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Knee Embolization

Knee Embolization

Living with knee problems can disrupt your quality of life, but hope is available. If you have knee arthritis, the new geniculate artery embolization (GAE) or “knee embolization” treatment, holds promise for those suffering from soreness, pain, and lack of mobility.

What is Knee Osteoarthritis (OA)

This condition can affect people of all ages, though it is most common in middle-aged and elderly adults. Osteoarthritis of the knee is a problem inside the knee joint. It occurs when the articular cartilage, the smooth caps at the end of the thigh and shin bones begin to break down. This interferes with the normal function of the knee. As the cartilage wears down, the severity of the symptoms – mostly knee pain – worsens. Traditionally, arthritis has been viewed by health care professionals as a “wear and tear” problem, however, that view is changing.

Stages of knee Osteoarthritis (OA). Kellgren and Lawrence criteria for assessment stage of osteoarthritis. The classifications are based on osteophyte formation and joint space narrowing.

Causes and Risk Factors for Development of Knee Osteoarthritis

There appear to be multiple factors which come into play in determining whether an individual will develop arthritis:

 

  • Genetics. Some people have a genetic defect in how well they produce collagen, the protein that makes up cartilage. Also, a person’s genes also control how their knee fits together. Any defect in alignment of the joint can cause early degeneration of the knee.
  • Excess weight or obesity can increase your chances of developing this condition. Excess weight overstresses the cartilage cushions of the knee joint, causing the cartilage to break down prematurely. Some studies also have suggested that excess fat in the body causes overproduction of certain inflammatory chemicals, called cytokines, that can damage joints as well.

  • Trauma or injury of the knee or surrounding bones can also lead to osteoarthritis. A fracture of the thigh or shin bone can cause the alignment of the joint to change, resulting in abnormal stress on the articular (contact) surfaces of the knee. Or a ligament tear or damage to a meniscus can alter the support required to help the knee joint function properly. Poor fitness can lead to imbalances or weaknesses of the muscles around the knee, which can affect how the joint moves and lead to premature damage to the cartilage.
  • Other disorders such as hemochromatosis, rheumatoid arthritis, acromegaly, and other systemic illnesses can affect the joints as well.
    Genetics. Some people have a genetic defect in how well they produce collagen, the protein that makes up cartilage. Also, a person’s genes also control how their knee fits together. Any defect in alignment of the joint can cause early degeneration of the knee.

How to Prevent the Condition

It may not be possible to prevent osteoarthritis in some people. However, there are steps you can take to minimize your chances of developing this debilitating condition. There is evidence that staying fit and at a healthy weight can reduce the likelihood of developing OA. A healthy diet can minimize inflammation in the body, possibly protecting against OA as well. 

When Is It Time To Seek a Medical Diagnosis?

Most people with knee pain will either self treat with NSAIDs like aspirin or Advil, or go see a doctor. A few weeks of NSAID use will often be recommended to see if the pain goes away. At some point x-rays and/or an MRI may be ordered to look at the knee in more detail. The idea here is to differentiate issues like muscle strains, tendinitis or nerve injuries from an actual joint problem. Problems due to trauma, such as internal joint problems like a torn meniscus or ligament tear, need to be diagnosed and repaired or they will lead to premature OA of the joint.

 

Interestingly, many knee pain patients thought to have arthritis or internal joint problems are found to have varicose vein disease, which can imitate a knee joint problem. Read more about varicose vein.

 

If knee pain persists despite the use of NSAIDs, or if you have suffered an injury, it is time to see a physician and get assessed. Delaying could lead to unnecessary damage to the knee joint.

How is OA of the Knee Treated?

Once you are diagnosed with OA, first-line treatment is generally NSAID medications, such as Advil. Shoe inserts and/or knee braces may be used in certain circumstances. Physical therapy is often helpful.

 

As the problem progresses, steroid injections in the knee are often performed. These will generally last 1-3 months and will, unfortunately, become less effective as the problem worsens. An alternative to long term NSAID use and/or knee injections are stronger pain medications such as narcotics. Unfortunately, patients often become dependent on narcotics when used long term and this becomes its own problem.

 

Eventually, knee replacement becomes the only option. For younger patients, knee specialists will often try to delay knee replacement surgery as long as possible because knee replacements do not last forever.

 

The new treatment for managing knee pain from osteoarthritis is Geniculate Artery Embolization or GAE.

What is GAE, and how does it work?

GAE is a minimally invasive procedure that uses a tiny catheter inserted into the arteries around the knee. Tiny particles are injected through the catheter, which blocks the smaller arteries that supply blood flow to the inner synovial lining of the knee joint. It has been found that this causes no damage to the joint but does provide relief from the pain of osteoarthritis.

 

The catheter used in this procedure is about the thickness of a strand of spaghetti and is inserted into the femoral artery at the top of the leg. There are no stitches or incisions. Recovery time is only a few hours and the patient typically notices relief of pain within a day or two.

 

GAE works because the knee pain of osteoarthritis is from chronic (long term) inflammation in the joint. This inflammation causes enlargement or thickening of the lining tissue of the joint, called the synovium. GAE shrinks the synovium, thereby relieving the pain.

 

Results of several studies have confirmed the safety of GAE, and shown it to provide substantial relief of knee pain for up to 3 years.

Why Vivid Vascular?

With a focus on patient comfort and safety, Vivid Vascular’s low-volume, boutique-style medical facility caters to the diagnosis and treatment of medical and cosmetic vascular disorders. Founded by Dr. Adam Gropper, Vivid Vascular takes a comprehensive approach to the treatment of a broad range of vascular conditions — including the latest diagnostic and therapeutic technology — in a calm, soothing atmosphere. Unlike the hectic hospital environment, each patient at Vivid Vascular receives individualized attention from our professional, knowledgeable, and compassionate staff. Our patient-centric attitude ensures that our patients receive the best care available.