Genicular Artery Embolization for Chronic Exudative Knee Synovitis: Prospective 6-Month Clinical and Functional Outcomes

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Abstract
Background/Objectives: The aim of this study is to analyze outcomes in patients who underwent genicular artery embolization (GAE) with respect to pain, symptoms, physical activity, quality of life, and knee joint range of motion and muscle strength of the knee joint. The study will provide evidence of the treatment’s effectiveness using both subjective and objective measurements. In addition, the study will examine the impact of the severity of radiological changes in the knee joint and the number of embolized vessels on the extent of improvement in outcomes following the procedure. Methods: Patients eligible for GAE who exhibited symptoms of chronic exudative knee arthritis, confirmed by USG and MRI with contrast, did not have laboratory markers of inflammation, nor did they respond effectively to standard non-surgical treatments. The analysis included 34 patients. Subjective parameters were assessed using the VAS and KOOS scales. Knee range of motion and muscle strength were assessed using an electronic dynamometer and goniometer. Measurements were performed according to the same schedule before GAE, and at 1, 3 and 6 months after the procedure. The results were subjected to statistical analysis. Results: In the analysis up to 6 months, a significant time effect was demonstrated for the VAS and all KOOS subscales. The improvement was visible after 1 month and continued after 3 and 6 months. No significant changes over time were demonstrated for objective parameters. Exploratory analysis demonstrated a relationship between increased knee extensor strength and pain reduction up to 3 months and increased range of motion up to 6 months after the GAE. There was no significant association between radiological changes and the number of embolized vessels with improved outcomes after GAE. Conclusions: GAE appears to be a promising minimally invasive treatment option for patients with chronic knee synovitis. Clinically meaningful improvements were observed in patient-reported outcomes.

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