Embolization of the arteries in the relief of joint and near joint pain: how, when and in whom? A review

Cover Page

Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access


This paper presents the results of embolization of popliteal artery branches as an innovative technique to treat pain syndrome not relieved by standard conservative methods for osteoarthritis of the knee joint. The study aimed to evaluate available data on the efficacy and safety of popliteal artery branch embolization in the treatment of pain syndrome in osteoarthritis. Relevant studies on the use of embolization at various degrees of gonarthrosis were analyzed. The results were evaluated using the visual analog scale and Western Ontario and McMaster University Osteoarthritis Index. The performance of patients improved based on both scales, and minor complications resolved on their own. Embolization of the branches of the popliteal artery with insufficiency is a promising and effective treatment method for patients with pain due to osteoarthritis of the knee joint of various degrees, and no serious complications have been identified in the procedures, making it safe.

Full Text

Restricted Access

About the authors

Kamal M. Medjidov

Domodedovo Central City Hospital

Author for correspondence.
Email: Medjidof@mail.ru
ORCID iD: 0000-0003-3967-3782


Russian Federation, Domodedovo

Mikhail V. Parshikov

Yevdokimov Moscow State University of Medicine and Dentistry

Email: parshikovmikhail@gmail.com
ORCID iD: 0000-0003-4201-4577
SPIN-code: 5838-4366

MD, Dr. Sci. (Med.), Professor

Russian Federation, Moscow

Leonid M. Ginzburg

Domodedovo Central City Hospital

Email: 1235263@yandex.ru
ORCID iD: 0000-0001-6807-731X

MD, Cand. Sci. (Med.), Department Head

Russian Federation, Domodedovo

Yuri S. Solov’yev

Domodedovo Central City Hospital

Email: iurij.soloviov@yandex.ru
ORCID iD: 0000-0001-6531-9491
SPIN-code: 3714-1423

