Efficacy of Genicular Artery Embolization in Symptomatic Knee Osteoarthritis

Abstract

Background: Knee osteoarthritis is a leading cause of pain and disability, with many patients not achieving adequate relief from conservative management. Genicular artery embolization (GAE) is a minimally invasive procedure targeting synovial neovascularity to reduce pain and inflammation in refractory cases. Objective: To assess the safety and efficacy of GAE for symptomatic moderate-to-severe knee osteoarthritis in patients unresponsive to standard non-surgical treatments. Methods: In this single-center, prospective trial, forty adults aged 40–80 years with Kellgren–Lawrence grade 2–4 knee osteoarthritis and baseline pain scores above 4 on the visual analog scale underwent GAE using 100-μm microspheres. Symptom scores were evaluated at 1 week, 1 month, 3 months, and 6 months post-procedure, with treatment success defined as a ≥50% reduction from baseline. Safety was monitored through adverse event reporting. Statistical analyses included Wilcoxon, χ², and logistic regression as appropriate. Results: At six months, 47.4% of patients achieved at least a 50% symptom reduction, with the success rate consistent across age, BMI, and osteoarthritis severity subgroups. Adverse events were mild and self-limited, occurring exclusively within six months of treatment. No significant predictors of treatment success were identified. Conclusion: GAE provides sustained symptom relief in a substantial proportion of patients with moderate-to-severe knee osteoarthritis who are not candidates for surgery, with an acceptable safety profile.