Genicular Artery Embolization for Persistent Pain after Total Knee Arthroplasty: Initial Clinical Experience

Abstract

Purpose: To evaluate the clinical effectiveness and safety of genicular artery embolization (GAE) for managing chronic knee pain after total knee arthroplasty (TKA) in a retrospective multicenter study.

Materials and methods: The authors retrospectively analyzed 18 GAE procedures performed in 16 patients with persistent post-TKA pain unresponsive to conservative treatment. All patients underwent conventional radiographic evaluation and clinical assessment using the visual analog scale (VAS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) before and after embolization. Technical success, adverse events, and analgesic consumption were recorded. Clinical success was defined as a ≥50% reduction in VAS and/or WOMAC scores at 6 months.

Results: The mean VAS score decreased from 7.0 (SD ± 1.4) to 3.4 (SD ± 2.1) (P < .001). Total WOMAC scores decreased from 45.7 (SD ± 11.6) to 24.1 (SD ± 13.4) (P < .001), with median subscale reductions in pain (9.4 to 4.5), function (33.3 to 17.2), and stiffness (2.7 to 1.4). At 6 months, 10 (62.5%) of 16 patients and 8 (50%) of 16 patients achieved ≥50% reduction in VAS and total WOMAC scores, respectively. Ten patients (62.5%) reported reduced analgesic use. No major complications were observed.

Conclusions: GAE appears to be a safe and effective treatment for refractory post-TKA pain. In this initial experience, significant improvements in pain, function, and stiffness were observed, with outcomes consistent with those described in prior reports, supporting its potential role in selected patients.