Clinical Outcomes of Transcatheter Arterial Embolisation for Chronic Knee Pain: Mild-to-Moderate Versus Severe Knee Osteoarthritis

Cardiovasc Intervent Radiol. 2019 Nov;42(11):1530-1536. doi: 10.1007/s00270-019-02289-4. Epub 2019 Jul 23.

Abstract

Purpose: This retrospective study was conducted to compare the clinical outcomes of transcatheter arterial embolisation for chronic knee pain in patients with mild-to-moderate versus severe knee osteoarthritis.

Materials and methods: This study included patients (n = 41) who were refractory to conservative treatments and who underwent transcatheter arterial embolisation using imipenem/cilastatin sodium between June 2017 and July 2018. A total of 71 knees, including 30 bilateral cases, were treated and categorised into two groups according to the Kellgren-Lawrence grade: mild-to-moderate osteoarthritis (n = 59, Kellgren-Lawrence grade 1-3) and severe osteoarthritis (n = 12, Kellgren-Lawrence grade 4). The clinical outcomes were measured by the visual analogue scale score.

Results: There were no significant differences in age, body mass index or baseline visual analogue scale scores between the two groups. The mean visual analogue scale scores in the mild-to-moderate osteoarthritis group were significantly decreased at 1 day, 1 week, 1 month, 3 months, and 6-months (5.5 at baseline vs. 3.2, 3.1, 2.9, 2.2, and 1.9, after treatment; all P = .00). These improvements were maintained at a mean of 10 ± 3 months (range 6-19 months) post-treatment. The visual analogue scale scores were significantly decreased in the severe osteoarthritis group for 1 month post-treatment (6.3 at baseline vs. 4.1, 4.1, and 4.4 at 1 day, 1 week, and 1 month; all P < .01). However, a decrease in pain was not statistically significant from 3 to 6 months (5.4 and 5.9 at 3 months and 6 months, respectively).

Conclusion: Transcatheter arterial embolisation effectively relieved pain in patients with mild-to-moderate osteoarthritis. In patients with severe osteoarthritis, pain severity decreased for 1 month but gradually increased to the initial severity score within 3 months.

Level of evidence: 4, Case series.

Keywords: Abnormal neovessels; Embolisation; Knee pain; Osteoarthritis.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Arthralgia / etiology
  • Arthralgia / therapy*
  • Chronic Pain / etiology
  • Chronic Pain / therapy*
  • Embolization, Therapeutic / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Osteoarthritis, Knee / complications
  • Osteoarthritis, Knee / therapy*
  • Retrospective Studies
  • Severity of Illness Index
  • Treatment Outcome