Effectiveness of Geniculate Artery Embolization for Chronic Pain after Total Knee Replacement-A Pilot Study.

Purpose: To evaluate the efficacy and safety of embolization of hyperemic synovial tissue for the treatment of persistent pain after total knee arthroplasty (TKA).Materials and Methods: Twelve patients with persistent pain after TKA were enrolled in this prospective, single-center pilot study. Genicular artery embolization (GAE) was performed using 75-mu m spherical particles. The patients were assessed using a 100-point Visual Analog Scale (VAS) and Knee Injury and Osteoarthritis Outcome Score (KOOS) at baseline and 3 and 6 months thereafter. Adverse events were recorded at all time points.Results: A mean of 1.8 +/- 0.8 abnormal hyperemic genicular arteries were identified and embolized, with a median volume of diluted embolic material of 4.3 mL in all 12 (100%) patients. The mean VAS score on walking improved from 73 +/- 16 at baseline to 38 +/- 35 at the 6-month follow-up (P < .05). The mean KOOS pain score improved from 43.6 +/- 15.5 at baseline to 64.6 +/- 27.1 at the 6-month follow-up (P < .05). At the 6-month follow-up, 55% and 73% of the patients attained a minimal clinically important change in pain and quality of life, respectively. Self-limited skin discoloration occurred in 5 (42%) patients. The VAS score increased by more than 20 immediately after embolization in 4 (30%) patients, who required analgesic treatment for 1 week.Conclusion: GAE is a safe method of treating persistent pain after TKA that demonstrates potential efficacy at 12 months.