Transcatheter Arterial Embolization as a Treatment for Medial Knee Pain in Patients with Mild to Moderate Osteoarthritis
- 4 July 2014
- journal article
- Published by Springer Science and Business Media LLC in CardioVascular and Interventional Radiology
- Vol. 38 (2), 336-343
- https://doi.org/10.1007/s00270-014-0944-8
Abstract
Osteoarthritis is a common cause of pain and disability. Mild to moderate knee osteoarthritis that is resistant to nonsurgical options and not severe enough to warrant joint replacement represents a challenge in its management. On the basis of the hypothesis that neovessels and accompanying nerves are possible sources of pain, previous work demonstrated that transcatheter arterial embolization for chronic painful conditions resulted in excellent pain relief. We hypothesized that transcatheter arterial embolization can relieve pain associated with knee osteoarthritis. Transcatheter arterial embolization for mild to moderate knee osteoarthritis using imipenem/cilastatin sodium or 75 μm calibrated Embozene microspheres as an embolic agent has been performed in 11 and three patients, respectively. We assessed adverse events and changes in Western Ontario and McMaster University Osteoarthritis Index (WOMAC) scores. Abnormal neovessels were identified within soft tissue surrounding knee joint in all cases by arteriography. No major adverse events were related to the procedures. Transcatheter arterial embolization rapidly improved WOMAC pain scores from 12.2 ± 1.9 to 3.3 ± 2.1 at 1 month after the procedure, with further improvement at 4 months (1.7 ± 2.2) and WOMAC total scores from 47.3 ± 5.8 to 11.6 ± 5.4 at 1 month, and to 6.3 ± 6.0 at 4 months. These improvements were maintained in most cases at the final follow-up examination at a mean of 12 ± 5 months (range 4-19 months). Transcatheter arterial embolization for mild to moderate knee osteoarthritis was feasible, rapidly relieved resistant pain, and restored knee function.Keywords
This publication has 19 references indexed in Scilit:
- Short-term results of transcatheter arterial embolization for abnormal neovessels in patients with adhesive capsulitis: a pilot studyJournal of Shoulder and Elbow Surgery, 2014
- Imipenem/cilastatin sodium (IPM/CS) as an embolic agent for transcatheter arterial embolisation: a preliminary clinical study of gastrointestinal bleeding from neoplasmsSpringerPlus, 2013
- Transcatheter Arterial Embolization Using Imipenem/Cilastatin Sodium for Tendinopathy and Enthesopathy Refractory to Nonsurgical ManagementJournal of Vascular and Interventional Radiology, 2013
- Peripatellar synovitis: comparison between non-contrast-enhanced and contrast-enhanced MRI and association with pain. The MOST studyOsteoarthritis and Cartilage, 2013
- Pain in patients with equal radiographic grades of osteoarthritis in both knees: the value of gray scale ultrasoundOsteoarthritis and Cartilage, 2012
- The discordance between clinical and radiographic knee osteoarthritis: A systematic search and summary of the literatureBMC Musculoskeletal Disorders, 2008
- A Controlled Trial of Arthroscopic Surgery for Osteoarthritis of the KneeThe New England Journal of Medicine, 2002
- Knee pain and osteoarthritis in older adults: a review of community burden and current use of primary health careAnnals Of The Rheumatic Diseases, 2001
- Clinical signs of early osteoarthritis: reproducibility and relation to x ray changes in 541 women in the general population.Annals Of The Rheumatic Diseases, 1991
- Do clinical findings associate with radiographic osteoarthritis of the knee?Annals Of The Rheumatic Diseases, 1990