Genicular Artery Embolization (GAE) for the Treatment of Knee Osteoarthritis: A Case Report
Keywords:
Genicular artery embolization, Knee osteoarthritis, Interventional radiologyAbstract
Knee osteoarthritis is a major cause of chronic pain and functional limitation. A proportion of patients fail conservative management yet remain unsuitable for, or unwilling to undergo, total knee arthroplasty. Genicular artery embolization (GAE) is a minimally invasive interventional radiology procedure that reduces the abnormal synovial neovascularization underlying chronic joint inflammation. We report a 47-year-old Thai woman with Kellgren–Lawrence (KL) grade 3 knee osteoarthritis and chronic left knee pain that had failed analgesics and physiotherapy (pre-procedural WOMAC 77 of 96 and NRS 8 of 10). Left GAE was performed with imipenem/cilastatin sodium as the embolic agent, delivered through the descending genicular artery and the inferior medial genicular artery. Pain decreased markedly from the first day after the procedure. The total WOMAC score reached a nadir of 4 of 96 at 3 to 6 months, a reduction of approximately 94.8% from baseline, and rose slightly to 12 of 96 at 9 months (about 84.4% reduction), while the NRS remained at 2 of 10 throughout the 9-month follow-up. No procedural complication occurred, and the patient reduced her NSAID use. In this single patient, GAE offered a promising and practical bridging option that could be delivered in a provincial hospital. Because the evidence derives from one uncontrolled case, comparative studies in larger cohorts are needed to confirm the efficacy and long-term safety of the procedure.
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