A new treatment provides relief for people with osteoarthritis in the knee who are not ready, or not candidates, for knee replacement surgery.
Knee embolization, also known as genicular or geniculate artery embolization, is a non-surgical procedure performed by an interventional radiologist. Interventional radiologists use X-ray and other imaging techniques to guide tiny tools through blood vessels to the area of the body being treated. They perform a wide range of procedures, sending their patients home with just a tiny nick in the skin.
Knee embolization fills an important gap in the list of treatments for osteoarthritis, a condition that has no cure.
“We see many people who have arthritis and who are no longer responding to conservative treatments but aren’t ready or able to have surgery,” says interventional radiologist Stephen Reis, MD, associate professor of radiology at Columbia University Irving Medical Center. “Knee embolization can provide immediate relief when there are no other good options.”
Knee embolization targets an inflammatory process that happens in the lining of the knee—called the synovium—when arthritis is present. Using tiny particles, each the size of a grain of sand, interventional radiologists block the blood flow to vessels that feed the synovium where inflammation is present. The procedure is performed in about one hour, often in an office setting, and patients go home on the same day.
With the blood flow blocked or slowed down, inflammation subsides quickly. Patients often experience increased mobility and improvement in pain in one or two weeks.
“Our patients have been very happy with the results,” Dr. Reis says. “I’ve seen people whose mobility was extremely limited before the procedure, who are walking miles when I see them for their follow up appointment several weeks later.”
Interventional radiologists have used embolization for decades to treat everything from fibroids and enlarged prostates to cancer. Its use for knee arthritis was pioneered in Japan and has been studied in the United States for more than five years. Research shows that between 70 and 85 percent of patients who undergo knee embolization experience significant and lasting improvement in their overall pain.
“Surgery involves risks and a long recovery and may not be the right choice for everyone,” says Dr. Reis. “Interventional radiology gives patients a minimally invasive option to consider as they weigh their choices.”
In the United States, osteoarthritis of the knee effects more than 65 million people, making it the most common form of arthritis. With an aging population and other factors, the number of people affected by knee arthritis projected to increase by 75 percent by 2050.
