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Semin intervent Radiol
DOI: 10.1055/s-0045-1808081
Review Article

Anatomic Considerations for Osteoarthritis Treatment Strategies

Abin Sajan
1   Department of Radiology, Section of Vascular and Interventional Radiology, Columbia University Medical Center, New York, New York
,
Osman Ahmed
2   Department of Radiology, Section of Vascular and Interventional Radiology, University of Chicago Medicine, Chicago, Illinois
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Abstract

Genicular artery embolization (GAE) has emerged over the recent years as a minimally invasive alternative for patients with chronic knee pain due to osteoarthritis (OA). A growing body of evidence in the literature continues to support the safety and efficacy of GAE. As more interventional radiologists adopt this service line in their practice, it is imperative to understand the genicular anatomy to optimize technical success. This review aims to summarize the anatomical considerations critical to optimizing outcomes with GAE in patients with knee OA, highlighting its growing role in clinical practice.

Keywords

osteoarthritis - genicular artery embolization


Publication History

Article published online:
22 April 2025

© 2025. Thieme. All rights reserved.

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  • References

  • 1 Zhang Y, Jordan JM. Epidemiology of osteoarthritis. Clin Geriatr Med 2010; 26 (03) 355-369
    CrossrefPubMedSearch in Google Scholar
  • 2 Steinmetz JD, Culbreth GT, Haile LM. et al; GBD 2021 Osteoarthritis Collaborators. Global, regional, and national burden of osteoarthritis, 1990-2020 and projections to 2050: a systematic analysis for the Global Burden of Disease Study 2021. Lancet Rheumatol 2023; 5 (09) e508-e522
    CrossrefPubMedSearch in Google Scholar
  • 3 Cui A, Li H, Wang D, Zhong J, Chen Y, Lu H. Global, regional prevalence, incidence and risk factors of knee osteoarthritis in population-based studies. EClinicalMedicine 2020; 29-30: 100587
    CrossrefPubMedSearch in Google Scholar
  • 4 Kiadaliri AA, Lohmander LS, Moradi-Lakeh M, Petersson IF, Englund M. High and rising burden of hip and knee osteoarthritis in the Nordic region, 1990-2015. Acta Orthop 2018; 89 (02) 177-183
    PubMedSearch in Google Scholar
  • 5 Bagla S, Piechowiak R, Sajan A, Orlando J, Hartman T, Isaacson A. Multicenter randomized sham controlled study of genicular artery embolization for knee pain secondary to osteoarthritis. J Vasc Interv Radiol 2022; 33 (01) 2-10.e2
    CrossrefPubMedSearch in Google Scholar
  • 6 Landers S, Hely R, Hely A. et al. Genicular artery embolization for early-stage knee osteoarthritis: results from a triple-blind single-centre randomized controlled trial. Bone Jt Open 2023; 4 (03) 158-167
    CrossrefPubMedSearch in Google Scholar
  • 7 van Zadelhoff TA, Bos PK, Moelker A, Bierma-Zeinstra SMA, van der Heijden RA, Oei EHG. Genicular artery embolisation versus sham embolisation for symptomatic osteoarthritis of the knee: a randomised controlled trial. BMJ Open 2024; 14 (10) e087047
    PubMedSearch in Google Scholar
  • 8 Okuno Y, Iwamoto W, Matsumura N. et al. Clinical outcomes of transcatheter arterial embolization for adhesive capsulitis resistant to conservative treatment. J Vasc Interv Radiol 2017; 28 (02) 161-167.e1
    CrossrefPubMedSearch in Google Scholar
  • 9 Sajan A, Bagla S, Isaacson A. A review of musculoskeletal embolization to treat pain outside of the knee. Semin Intervent Radiol 2021; 38 (05) 515-517
    PubMedSearch in Google Scholar