Department Head

Russian Federation, Domodedovo

Ibragim M. Uzhakhov

Yevdokimov Moscow State University of Medicine and Dentistry

Email: ibra_moscow@mail.ru
ORCID iD: 0000-0002-2749-9820
SPIN-code: 4894-8483

Department Assistant, Traumatologist-Orthopedist

Russian Federation, Moscow


  1. Peat G, McCarney R, Croft P. Knee pain and osteoarthritis in older adults: a review of community burden and current use of primary health care. Ann Rheum Dis. 2001;60(2):91–97. doi: 10.1136/ard.60.2.91
  2. Loeser RF, Goldring SR, Scanzello CR, Goldring MB. Osteoarthritis: a disease of the joint as an organ. Arthritis Rheum. 2012;64(6):1697–1707. doi: 10.1002/art.34453
  3. Goldring MB, Otero M. Inflammation in osteoarthritis. Curr Opin Rheumatol. 2011;23(5):471–478. doi: 10.1097/BOR.0b013e328349c2b1
  4. Jacobson AF, Myerscough RP, Delambo K, et al. Patients’ perspectives on total knee replacement. Am J Nurs. 2008;108(5):54–63. doi: 10.1097/01.NAJ.0000318000.62786.fb
  5. Wathiong J, Brys P, Samson I, Maleux G. Selective arterial embolization in the treatment of an aneurysmal bone cyst of the pelvis. JBR-BTR. 2003;86(6):325–328.
  6. Mavrogenis AF, Angelini A, Rossi G, et al. Successful NBCA embolization of a T2 aneurysmal bone cyst. Acta Orthop Belg. 2014;80(1):126–131.
  7. Guzman R, Dubach-Schwizer S, Heini P, et al. Preoperative transarterial embolization of vertebral metastases. Eur Spine J. 2005;14(3):263–268. doi: 10.1007/s00586-004-0757-6
  8. Gottfried ON, Schmidt MH, Stevens EA. Embolization of sacral tumors. Neurosurg Focus. 2003;15(2):E4. doi: 10.3171/foc.2003.15.2.4
  9. Iwamoto W, Okuno Y, Matsumura N, et al. Transcatheter arterial embolization of abnormal vessels as a treatment for lateral epicondylitis refractory to conservative treatment: a pilot study with a 2-year follow-up. J Shoulder Elbow Surg. 2017;26(8):1335–1341. doi: 10.1016/j.jse.2017.03.026
  10. Gremen E, Frandon J, Lateur G, et al. Safety and Efficacy of Embolization with Microspheres in Chronic Refractory Inflammatory Shoulder Pain: A Pilot Monocentric Study on 15 Patients. Biomedicines. 2022;10(4):744. doi: 10.3390/biomedicines10040744
  11. Landers S, Hely R, Page R, et al. Genicular Artery Embolization to Improve Pain and Function in Early-Stage Knee Osteoarthritis-24-Month Pilot Study Results. J Vasc Interv Radiol. 2020;31(9):1453–1458. doi: 10.1016/j.jvir.2020.05.007
  12. Little MW, Gibson M, Briggs J, et al. Genicular artery embolization in patients with osteoarthritis of the Knee (GENESIS) Using Permanent Microspheres: Interim Analysis. Cardiovasc Intervent Radiol. 2021;44(6):931–940. doi: 10.1007/s00270-020-02764-3
  13. Guevara CJ, Lee KA, Barrack R, Darcy MD. Technically Successful Geniculate Artery Embolization Does Not Equate Clinical Success for Treatment of Recurrent Knee Hemarthrosis after Knee Surgery. J Vasc Interv Radiol. 2016;27(3):383–387. doi: 10.1016/j.jvir.2015.11.056
  14. Ashraf S, Wibberley H, Mapp PI, et al. Increased vascular penetration and nerve growth in the meniscus: a potential source of pain in osteoarthritis. Ann Rheum Dis. 2011;70(3):523–529. doi: 10.1136/ard.2010.137844
  15. Mapp PI, Walsh DA. Mechanisms and targets of angiogenesis and nerve growth in osteoarthritis. Nat Rev Rheumatol. 2012;8(7):390–398. doi: 10.1038/nrrheum.2012.80
  16. Walsh DA, McWilliams DF, Turley MJ, et al. Angiogenesis and nerve growth factor at the osteochondral junction in rheumatoid arthritis and osteoarthritis. Rheumatology (Oxford). 2010;49(10):1852–1861. doi: 10.1093/rheumatology/keq188
  17. Walsh DA, Bonnet CS, Turner EL, et al. Angiogenesis in the synovium and at the osteochondral junction in osteoarthritis. Osteoarthritis Cartilage. 2007;15(7):743–751. doi: 10.1016/j.joca.2007.01.020
  18. Weng LH, Ko JY, Wang CJ, et al. Dkk-1 promotes angiogenic responses and cartilage matrix proteinase secretion in synovial fibroblasts from osteoarthritic joints. Arthritis Rheum. 2012;64(10):3267–3277. doi: 10.1002/art.34602
  19. Pesesse L, Sanchez C, Henrotin Y. Osteochondral plate angiogenesis: a new treatment target in osteoarthritis. Joint Bone Spine. 2011;78(2):144–149. doi: 10.1016/j.jbspin.2010.07.001
  20. Okuno Y, Korchi AM, Shinjo T, Kato S. Transcatheter arterial embolization as a treatment for medial knee pain in patients with mild to moderate osteoarthritis. Cardiovasc Intervent Radiol. 2015;38(2):336–343. doi: 10.1007/s00270-014-0944-8
