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膝下动脉栓塞术:全膝关节置换术后复发性积液的一种有前景的治疗选择。

Genicular Artery Embolization: A Promising Treatment Option for Recurrent Effusion Following Total Knee Arthroplasty.

作者信息

Lutz Rex W, Post Zachary D, Thalody Hope S, Czymek Miranda M, Ponzio Danielle Y, Kim Christopher E, Ong Alvin C

机构信息

Jefferson Health New Jersey, Stratford, NJ, USA.

Rothman Orthopaedic Institute, Egg Harbor Township, NJ, USA.

出版信息

HSS J. 2024 Nov;20(4):508-514. doi: 10.1177/15563316231183971. Epub 2023 Jul 6.

Abstract

BACKGROUND

Selective genicular artery embolization (GAE) has shown promise as a minimally invasive treatment option for persistent symptomatic recurrent effusions (REs) following total knee arthroplasty (TKA).

PURPOSE

We sought to investigate the radiographic and clinical success of GAE for RE after TKA.

METHODS

We performed a retrospective review of prospectively collected data on primary and revision TKA patients with RE, both hemorrhagic and non-hemorrhagic, who underwent GAE between 2019 and 2021 with a minimum of 6-month follow-up. All embolization procedures were performed by a single interventional radiologist. Western Ontario and McMaster University Osteoarthritis Index (WOMAC) and visual analog scale (VAS) scores were collected prior to GAE and at 1, 3, and 6 months post-procedure. Recurrence of effusion following GAE was assessed at 6 months using ultrasound.

RESULTS

Seventeen patients, 10 female and 7 male, with 18 TKAs and a mean (SD) age of 63.1 (8.6) years were included. We saw a mean (SD) of 36.1 (24.4) and 3.3 (3.0) point improvement in WOMAC and VAS scores, respectively. In addition, 14 of the 18 TKAs (77.8%) seen at final follow-up had complete resolution of effusion confirmed by ultrasound.

CONCLUSION

Our retrospective review found that a majority of patients showed significant clinical improvement and resolution of effusion following GAE. These findings suggest that GAE may be an effective minimally invasive treatment option for RE following TKA and should be further investigated.

摘要

背景

选择性膝下动脉栓塞术(GAE)已显示出作为全膝关节置换术(TKA)后持续性有症状复发性积液(RE)的微创治疗选择的前景。

目的

我们试图研究GAE治疗TKA后RE的影像学和临床成功率。

方法

我们对2019年至2021年间接受GAE且至少随访6个月的原发性和翻修性TKA合并RE(包括出血性和非出血性)患者的前瞻性收集数据进行了回顾性分析。所有栓塞手术均由一名介入放射科医生进行。在GAE前以及术后1、3和6个月收集西安大略和麦克马斯特大学骨关节炎指数(WOMAC)和视觉模拟量表(VAS)评分。在术后6个月使用超声评估GAE后积液的复发情况。

结果

纳入17例患者,10例女性和7例男性,共18例TKA,平均(标准差)年龄为63.1(8.6)岁。我们发现WOMAC和VAS评分分别平均(标准差)提高了36.1(24.4)分和3.3(3.0)分。此外,在最终随访时,18例TKA中有1

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