Genicular artery embolization as a minimally invasive treatment for knee osteoarthritis: systematic review and meta-analysis.
Lucas Habiro Alves, Davi Barbosa, Maria Clara Merighi et al.
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In 30 seconds
This systematic review and meta-analysis assessed genicular artery embolization (GAE) for knee osteoarthritis using patient-reported outcomes from 18 studies involving 534 patients. Random-effects pooling found mean VAS pain reductions from baseline of 3.96 (95% CI - 4.64 to - 3.27) points at 1 month and 4.53 (95% CI - 5.47 to - 3.60) points at 12 months. WOMAC and KOOS outcomes also improved and remained improved through 12 months. However, substantial heterogeneity and recent sham-controlled data leave the magnitude of GAE’s treatment effect uncertain.
Key findings
- Mean VAS pain reduction was 3.96 (95% CI - 4.64 to - 3.27) points at 1 month and 4.53 (95% CI - 5.47 to - 3.60) at 12 months.
- WOMAC and KOOS outcomes improved by 1 month, with improvements maintained through 12-month follow-up.
- Substantial heterogeneity was observed (I 2 > 80%), reflecting differences in embolic agents, patient selection criteria, and techniques.
Why it matters
The pooled findings suggest symptom improvement after GAE may persist over a year, an outcome of interest for knee osteoarthritis refractory to conservative management. Yet variation across studies and uncertainty about the treatment effect, including in light of recent sham-controlled data, mean the pooled improvements should not be interpreted as definitive evidence of benefit. Consistent protocols and outcome reporting are needed to clarify effectiveness.
What to keep in mind
Substantial heterogeneity (I 2 > 80%) across studies limits confidence in the pooled estimates; the abstract also notes that recent sham-controlled data leave the magnitude of treatment effect uncertain.