¹Center for Musculoskeletal Surgery, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Deutschland
²Istituto Ortopedico Rizzoli, Bologna – Università degli Studi “Alma Mater Studiorum” di Bologna, Bologna, Italien
³Department of Diagnostic and Interventional Radiology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Deutschland
⁴Institute of Biometry and Clinical Epidemiology, Charité – Universitätsmedizin Berlin, Berlin, Deutschland
⁵Julius Wolff Institute, Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Berlin, Deutschland
⁶Berlin Institute of Health Center for Regenerative Therapies, Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Berlin, Deutschland

Text

Objectives and questions: Patellofemoral osteoarthritis (PFOA) is a debilitating condition characterized by chronic anterior knee pain that significantly impacts patients quality of life. Conservative treatments often provide limited relief, and surgical options are invasive and not always suitable for isolated PFOA. Abnormal hypervascularity in the genicular arteries has been implicated as a potential contributor to pain in patellofemoral osteoarthritis, making Genicular Artery Embolization (GAE) an emerging minimally invasive option for effective pain relief. The aim of this study is to evaluate the safety and efficacy of GAE in reducing chronic pain associated with PFOA.

Material and methods: This prospective, single-center pilot study included 41 patients with chronic anterior knee pain due to PFOA confirmed by clinical examination and imaging. Embolization was performed using temporary particles targeting hypervascular regions identified via angiography. Outcomes were assessed at baseline, six weeks, three, six, and twelve months post-procedure using the Knee Injury and Osteoarthritis Outcome Score (KOOS), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Patient-Reported Outcomes Measurement Information System (PROMIS). Adverse events were recorded throughout follow-up.

Results: An average of 1.8 ± 1 hypervascular genicular arteries were embolized per patient, with a median embolic material volume of 2.5 mL. KOOS Pain scores improved from 43 ± 15 at baseline to 66 ± 14 at twelve months (P < .05), while PROMIS Pain Intensity scores decreased from 6.4 ± 1.6 to 4.1 ± 1.7 at twelve months (P < .05). Quality of life (KOOS QoL) improved in 100% of patients at 6 months. Minor adverse events included transient skin discoloration in 8 patients (19%).

Discussion and conclusions: Preliminary findings suggest that GAE is a safe and potentially effective treatment for managing chronic anterior knee pain associated with PFOA. This study highlights GAE as a novel and minimally invasive approach for pain relief in patients with limited therapeutic options. Further studies with larger cohorts and randomized control trials are needed to confirm these findings.