Genicular artery embolization for early-stage knee osteoarthritis: results from a triple-blind single-centre randomized controlled trial
Aims: This study investigated the effects of transcatheter arterial embolization (TAE) on pain, function, and quality of life in people with early-stage symptomatic knee osteoarthritis (OA) compared to a sham procedure. Methods: A total of 59 participants with symptomatic Kellgren-Lawrence grade 2 k...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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The British Editorial Society of Bone & Joint Surgery
2023-03-01
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| Series: | Bone & Joint Open |
| Subjects: | |
| Online Access: | https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.43.BJO-2022-0161.R2 |
| _version_ | 1797853297029152768 |
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| author | Steve Landers Rachael Hely Andrew Hely Benjamin Harrison Richard S. Page Nick Maister Stella M. Gwini Stephen D. Gill |
| author_facet | Steve Landers Rachael Hely Andrew Hely Benjamin Harrison Richard S. Page Nick Maister Stella M. Gwini Stephen D. Gill |
| author_sort | Steve Landers |
| collection | DOAJ |
| description | Aims: This study investigated the effects of transcatheter arterial embolization (TAE) on pain, function, and quality of life in people with early-stage symptomatic knee osteoarthritis (OA) compared to a sham procedure. Methods: A total of 59 participants with symptomatic Kellgren-Lawrence grade 2 knee OA were randomly allocated to TAE or a sham procedure. The intervention group underwent TAE of one or more genicular arteries. The control group received a blinded sham procedure. The primary outcome was knee pain at 12 months according to the Knee injury and Osteoarthritis Outcome Score (KOOS) pain scale. Secondary outcomes included self-reported function and quality of life (KOOS, EuroQol five-dimension five-level questionnaire (EQ-5D-5L)), self-reported Global Change, six-minute walk test, 30-second chair stand test, and adverse events. Subgroup analyses compared participants who received complete embolization of all genicular arteries (as distinct from embolization of some arteries) (n = 17) with the control group (n = 29) for KOOS and Global Change scores at 12 months. Continuous variables were analyzed with quantile regression, adjusting for baseline scores. Dichotomized variables were analyzed with chi-squared tests. Results: Overall, 58 participants provided questionnaire data at 12 months. No significant differences were found for the primary and secondary outcomes, with both groups improving following the procedure. At 12 months, KOOS pain scores improved by 41.3% and 29.4% in the intervention and control groups, respectively. No adverse events occurred. Subgroup analysis indicated that the complete embolization group had significantly better KOOS Sports and Recreation, KOOS Quality of Life, and Global Change scores than the control group; 76.5% of participants who received complete embolization reporting being moderately or much better compared to 37.9% of the control group. Conclusion: TAE might produce benefits above placebo, but only when complete embolization of all genicular arteries is performed. Further comparative studies are required before definitive conclusions regarding the effectiveness of TAE can be made. Level of evidence: I Cite this article: Bone Jt Open 2023;4(3):158–167. |
| first_indexed | 2024-04-09T19:48:19Z |
| format | Article |
| id | doaj.art-0fc460bda73a4e7b9d155829a075f217 |
| institution | Directory Open Access Journal |
| issn | 2633-1462 |
| language | English |
| last_indexed | 2024-04-09T19:48:19Z |
| publishDate | 2023-03-01 |
| publisher | The British Editorial Society of Bone & Joint Surgery |
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| series | Bone & Joint Open |
| spelling | doaj.art-0fc460bda73a4e7b9d155829a075f2172023-04-03T11:07:51ZengThe British Editorial Society of Bone & Joint SurgeryBone & Joint Open2633-14622023-03-014315816710.1302/2633-1462.43.BJO-2022-0161.R2Genicular artery embolization for early-stage knee osteoarthritis: results from a triple-blind single-centre randomized controlled trialSteve Landers0Rachael Hely1Andrew Hely2Benjamin Harrison3Richard S. Page4Nick Maister5Stella M. Gwini6Stephen D. Gill7Barwon Medical Imaging, University Health Geelong, Geelong, AustraliaBarwon Medical Imaging, University Health Geelong, Geelong, AustraliaBarwon Medical Imaging, University Health Geelong, Geelong, AustraliaBarwon Medical Imaging, University Health Geelong, Geelong, AustraliaDepartment of Orthopaedics, Barwon