Title: Meta-analysis of genicular artery embolization for treatment of osteoarthritis of the knee

Monday, March 6, 2023

12:00 PM – 1:00 PM

Location: Phoenix Convention Center, North Ballroom 120 D

Poster Presenter(s)

Aaron W. Lyon, MD

Medical Student
University of Washington

Disclosure(s): No financial relationships to disclose

Author/Co-author(s)

Qian Yu, MD (he/him/his)

Resident
University of Chicago
Anna Hu (she/her/hers)

Medical Student
George Washington University School of Medicine and Health Sciences
JB

Jacob Benson, n/a

Medical Student
University of Washington
Osman Ahmed, MD, FSIR

Associate Professor of Radiology
University of Chicago

Disclosure(s):

Aaron W. Lyon, MD: No financial relationships to disclose

Qian Yu, MD: No financial relationships to disclose

Anna Hu: No financial relationships to disclose

Osman Ahmed, MD, FSIR: Argon Medical: Advisory Committee or Review Panel Member (Ongoing); Asahi: Consultant (Ongoing); Bard Peripheral Vascular: Speaking and Teaching (Terminated, September 1, 2022); Boston Scientific: Advisory Committee or Review Panel Member (Ongoing), Consultant (Ongoing); Canon Medical Systems: Consultant (Ongoing), Contracted Research (Ongoing); Cook: Speaking and Teaching (Ongoing); Johnson & Johnson: Advisory Committee or Review Panel Member (Ongoing); Penumbra Inc.: Speaking and Teaching (Ongoing); Philips: Contracted Research (Terminated, October 1, 2022)

Purpose: To evaluate the safety and efficacy of genicular artery embolization (GAE) in the treatment of osteoarthritis of the knee.

Materials and Methods: A systematic review and meta-analysis was conducted using Pubmed and Embase. Relevant articles published from establishment to July 2022 were searched using the key words "genicular artery embolization", "knee osteoarthritis embolization", "knee osteoarthritis embolisation", "osteoarthritis embolization", or "osteoarthritis embolisation". The following data were retrieved from each article: author, number of patients in study, number of knees embolized, patient demographics, measured outcomes and number of adverse events. Statistics were performed with STATA 16.1 (STATA Corp., College Station, TX, USA.)

Results: Among 502 articles in the initial search results, 9 studies totalling 248 patients and 321 GAE procedures were evaluated in this study. Visual analog scale (VAS) scores significantly decreased from baseline in all study arms with a standard deviations of 1.68 ([95%CI 0.551-2.809], p< 0.004), 2.917 ([95%CI 1.938-3.896]p< .001), 1.524 ([95%CI 0.941-2.106], p< .001), 3.563 ([95%CI 0.765-6.361] p< 0.013), 2.012 ([95% CI 1.177-2.847], p< .001), 1.563 ([95% CI 0.258-2.867] p< 0.019) and 3.559 ([95% CI 2.907-4.211], p< .001) at 1 week, 1 month, 3 months, 4 months, 6 months and 12 months, respectively. Western Ontario and McMaster Universities Osteoarthritis (WOMAC) pain scores also decreased across all study arms with a standard deviations of 3.035 ([95%CI 1.502-4.567], p< 0.001), 2.280 ([95%CI 1.406-3.154.] p< 0.001), 3.736 ([95%CI 1.289-6.183], p< 0.003), 3.381 ([95%CI 1.946-4.815] p< 0.001), and 3.416 ([95% CI 2.859-3.974] p< 0.001) at 1 month, 3 months, 4 months, 6 months and 12 months, respectively. WOMAC total scores showed significant improvement across all study arms with a standard deviations of 3.457 ([95%CI 2.117-4.797] p< 0.001), 1.910 ([95%CI 1.355-2.466] p< 0.001), 4.796 ([95% CI 0.831-8.761] p< 0.018), 2.434 ([95%CI 1.160-3.708] p< 0.001), and 2.002 ([95% CI 1.566-2.439] p< 0.001) at 1 month, 3 months, 4 months and 12 months, respectively. There were no major complications reported but 18% of patients (45 total) had minor complications with most common being reddening of the knee that disappeared after 3 weeks.

Conclusion:

GAE appears to be an effective and safe treatment for reducing pain due to osteoarthritis as measured by VAS and WOMAC scores up to 12 months.