduction in synovial contrast enhancement scores and the decrease in VAS pain scores, suggesting that greater reductions in synovitis were associated with better pain relief.
Functional Improvement: Significant improvements were also noted in the WOMAC pain and total scores, indicating enhanced knee function and reduced pain post-GAE.
Subgroup Analysis: The study found that patients with higher pre-intervention synovitis scores experienced more significant pain relief post-GAE, particularly in specific knee regions (parapatellar and periligamentous areas).
Conclusions:
The study concluded that GAE is effective in reducing synovitis in patients with knee osteoarthritis, as evidenced by contrast-enhanced MRI. The reduction in synovitis was associated with decreased pain levels, suggesting that GAE could be a viable treatment option for managing inflammation and pain in knee OA.
The study calls for further research with larger, more diverse patient populations and longer follow-up periods to confirm the durability and broader applicability of these results.
Limitations:
Sample Size: The study had a relatively small sample size, which limits the generalizability of the results.
Study Design: The retrospective nature and the lack of a control group limit the ability to attribute observed outcomes solely to GAE.
Short Follow-Up: The three-month follow-up period may not fully capture the long-term effects of GAE on synovitis and pain.
References:
(1) Dablan, A., Erdim, Ç., Güzelbey, T., Cingöz, M., Arslan, M.F., Mutlu, İ.N. and Kılıçkesmez, Ö., 2024. Effectiveness of Genicular Artery Embolization for Reducing Synovitis As Assessed by Contrast-Enhanced MR Imaging in Knee Osteoarthritis: A Pilot Study. Journal of Vascular and Interventional Radiology.
(2) Torkian, P., Golzarian, J., Chalian, M., Clayton, A., Rahimi-Dehgolan, S., Tabibian, E. and Talaie, R., 2021. Osteoarthritis-related knee pain treated with genicular artery embolization: a systematic review and meta-analysis. Orthopaedic Journal of Sports Medicine, 9(7), p.23259671211021356.
(3) Bonnet, C.S. and Walsh, D.A., 2005. Osteoarthritis, angiogenesis and inflammation. Rheumatology, 44(1), pp.7-16.
Thank you for reading and see you next time!
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