A technique that starves abnormal blood vessels around arthritic knees is showing promise as a middle ground between injections and joint replacement, according to research published in Radiology by the Radiological Society of North America.
The procedure, called genicular artery embolization or GAE, uses a thin catheter to inject tiny particles into problem blood vessels surrounding the knee joint. The particles block blood flow to those vessels, which researchers believe reduces inflammation and pain that stems from damaged sensory nerves.
Nearly 200 patients with knee osteoarthritis received the treatment at a Berlin medical center between July and November 2024. All had tried conservative approaches for at least three months, including physical therapy, anti-inflammatory drugs, and steroid injections, without adequate relief.
The results point to sustained pain relief. Before treatment, patients rated their pain at a median of 7 on a 0-to-10 scale. Six weeks after the procedure, that dropped to 4. At both the six-month and 12-month marks, the median held steady at 3, indicating pain relief persisted through the year of follow-up.
Functional improvements were equally striking. Scores for daily activities jumped from 53 to 71.5. Sports and recreation capacity rose from 15 to 36. Overall quality of life doubled, climbing from 19 to 40 on the measurement used.
The treatment used rapidly resorbable gelatin-based microspheres, which dissolve within hours after blocking the abnormal vessels. Researchers chose this approach to combine benefits of temporary and permanent blocking agents while avoiding drawbacks of each.
Safety was strong across the trial. Every one of the 239 procedures performed was technically successful. No moderate or severe complications occurred. Only about 6.7% of patients experienced mild reactions that resolved on their own. Forty-five participants had both knees treated.
At the 12-month follow-up, 80% of patients showed clinically meaningful improvement, defined as at least a 2-point drop in pain scores combined with functional gains of 10 or more points.
Osteoarthritis affects more than 365 million adults globally, making it the most common form of arthritis and a leading cause of disability. For many patients, the current options are limited. Conservative treatments eventually fail, but surgery carries medical risks or personal objections.
Dr. Florian Nima Fleckenstein, who led the research at Charité Hospital in Berlin, emphasized that the trial enrolled typical patients physicians see daily, with a median age of 69. Follow-up rates remained robust, with 79% of participants returning for 12-month evaluation.
The study represents the largest body of evidence so far for GAE using resorbable microspheres. Future work will likely test whether the approach can slow disease progression or whether repeat procedures might extend relief beyond a year.
Author Jessica Williams: "A minimally invasive option that actually sticks around for a full year is exactly what patients stuck between injections and surgery need."
Comments