  21. Okuno Y, Korchi AM, Shinjo T, et al. Midterm clinical outcomes and MR imaging changes after transcatheter arterial embolization as a treatment for mild to moderate radiographic knee osteoarthritis resistant to conservative treatment. J Vasc Interv Radiol. 2017;28(7):995–1002. doi: 10.1016/j.jvir.2017.02.033
  22. Lee SH, Hwang JH, Kim DH, et al. Clinical outcomes of transcatheter arterial embolisation for chronic knee pain: mild-to-moderate versus severe knee osteoarthritis. Cardiovasc Intervent Radiol. 2019;42(11):1530–1536. doi: 10.1007/s00270-019-02289-4
  23. Antipov VA, Smyshlyaev IA, Tumakov MI, Gilfanov SI. The possibilities superselective embolization of the genucular artery as a treatment osteoarthritis for mild knee osteoarthritis. Modern literature review. Analysis of the world experience. Kremlin Medicine Journal. 2019;(2):100–117. (In Russ). doi: 10.26269/y4wv-cn09
  24. Kozadaev MN, Shchanitsyn IN, Girkalo MV, et al. Management of Chronic Pain Syndrome in Knee Osteoarthritis with Selective Embolization of Popliteal Artery Branches: Review. Traumatology and Orthopedics of Russia. 2020;26(4):163–174. (In Russ). doi: 10.21823/2311-2905-2020-26-4-163-174
  25. Bagla S, Piechowiak R, Hartman T, et al. Genicular artery embolization for the treatment of knee pain secondary to osteoarthritis. J Vasc Interv Radiol. 2019;31(7):1–7. doi: 10.1016/j.jvir.2019.09.018
  26. Van Zadelhoff TA, Okuno Y, Bos PK, et al. Association between Baseline Osteoarthritic Features on MR Imaging and Clinical Outcome after Genicular Artery Embolization for Knee Osteoarthritis. J Vasc Interv Radiol. 2021;32(4):497–503. doi: 10.1016/j.jvir.2020.12.008
  27. Bedson J, Croft PR. The discordance between clinical and radiographic knee osteoarthritis: a systematic search and summary of the literature. BMC Musculoskelet Disord. 2008;9:116. doi: 10.1186/1471-2474-9-116
  28. Torkian P, Golzarian J, Chalian M, et al. Osteoarthritis-Related Knee Pain Treated With Genicular Artery Embolization: A Systematic Review and Meta-analysis. Orthop J Sports Med. 2021;9(7):23259671211021356. doi: 10.1177/23259671211021356
  29. Bagla S, Piechowiak R, Sajan A, et al. Multicenter Randomized Sham Controlled Study of Genicular Artery Embolization for Knee Pain Secondary to Osteoarthritis. J Vasc Interv Radiol. 2022;33(1):2.e2–10.e2. doi: 10.1016/j.jvir.2021.09.019
  30. Casadaban LC, Mandell JC, Epelboym Y. Genicular Artery Embolization for Osteoarthritis Related Knee Pain: A Systematic Review and Qualitative Analysis of Clinical Outcomes. Cardiovasc Intervent Radiol. 2021;44(1):1–9. doi: 10.1007/s00270-020-02687-z
  31. Digge VK, Kumar V, Kar S, et al. Is there evidence to recommend transcatheter arterial embolisation in adhesive capsulitis: A review of literature. J Orthop. 2022;30:77–82. doi: 10.1016/j.jor.2022.02.008
  32. Fernández Martínez AM, Baldi S, Alonso-Burgos A, et al. Mid-Term Results of Transcatheter Arterial Embolization for Adhesive Capsulitis Resistant to Conservative Treatment. Cardiovasc Interv Radiol. 2021;44(3):443–451. doi: 10.1007/s00270-020-02682-4
  33. Sajan A, Bagla S, Isaacson A. A Review of Musculoskeletal Embolization to Treat Pain Outside of the Knee. Semin Intervent Radiol. 2021;38(5):515–517. doi: 10.1055/s-0041-1736530
  34. Landers S, Hely A, Harrison B, et al. Protocol for a single-centre, parallel-arm, randomised controlled superiority trial evaluating the effects of transcatheter arterial embolisation of abnormal knee neovasculature on pain, function and quality of life in people with knee osteoarthritis. BMJ Open. 2017;7(5):e014266. doi: 10.1136/bmjopen-2016-014266
  35. Sajan A, Bagla S, Isaacson A. Musculoskeletal Interventions: A Review on Genicular Artery Embolization. Semin Intervent Radiol. 2021;38(5):511–514. doi: 10.1055/s-0041-1736529
  36. Padia SA, Genshaft S, Blumstein G, et al. Genicular Artery Embolization for the Treatment of Symptomatic Knee Osteoarthritis. JB JS Open Access. 2021;6(4):e21.00085. doi: 10.2106/JBJS.OA.21.00085
  37. Lauko K, Tangchaiburana S, Padia SA. Transarterial genicular artery embolization as treatment of painful knee osteoarthritis in a 64-year-old woman. J Radiol Nurs. 2020;39(2):89–91. doi: 10.1016/j.jradnu.2020.02.002
  38. Choi JW. Genicular Artery Embolization: Beyond the Placebo Effect, and Planning for the Long Road Ahead. J Vasc Interv Radiol. 2022;33(1):11–13. doi: 10.1016/j.jvir.2021.09.020

Copyright (c) 2023 Eco-Vector

СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77-76249 от 19.07.2019.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies