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. 2023 Mar:41:38-47.
doi: 10.1016/j.knee.2022.12.008. Epub 2023 Jan 4.

Two-year outcomes comparing Embosphere® microspheres versus Imipenem Cilastatin for genicular artery embolization in patients with moderate to severe knee osteoarthritis

Shivank Bhatia  1 , Hamed Jalaeian  1 , Jessica Kumar  1 , Vedant Acharya  2 , Masahiko Shibuya  3 , Ansh Bhatia  4 , Yuji Okuno  3
Affiliations

Two-year outcomes comparing Embosphere® microspheres versus Imipenem Cilastatin for genicular artery embolization in patients with moderate to severe knee osteoarthritis

Shivank Bhatia et al. Knee. 2023 Mar.

Abstract

Background: Genicular artery embolization (GAE) is a novel technique and has the potential to provide midterm relief of pain for patients with mild-to-moderate knee osteoarthritis resistant to conservative management. This study compares the efficacy and safety of trisacryl gelatin microspheres to Imipenem/Cilastatin particles for GAE with 2 years of clinical follow-up.

Methods: In this retrospective study, eight patients with knee osteoarthritis (11 knees) who underwent GAE with 100-300 μm trisacryl gelatin microspheres particles were compared with six patients (nine knees) who underwent GAE with Imipenem/Cilastatin particles. Clinical outcomes were evaluated at 3-month and 24-month follow-ups and compared to baseline using the WOMAC questionnaire.

Results: The median follow-up was 796 days (range: 736-808). There were no significant differences in clinical outcome measures at the 3-month or 24-month follow-up. Both embolic materials resulted in a decrease in Pain WOMAC and Total WOMAC scores at 3 months (p < 0.05), and the effect of treatment on Pain WOMAC and Total WOMAC score reduction was sustained until the 24-month follow-up (p < 0.05). Minor events (Clavien-Dindo classification grade I) included transient cutaneous color change (n = 3) and transient leg numbness (n = 1) after embolization with trisacryl gelatin microspheres particles (p = 0.08). All minor adverse events resolved spontaneously. There were no major adverse events.

Conclusion: One hundred to three hundred μm trisacryl gelatin microspheres particles can be considered for genicular artery embolization and is comparable to Imipenem/Cilastatin particles in pain reduction of moderate to severe knee osteoarthritis. A sustained effect is observed for up to 2 years of follow-up.

Keywords: Embosphere; Genicular artery embolization; Imipenem/Cilastatin; Osteoarthritis; Pain.

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Conflict of interest statement

Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Shivank Bhatia reports a relationship with Embolx that includes: consulting or advisory. Shivank Bhatia reports a relationship with Merit Medical Systems Inc that includes: consulting or advisory, funding grants, and travel reimbursement. Yuji Okuno reports a relationship with Asahi Intecc Co Ltd that includes: consulting or advisory, funding grants, and speaking and lecture fees.

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