Percutaneous Management of Osteoarthritis in the Knee: Proceedings from the Society of Interventional Radiology Research Consensus Panel

Abstract

GAE ¼ genicular artery embolization, GNA ¼ genicular nerve ablation, NSAIDs ¼ nonsteroidal anti-inflammatory drugs, OA ¼ osteoarthritis, RCP ¼ research consensus panel, TKA ¼ total knee arthroplasty BACKGROUND Osteoarthritis (OA) of the knee is a complex, multifactorial disease with no known cure (1). Treatment options seek to manage symptoms, since no proven disease-modifying therapies currently exist. However, for many patients, adequate and sustained symptom control can be challenging to achieve. Depending on disease severity, various

Genicular Artery Embolization for Primary Knee Osteoarthritis

“…In 2021, a research consensus panel (RCP) consisting of a multidisciplinary group of experts convened to summarize the current existing knowledge of the management of knee OA, while also prioritizing the specific areas of further research. 14 One of the many important questions that came from this RCP was what specific types of studies are currently needed to further validate GAE as an accepted treatment for knee OA. 14 Consensus on large sham-controlled randomized trials as the gold standard was met, largely due in part to the history of previous OA studies showing very high placebo effects, some as high as 40%.…”

“…14 One of the many important questions that came from this RCP was what specific types of studies are currently needed to further validate GAE as an accepted treatment for knee OA. 14 Consensus on large sham-controlled randomized trials as the gold standard was met, largely due in part to the history of previous OA studies showing very high placebo effects, some as high as 40%. 14 Issues with institutional review board approval as well as the practical and ethical ramifications of creating a sham trial were acknowledged.…”

“…14 Optimal patient cohorts for these trials were also discussed with the RCP concluding a presurgical cohort, both ineffectively managed by current standard of care and ineligible for surgery, had the greatest potential to demonstrate the benefits of percutaneous therapies. 14…”

Intraarticular STP Radiofrequency for Painful Osteoarthritis in the Knee: A Retrospective Single Center Analysis

“…Pulsed and/or continuous radiofrequency are neuromodulatory and/or neurolytic techniques that represent an alternative to these therapies. 23–26 , 39 …”

“…Pulsed and/or continuous radiofrequency are neuromodulatory and/or neurolytic techniques that represent an alternative to these therapies. [23][24][25][26]39 Radiofrequency does not involve the use of drugs; it is not particularly invasive and may be repeatable. 27,28 In 2011, in a double-blind randomized controlled trial, Choi et al proposed continuous radiofrequency treatment from 70 ° C to 80 ° C for 90-180 seconds on the superior lateral (SLGN), upper medial (SMGN) and lower medial (IMGN) genicular nerves (IMGN).…”