Health, Geelong, AustraliaDepartment of Orthopaedics, Barwon Health, Geelong, AustraliaBarwon Health, Geelong, AustraliaBarwon Medical Imaging, University Health Geelong, Geelong, AustraliaAims: This study investigated the effects of transcatheter arterial embolization (TAE) on pain, function, and quality of life in people with early-stage symptomatic knee osteoarthritis (OA) compared to a sham procedure. Methods: A total of 59 participants with symptomatic Kellgren-Lawrence grade 2 knee OA were randomly allocated to TAE or a sham procedure. The intervention group underwent TAE of one or more genicular arteries. The control group received a blinded sham procedure. The primary outcome was knee pain at 12 months according to the Knee injury and Osteoarthritis Outcome Score (KOOS) pain scale. Secondary outcomes included self-reported function and quality of life (KOOS, EuroQol five-dimension five-level questionnaire (EQ-5D-5L)), self-reported Global Change, six-minute walk test, 30-second chair stand test, and adverse events. Subgroup analyses compared participants who received complete embolization of all genicular arteries (as distinct from embolization of some arteries) (n = 17) with the control group (n = 29) for KOOS and Global Change scores at 12 months. Continuous variables were analyzed with quantile regression, adjusting for baseline scores. Dichotomized variables were analyzed with chi-squared tests. Results: Overall, 58 participants provided questionnaire data at 12 months. No significant differences were found for the primary and secondary outcomes, with both groups improving following the procedure. At 12 months, KOOS pain scores improved by 41.3% and 29.4% in the intervention and control groups, respectively. No adverse events occurred. Subgroup analysis indicated that the complete embolization group had significantly better KOOS Sports and Recreation, KOOS Quality of Life, and Global Change scores than the control group; 76.5% of participants who received complete embolization reporting being moderately or much better compared to 37.9% of the control group. Conclusion: TAE might produce benefits above placebo, but only when complete embolization of all genicular arteries is performed. Further comparative studies are required before definitive conclusions regarding the effectiveness of TAE can be made. Level of evidence: I Cite this article: Bone Jt Open 2023;4(3):158–167.https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.43.BJO-2022-0161.R2osteoarthritiskneetranscatheter arterial embolizationarteriesrandomized controlled trialknee injury and osteoarthritis outcome score (koos)knee painpain scoreschi-squared testsknee oaearly-stage knee osteoarthritissymptomatic knee osteoarthritis (oa)eq-5d-5l |
| spellingShingle | Steve Landers Rachael Hely Andrew Hely Benjamin Harrison Richard S. Page Nick Maister Stella M. Gwini Stephen D. Gill Genicular artery embolization for early-stage knee osteoarthritis: results from a triple-blind single-centre randomized controlled trial Bone & Joint Open osteoarthritis knee transcatheter arterial embolization arteries randomized controlled trial knee injury and osteoarthritis outcome score (koos) knee pain pain scores chi-squared tests knee oa early-stage knee osteoarthritis symptomatic knee osteoarthritis (oa) eq-5d-5l |
| title | Genicular artery embolization for early-stage knee osteoarthritis: results from a triple-blind single-centre randomized controlled trial |
| title_full | Genicular artery embolization for early-stage knee osteoarthritis: results from a triple-blind single-centre randomized controlled trial |
| title_fullStr | Genicular artery embolization for early-stage knee osteoarthritis: results from a triple-blind single-centre randomized controlled trial |
| title_full_unstemmed | Genicular artery embolization for early-stage knee osteoarthritis: results from a triple-blind single-centre randomized controlled trial |
| title_short | Genicular artery embolization for early-stage knee osteoarthritis: results from a triple-blind single-centre randomized controlled trial |
| title_sort | genicular artery embolization for early stage knee osteoarthritis results from a triple blind single centre randomized controlled trial |
| topic | osteoarthritis knee transcatheter arterial embolization arteries randomized controlled trial knee injury and osteoarthritis outcome score (koos) knee pain pain scores chi-squared tests knee oa early-stage knee osteoarthritis symptomatic knee osteoarthritis (oa) eq-5d-5l |
| url | https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.43.BJO-2022-0161.R2 |
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