[Osteoarthritis of the Knee] [Transarterial Microembolization (TAME)] Successful Case Sharing

Ms. W, 63 years old, had been experiencing pain in her right knee for more than 2 years. After seeking medical help, she was diagnosed with stage 2 "degenerative knee arthritis" and had to use painkillers and pain patches for a long time.

After months of rehabilitation therapy, several intra-articular steroid injections, and proliferative therapy, the pain persisted, with a pain index (out of 10) reaching a high level of 7. The pain would begin after walking for only a short time, and without medication, the pain was so severe that she couldn't sleep.

After various treatments proved ineffective, Ms. W consulted National Cheng Kung University Hospital Orthopedics and was subsequently referred to the Interventional Medicine Center for further discussion.

Following discussions with Ms. W, Bow Wang, M.D. ultimately opted for "transarterial embolization therapy for inflammatory vessels." Guided by X-ray fluoroscopy and under local anesthesia, a microcatheter was inserted through a puncture in the inguinal artery into the painful area.

Then, under arterial angiography, contrast agent was injected to identify newly formed capillary-like vessels; embolizing medication was then injected through the microcatheter to remove these abnormal capillary-like vessels.

Two weeks after embolization treatment, Ms. W's pain while walking began to decrease significantly, with her pain index dropping from 7 to 2.

(Video recorded with the patient's consent)

Four months after embolization treatment, Ms. W received a second, enhanced treatment, and her pain index finally dropped from 2 to 0-1.

Bow Wang, M.D. reminds patients that "transarterial embolization" for "knee osteoarthritis" also has limitations. Its main indications are grade I to III osteoarthritis of the knee, a pain index exceeding 5, and no significant improvement after more than three months of various treatments.

This treatment is not suitable in the following situations:

1. Severe bone and joint degeneration and destruction shown on X-ray

2. Pain accompanied by other nerve compression symptoms, such as numbness

3. Poor kidney function (eGFR < 30 mL/min/1.73m2)

4. Low platelet count, abnormal coagulation function

5. The patient is unable to lie flat for two hours

6. Pregnancy

Side effects of the treatment include potential local hematoma and bruising at the puncture site; temporary local discoloration at the embolization site may occur, which usually improves and disappears within several days to a month.

It is recommended that patients undergo a thorough evaluation by a physician to identify the true source of pain, and have a full discussion with their doctor and family to understand the treatment process and related precautions before receiving treatment for better assurance.