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    2. Deutscher Kongress für Orthopädie und Unfallchirurgie 2025 (DKOU 2025)
    3. Genicular artery embolization for the treatment of symptomatic knee osteoarthritis
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German Congress of Orthopaedics and Traumatology (DKOU 2025)

Deutsche Gesellschaft für Orthopädie und Unfallchirurgie (DGOU), Deutsche Gesellschaft für Orthopädie und Orthopädische Chirurgie (DGOOC), Deutsche Gesellschaft für Unfallchirurgie (DGU), Berufsverband für Orthopädie und Unfallchirurgie (BVOU)
28.-31.10.2025
Berlin


Meeting Abstract

Genicular artery embolization for the treatment of symptomatic knee osteoarthritis

Florian Fleckenstein 1
Tazio Maleitzke 2
Alexander Hildebrandt 2
Federico Collettini 1
Tobias Winkler 2
1Department of Diagnostic and Interventional Radiology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Deutschland
2Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Orthopedic and Traumasurgery, Berlin, Deutschland

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Objectives and questions: Genicular artery embolization (GAE) is an innovative minimally invasive therapy for patients with symptomatic knee osteoarthritis (OA) refractory to conservative treatments, aiming to reduce synovial arterial hypervascularity. This study evaluates the safety and efficacy of GAE for the treatment of symptomatic knee OA.

Material and methods: A retrospective, single-center study was conducted at our institution. Patients enrolled in the study were aged 40 to 90 years, had moderate to severe knee OA (Kellgren-Lawrence grade 2 to 4), and had previously experienced failure of conservative therapy. Baseline pain (assessed using the visual analog scale [VAS]) and symptom scores (Knee Injury and Osteoarthritis Outcome Score [KOOS]) were evaluated. After achieving femoral arterial access via a 4 Fr sheath, embolization was performed using Imipenem/Cilastatin. Target vessels were determined using digital subtraction angiography in correlation with the patients' pain points. Adverse events and symptom scores were assessed at six weeks, three months, and six months after GAE.

Results: 444 GAE procedures and patient-reported outcomes were available for 265, 199, 167 and 137 patients at 6-weeks, 3-, 6- and 12-months follow-up, respectively. The median age of the patients was 69 years (IQR 61–74), with OA severity distributed as 12% grade 2, 41% grade 3, and 47% grade 4. The procedure had a technical success rate of 100%. Transient skin discoloration and mild knee pain were reported in 18% of cases, with no severe complications. At 12 months, the KOOS quality of life index and VAS scores improved by 87% and 71%, respectively, from baseline values of 57 (KOOS) and 7 (NRS). These improvements were consistent across varying severities of OA

Discussion and conclusions: This study demonstrates that GAE is an effective and safe treatment option for patients with symptomatic knee OA who do not respond to conservative treatments. The significant improvements in pain and quality of life across a large patient cohort suggest that GAE is a viable alternative to more invasive procedures, such as total knee arthroplasty.