Ashraf Nader, Tahir Muhammad Junaid, Arabi Tarek Ziad, Abou Shaar Bader, Osman Nadine, Sabbah Belal Nedal, Mashkoor Yusra, Khan Faheemullah, Asad Ali, Asghar Muhammad Sohaib, Ouban Abderrahman, Yousaf Zohaib
College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
Pakistan Kidney and Liver Institute and Research Center, Lahore, Pakistan.
J Endovasc Ther. 2025 Apr 11:15266028251326770. doi: 10.1177/15266028251326770.
To systematically review the literature on the effectiveness, safety, and long-term outcomes of genicular artery embolization (GAE) for knee joint osteoarthritis (OA) associated pain.
After registering the protocol with the PROSPERO database, a search was conducted from inception until July 31, 2023, in MEDLINE, Cochrane Central Register of Controlled Trials, and ScienceDirect databases to gather studies evaluating GAE's safety and efficacy in knee OA. A total of 4979 studies were identified and evaluated against the inclusion criteria. Data on study characteristics, success parameters, and adverse events were collected and synthesized.
Twenty-three studies, primarily single-center prospective studies with a total of 657 patients, were included. Most studies reported a 100% technical success rates, except one study reporting a rate of 84.2%. Clinical success rates, defined variably across studies, ranged from 30% to 100%, depending on the study's follow-up period and outcome measures. The most frequent adverse events included skin discoloration without an ulcer (15.6%, n = 98) and transient post-procedural knee pain (10.2%, n = 64). Most studies were rated as fair in terms of quality, but the lack of robust randomized controlled trials highlighted the need for further comparative studies to standardize outcome reporting.
GAE appears to be a promising option for knee OA pain, particularly for patients unresponsive to conservative treatments or ineligible for surgery. High-quality studies are needed to confirm long-term effectiveness and standardize outcome measures.Clinical ImpactThis study highlights the safety and efficacy of genicular artery embolization as a minimally invasive treatment for knee osteoarthritis, particularly in patients who are unresponsive to conservative treatments or unsuitable for surgery. By targeting neovascularization and reducing inflammation, genicular artery embolization provides pain relief and functional improvement. Clinicians can consider genicular artery embolization as an alternative to surgery for mild-to-moderate OA, offering a lower adverse event rate and faster recovery.
系统回顾关于膝下动脉栓塞术（GAE）治疗膝关节骨关节炎（OA）相关疼痛的有效性、安全性及长期疗效的文献。
在PROSPERO数据库注册方案后，从数据库建立至2023年7月31日，在MEDLINE、Cochrane对照试验中央注册库和ScienceDirect数据库中进行检索，以收集评估GAE治疗膝骨关节炎安全性和有效性的研究。共识别出4979项研究，并根据纳入标准进行评估。收集并综合了关于研究特征、成功参数和不良事件的数据。
纳入23项研究，主要为单中心前瞻性研究，共657例患者。除一项研究报告技术成功率为84.2%外，大多数研究报告技术成功率为100%。临床成功率在不同研究中的定义不同，取决于研究的随访期和结局指标，范围为30%至100%。最常见的不良事件包括无溃疡的皮肤变色（15.6%，n = 98）和术后短暂性膝关节疼痛（10.2%，n = 64）。大多数研究在质量方面被评为中等，但缺乏有力的随机对照试验凸显了进一步进行比较研究以规范结局报告的必要性。
GAE似乎是治疗膝OA疼痛的一个有前景的选择，特别是对于对保守治疗无反应或不适合手术的患者。需要高质量的研究来确认其长期有效性并规范结局指标。临床影响本研究强调了膝下动脉栓塞术作为膝关节骨关节炎微创治疗的安全性和有效性，特别是对于对保守治疗无反应或不适合手术的患者。通过靶向新生血管形成和减轻炎症，膝下动脉栓塞术可缓解疼痛并改善功能。临床医生可将膝下动脉栓塞术视为轻至中度OA手术的替代方案，其不良事件发生率较低且恢复较快。
