For decades, legions of adults enduring the chronic pain and physical limitations of knee osteoarthritis have been offered two treatment paths, both of which have drawbacks.
The more traditional route involves medications, physical therapy and maybe joint injections, and usually brings only temporary relief. The second option has been to substitute artificial material for damaged bone and cartilage — the so-called knee replacement. Each year, more than half a million people nationwide opt for the surgery, which generally yields excellent results and has a low rate of complications. However, not everyone is a candidate for knee replacement, with many having to forgo the surgery due to age or medical conditions. Some who would otherwise be candidates balk at the long rehabilitation period. Still others, aware of the 15- to 20-year implant life, put off having surgery as long as possible to avoid needing another operation later on.
Since 2017, UCLA has been among the only U.S. medical centers to offer a middle-ground option. Genicular artery embolization (GAE) aims to permanently reduce inflammation in the knee joint, widely believed to be the cause of the pain and dysfunction. In the procedure, tiny particles are injected into the enlarged artery, decreasing blood flow to the area. Most patients can resume normal activities by evening on the day of the procedure, with maximum pain relief typically occurring in the first one to three months.
A team headed by Siddharth Padia, a UCLA vascular and interventional radiologist, recently published results of the largest U.S. clinical trial of GAE. Of 40 patients with moderate or severe knee arthritis who weren’t benefiting from conservative therapies, more than half reported a significant reduction in pain and improvement in function following a GAE procedure. “Total knee replacement is still the gold-standard procedure for people with advanced-stage knee arthritis,” Padia says. “But for those who aren’t candidates or who aren’t ready, genicular artery embolization shows significant benefit and doesn’t affect the ability to get a total knee replacement in the future.”
Padia, who also performs GAE for frozen shoulder and tennis elbow, estimates that his office has received approximately 1,500 inquiries about the procedure in the last three years. “There have been markedly few developments in treating this patient population,” he says. “Until we began doing this, I didn’t fully appreciate the unmet need.”
Read more from UCLA Magazine's April 2022 issue.