SIR backs genicular artery embolization for knee osteoarthritis

The Society of Interventional Radiology has issued a position statement supporting genicular artery embolization for symptomatic knee osteoarthritis.

Published in the Journal of Vascular and Interventional Radiology, the statement supports GAE as a minimally invasive treatment option for patients who have failed conservative therapy and are not candidates for, or wish to delay, total knee arthroplasty.

SIR said the manuscript cites clinical data supporting GAE as a safe, durable, joint-preserving intervention that targets inflammatory and neurovascular drivers of osteoarthritis-related pain. The statement also calls for larger randomized controlled trials to confirm early clinical data and inform future care guidelines.

The procedure uses a catheter to inject particles that block abnormal blood vessels associated with knee pain, Radiology Business reported. First described in the medical literature in 2014, GAE is intended to reduce painful inflammation by reducing abnormal blood flow in the affected knee.

“Knee osteoarthritis affects millions of patients worldwide,” said Saher S. Sabri, MD, FSIR, president of SIR.

Osman Ahmed, MD, a professor of radiology at the University of Utah, and co-authors wrote that knee osteoarthritis has a “significant therapeutic gap” between failed conservative therapy and surgical arthroplasty.

Broader adoption of GAE will require continued high-quality evidence, including randomized studies, the authors noted. They said these studies are needed to separate the physiological treatment effect from placebo response and compare the procedure with conservative therapies such as intra-articular corticosteroid injections.

Regulatory pathways are also evolving. The authors noted that the U.S. Food and Drug Administration has granted Breakthrough Device designation to 5 embolic platforms, although no embolic agent currently has a formal FDA indication for musculoskeletal procedures in the U.S.

SIR emphasized that GAE should be performed by interventional specialists with formal training and advanced microcatheter experience. The society also said the procedure should be delivered within multidisciplinary care pathways and reported using standardized outcome measures.