Two-year Outcomes Comparing Embosphere® Microspheres Versus Imipenem Cilastatin for Genicular Artery Embolization in Patients with Moderate to Severe Knee Osteoarthritis

Background: Genicular artery embolization (GAE) is a novel technique and has the poten-tial to provide midterm relief of pain for patients with mild-to-moderate knee osteoarthri-tis resistant to conservative management. This study compares the efficacy and safety of trisacryl gelatin microspheres to Imipenem/Cilastatin particles for GAE with 2 years of clin-ical follow-up.Methods: In this retrospective study, eight patients with knee osteoarthritis (11 knees) who underwent GAE with 100-300 lm trisacryl gelatin microspheres particles were com-pared with six patients (nine knees) who underwent GAE with Imipenem/Cilastatin parti-cles. Clinical outcomes were evaluated at 3-month and 24-month follow-ups and compared to baseline using the WOMAC questionnaire.Results: The median follow-up was 796 days (range: 736-808). There were no significant differences in clinical outcome measures at the 3-month or 24-month follow-up. Both embolic materials resulted in a decrease in Pain WOMAC and Total WOMAC scores at 3 months (p < 0.05), and the effect of treatment on Pain WOMAC and Total WOMAC score reduction was sustained until the 24-month follow-up (p < 0.05). Minor events (Clavien-Dindo classification grade I) included transient cutaneous color change (n = 3) and tran-sient leg numbness (n = 1) after embolization with trisacryl gelatin microspheres particles (p = 0.08). All minor adverse events resolved spontaneously. There were no major adverse events.Conclusion: One hundred to three hundred lm trisacryl gelatin microspheres particles can be considered for genicular artery embolization and is comparable to Imipenem/Cilastatin particles in pain reduction of moderate to severe knee osteoarthritis. A sustained effect is observed for up to 2 years of follow-up.(c) 2022 Elsevier B.V. All rights reserved.