Knee Osteoarthritis
Knee osteoarthritis (OA), also known as degenerative joint disease, is typically the result of wear and tear and progressive loss of articular cartilage, enabling the bones to rub together. It is most common among the elderly. Knee osteoarthritis can be divided into two types, primary and secondary. Primary osteoarthritis is articular degeneration without any apparent underlying reason. Secondary osteoarthritis is the consequence of either an abnormal concentration of force across the joint as with post-traumatic causes or abnormal articular cartilage, such as rheumatoid arthritis (RA).
How common is osteoarthritis of the knee?
Osteoarthritis of the knee is very common. Approximately 46% of people will develop it during their lifetimes.
Who is affected by osteoarthritis of the knee?
Women are more likely than men to develop osteoarthritis of the knee. Most people develop this condition after age 40. But other factors such as injury or genetics can cause it to happen earlier.
If you’ve been diagnosed with osteoarthritis of the knee, also known as degenerative joint disease (DJD), you may have been told that anti-inflammatories and joint injections are your only treatment options, short of joint replacement surgery. However, did you know that genicular artery embolization (GAE), a non-surgical, outpatient treatment, is being used to successfully relieve the pain caused by DJD?
The Solution
Genicular Artery Embolization (GAE), or embolization of the knee, is a novel minimally invasive procedure providing immediate and long-term pain relief for patients with osteoarthritis (OA), by reducing the blood flow to the lining of the knee, known as the synovium. It is performed by an Interventional Radiologist (IR), who is a specialist physician that uses X-rays and other imaging modalities to see in the body and treat diseases without surgery.
How is GAE performed?
GAE is performed with moderate ‘twilight’ sedation as an outpatient procedure, meaning the patient will go home after the procedure. The procedure generally takes one to two hours. Our IR physicians will insert a small catheter (a thin hollow tube) into the artery of the patient’s upper thigh and, with the use of X-rays, guide the catheter to the arteries supplying the lining of the knee. Tiny particles are then injected through the catheter into these arteries, reducing the blood supply. This in turn reduces the inflammation associated with osteoarthritis, which alleviates the pain.
Initial (left) and final (right) angiograms of the knee after embolization. A circular marker was placed at the site of pain. The reduced blood-flow at the site of pain after embolization reduced inflammation of the knees.
After the GAE procedure:
Patients go home the same day. Typically, relief begins to occur in two weeks, as the inflammation in the lining of the knee is reduced, relieving the knee pain associated with osteoarthritis.
Are you a candidate for GAE?
GAE is a non-surgical treatment alternative for patients with knee pain due to osteoarthritis who have failed conservative therapy, such as anti-inflammatory medications or knee injections, and who do not wish to undergo or are ineligible for knee replacement surgery.
Patients who undergo GAE have reported significant reductions in pain scores and use of pain medications, and significant increases in function scores. These improvements were sustained for several months from just one treatment.