  • 10 Kishore S, Sheira D, Malin ML, Trost DW, Mandl LA. Transarterial embolization for the treatment of chronic musculoskeletal pain: a systematic review of indications, safety, and efficacy. ACR Open Rheumatol 2022; 4 (03) 209-217
    CrossrefPubMedSearch in Google Scholar
  • 11 Correa MP, Motta-Leal-Filho JM, Junior EB. et al. 6-Month follow-up of lateral femoral circumflex artery embolization to control pain related to hip osteoarthritis and greater trochanteric pain syndrome. Cardiovasc Intervent Radiol 2022; 45 (11) 1710-1715
    CrossrefPubMedSearch in Google Scholar
  • 12 Iwamoto W, Okuno Y, Matsumura N, Kaneko T, Ikegami H. Transcatheter arterial embolization of abnormal vessels as a treatment for lateral epicondylitis refractory to conservative treatment: a pilot study with a 2-year follow-up. J Shoulder Elbow Surg 2017; 26 (08) 1335-1341
    CrossrefPubMedSearch in Google Scholar
  • 13 Liu S, Swilling D, Morris EM. et al. Genicular artery embolization: a review of essential anatomic considerations. J Vasc Interv Radiol 2024; 35 (04) 487-496.e6
    CrossrefPubMedSearch in Google Scholar
  • 14 García-Pumarino R, Franco JM. Anatomical variability of descending genicular artery. Ann Plast Surg 2014; 73 (05) 607-611
    CrossrefPubMedSearch in Google Scholar
  • 15 O'Grady A, Welsh L, Gibson M, Briggs J, Speirs A, Little M. Cadaveric and angiographic anatomical considerations in the genicular arterial system: implications for genicular artery embolisation in patients with knee osteoarthritis. Cardiovasc Intervent Radiol 2022; 45 (01) 80-90
    CrossrefPubMedSearch in Google Scholar
  • 16 Bagla S, Piechowiak R, Sajan A. et al. Angiographic analysis of the anatomical variants in genicular artery embolization. J Clin Interventional Radiol 2021; 6 (01) 18-22
    PubMedSearch in Google Scholar
  • 17 Sighary M, Sajan A, Walsh JP, Marquez S. Cadaveric classification of the genicular arteries with implications for the interventional radiologist. J Vasc Interv Radiol 2021
    PubMedSearch in Google Scholar
  • 18 Callese TE, Cusumano L, Redwood KD. et al. Classification of genicular artery anatomic variants using intraoperative cone-beam computed tomography. Cardiovasc Intervent Radiol 2023; 46 (05) 628-634
    CrossrefPubMedSearch in Google Scholar
  • 19 Guermazi A, Roemer FW, Hayashi D. et al. Assessment of synovitis with contrast-enhanced MRI using a whole-joint semiquantitative scoring system in people with, or at high risk of, knee osteoarthritis: the MOST study. Ann Rheum Dis 2011; 70 (05) 805-811
    CrossrefPubMedSearch in Google Scholar
  • 20 Sajan A, Lerner J, Kasimcan MO. et al. Feasibility and technique of retrograde pedal access for genicular artery embolization. J Vasc Interv Radiol 2023; 34 (11) 2030-2033
    CrossrefPubMedSearch in Google Scholar
  • 21 Ahmed O, Epelboym Y, Haskal ZJ. et al. Society of Interventional Radiology Research Reporting Standards for genicular artery embolization. J Vasc Interv Radiol 2024; 35 (08) 1097-1103
    PubMedSearch in Google Scholar
  • 22 Little MW, O'Grady A, Briggs J. et al. Genicular Artery Embolisation in Patients with Osteoarthritis of the Knee (GENESIS) using permanent microspheres: long-term results. Cardiovasc Intervent Radiol 2024
    PubMedSearch in Google Scholar
  • 23 Little MW, Gibson M, Briggs J. et al. Genicular artEry embolizatioN in patiEnts with oSteoarthrItiS of the Knee (GENESIS) using permanent microspheres: interim analysis. Cardiovasc Intervent Radiol 2021; 44 (06) 931-940
    CrossrefPubMedSearch in Google Scholar