Geniculate Artery Embolization for the Treatment of Knee Pain Secondary to Osteoarthritis
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Osteoarthritis Of Knee
- Sponsor
- University of North Carolina, Chapel Hill
- Enrollment
- 20
- Locations
- 2
- Primary Endpoint
- Patient Function (Units on a Scale)
- Status
- Completed
- Last Updated
- 6 years ago
Overview
Brief Summary
This study is to test a new treatment method, geniculate artery embolization (GAE), to reduce the severity of pain and disability caused by knee osteoarthritis.
Detailed Description
Purpose: The primary aims of this study are to determine if geniculate artery embolization (GAE) will reduce the severity of pain as well as global disability (resulting from the combination of pain, stiffness and difficulty performing daily activities) caused by knee OA and if it can be performed safely. The secondary aim is to determine if GAE can result in the decreased necessity for ongoing conservative OA therapies such as medication therapy and joint injections. Participants: Twenty patients with knee osteoarthritis resulting in knee pain that is refractory to conservative therapies, who are not planning to undergo surgery within 6 months. Procedures (methods): This will be an open label 24-month pilot study with a small population undergoing GAE to determine safety and efficacy. Clinical procedures and evaluations will consist of a preoperative screening assessment to determine if the potential study subject meets the inclusion and exclusion criteria, enrollment, surgical procedure for geniculate artery embolization, and follow-up visits at 24 hours, 1, 3 \& 6 months. An MRI will be performed at the 1-month visit to detect a change in synovial vascularity and to exclude complication.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Moderate to severe knee pain (visual analog scale (VAS) \> 50 mm), and
- •Pain refractory to at least 3 months\* of conservative therapies (anti-inflammatory drugs, or physical therapy, or muscle strengthening, or intra-articular injections), and
- •Kellgren-Lawrence grade 1, 2 or 3 on radiograph of the knee.
Exclusion Criteria
- •Current local infection, or
- •Life expectancy less than 6 months, or
- •Known advanced atherosclerosis, or
- •Rheumatoid or infectious arthritis, or
- •Prior knee surgery, or
- •Uncorrectable coagulopathy including international normalized ratio (INR) \> 2.5 or platelets \< 30,000, or
- •Iodine allergy resulting in anaphylaxis, or
- •Renal dysfunction as defined by serum creatinine \>1.6 dl/mg obtained within the past 30 days.
Outcomes
Primary Outcomes
Patient Function (Units on a Scale)
Time Frame: 6 months
Western Ontario and McMaster University Osteoarthritis Index will be used to measure function. This is a score derived from a questionnaire in which the patient answers questions regarding rheumatic symptoms, stiffness, pain and how it affects the ability to function. Participants are asked to rate each question on a scale from 0 to 4 (0 = None, 1 = Slight, 2 = Moderate, 3 = Very, 4 = Extremely) for the level of difficulty to complete each task. The categories are then totaled for an overall score out of 96. Higher values indicate greater levels of pain, stiffness, and functional limitations.
Patient Pain (mm)
Time Frame: 6 months
The pain intensity is assessed using a visual analogue scale (VAS), which is a horizontal line 100 mm in length. Subjects mark the VAS with a single vertical line to indicate their current pain level, with 0 mm representing "No Pain" and 100 mm representing "Worst Possible Pain".
Secondary Outcomes
- Reduction in Medication (Percentage of Participants With a Reduction in Medication Therapy at Month 6)(6 months)