The short-to-midterm outcomes of geniculate artery embolization for mild-to-moderate osteoarthritis of the knee: a systematic review.

Abstract

Geniculate Artery Embolization (GAE) is a novel, minimally-invasive treatment for mild to moderate Osteoarthritis (OA) associated with musculoskeletal pain. To investigate the outcomes of GAE in patients with mild to moderate OA of the knee using a Quantitative-analysis of the available literature. The PubMed, EMBASE and Cochrane databases were searched for GAE-related studies. Qualitative and quantitative analyses were performed following PRISMA-guidelines. Quantitative-analysis was performed using windows based 'MedCalc-Statistical-Software version 19.6.1 (2020). Statistical analysis was performed in Stata-IC-13.1(Stata corp-USA). Quantitative-analysis was done using the random-effects model, and the Standardized-Mean-Differences (SMD) were calculated. After a full-text review, 13 studies with 399 knees (345-patients) were included in the qualitative synthesis, 10 were included in the quantitative synthesis. The total WOMAC score improved by a [SMD (95% CI)] of 3.46 points (1.27, 5.65), 3.50 (1.28, 5.71), 3.77 (0.58, 6.96), 5.46 (1.59, 9.33), 2.96 (-0.93, 6.85) compared to baseline at 1, 3, 6, 12, 24 months respectively. The VAS score improved by 2.06 (1.35, 2.76), 2.13 (1.39, 2.87), 2.36 (1.85, 2.90), 2.09 (0.91, 3.28) compared to baseline at 1, 3, 6, 12 months respectively. The Pain WOMAC score improved by SMD 2.97 (0.51, 5.43), 3.77 (0.58, 6.96), 2.27 (0.31, 4.22), 2.27 (0.31, 4.22) compared to baseline at 1, 3, 12, 24 months, respectively. There was a statistically significant change from baseline in all outcome measures after GAE. GAE is a safe and effective method for pain control in mild to moderate OA-associated knee pain in the short and medium term.