Safety and Feasibility of Genicular Artery Embolization with Degradable Starch Microspheres for Knee Osteoarthritis: A One Year Experience and Preliminary Clinical Results

Purpose: To evaluate the clinical efficacy and safety of genicular artery embolization (GAE) using degradable starch microspheres in patients with moderate to severe knee osteoarthritis (OA) refractory to conservative therapies. Materials and methods: Sixteen patients (19 knees) with Kellgren-Lawrence grade 1-4 osteoarthritis and persistent symptoms despite standard therapies were treated with genicular arteries embolization procedure using degradable starch microspheres. Adverse events were recorded using the CIRSE classification system. Pain and function were assessed using the Visual Analog Scale (VAS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) at baseline, 48 h, 1 month, 6 months, and 12 months. Clinical success was defined as ≥ 50% improvement in both VAS and WOMAC scores from baseline. Results: No minor or major complications were observed. Transient skin changes around the treated knee were observed in all patients and resolved spontaneously within 2 h. Clinical success was achieved in 89,5% of knees at 48 h, in 84,2% at 1 month, and in 68,4% at 6 and 12 months. Mean VAS scores decreased from 7.2 ± 1.1 to 2.5 ± 1.3 at 1 month (p < 0.0001) and to 3.3 ± 1.5 at 6-12 months (p < 0.0001). WOMAC scores improved from 68.4 ± 9.2 to 25.1 ± 10.4 at 1 month (p < 0.0001) and to 38.4 ± 11.6 at 6-12 months (p < 0.0001). Conclusion: GAE using degradable starch microspheres is a safe and effective minimally invasive treatment for symptomatic relief and functional improvement in patients with moderate to severe knee OA refractory to other therapies. Evidence level 3