Knee Pain Relief Achieved - Genicular Artery Embolization for Osteoarthritis

Background

A 68-year-old woman with Kellgren-Lawrence (KL) grade III osteoarthritis (OA) of the left knee came to us with significant pain despite conservative management efforts. She was not inclined to undergo an open surgical procedure such as total knee replacement.

Investigation & Analysis

The patient’s condition was evaluated through clinical assessment and imaging. The KL grade III classification indicated moderate to severe osteoarthritis, characterised by joint space narrowing, bone spur formation, and significant pain. Despite following conservative treatments, the patient’s symptoms persisted, prompting the consideration of a novel treatment approach. Due to persistent nagging pain and inadequate relief from medications and physical therapy, she was offered a less invasive alternative: genicular artery embolization (GAE).

Treatment & Management

The patient underwent a genicular artery embolization (GAE) procedure, a minimally invasive endovascular technique aimed at providing relief from knee pain. For patients with moderate knee OA who are either poor candidates for surgery or unwilling to consider total knee arthroplasty, genicular artery embolization offers a viable alternative. The process involved:

1. Endovascular Access: A catheter was inserted into an artery in the left groin under image guidance and local anaesthesia.
2. Catheter Navigation: A thin wire and catheter were advanced through the blood vessels to reach the arteries supplying the left knee joint.
3. Embolization: Small particles were injected to block the hypertrophied genicular arterial branches leading to synovial hypertrophy. This technique reduced the arterial blush while maintaining overall arterial flow.

This procedure was performed on a day-care basis, allowing the patient to mobilise within 6-8 hours and be discharged either the same day or the following day.

Post-Operative Care 

Post-procedure, the patient reported comfort and was discharged the following day. Within a week of the procedure, she experienced noticeable symptomatic relief from knee pain. Regular follow-up appointments have confirmed that she continues to have optimal pain relief and improved quality of life. The success of this case demonstrates that genicular artery embolization can be a successful intervention for managing pain in patients with significant knee osteoarthritis who are not suitable candidates for or prefer to avoid traditional surgical approaches. Dr. Bhattacharya and his team not only reduced patient’s knee pain, but also provided a safe option with minimal risk of typical surgical complications such as bleeding or infection.