Abstract
Objectives
To document the effects of embolization of branches of genicular arteries in patients with pain and synovitis after total knee arthroplasty due to osteoarthritis (OA)
Methods
Prospective case series of eight patients (nine knees) with persistent pain, effusion, stiffness, and synovitis after knee arthroplasty submitted to transcatheter arterial embolization since August 2021. Clinical outcomes were evaluated at baseline, one and two years with EQ5D, WOMAC (0-96) and KOOS. All patients had their knees aspirated at the operating room to ascertain lack of infection.
Results
Abnormal neovessels were identified in all cases. One patient remained with cutaneous color changes even after two years of the procedure in both knees. No tissue necrosis, dermal ulcers, or peripheral ulcers. Three patients required to do the procedure more than once (twice in two and thrice in one). EQ5D improved from an average of 0.9063±0.05 to 0,9562±0.04 (one year), and 0.9828±0.02 at 2 years. WOMAC pain improved from 1.83±2 to 1.33±1(one year ) and 0 at 2 years (only three patients, i.e., four knees performed the procedure only once and reached de 2-year follow-up mark). Stiffness improved from 1±1.5 to 0.5±1.2(one year) and 0 (2-year). Baseline WOMAC function was 9.5±6.2 improving to 3.1±2.3 (one year) and 1.75±0.96 at two years. WOMAC total (0-96) WOMAC total reduced from average of 12.3 to ±7.4 to 4.7±2.9(one year) and 1.75±0.96 (two years). KOOS general improved from 75.8±11.3 to 84±4.3 at one year and to 88±3.4 at two years. All patients improved in all parameters continuously.
Conclusion
Embolization of branches of genicular arteries in patients with persistent pain, stiffness, effusion, and synovitis, after total knee arthroplasty, due to OA, may provide long lasting improvements in pain, function, and quality of life.