Research & Academic Exchange

[Osteoarthritis of the Knee] [Transarterial Microembolization (TAME)] Pain Relief Treatment: Latest Literature Review; Taiwan Society of Interventional Radiology 111th Annual Meeting/Academic Exchange

Creator: Bow Wang, M.D.
Published: 2022-03-06

2022-03-06Author and reviewer: Bow Wang, M.D.

[Osteoarthritis of the Knee] [Transarterial Microembolization (TAME)] Pain Relief Treatment: Latest Literature Review; Taiwan Society of Interventional Radiology 111th Annual Meeting/Academic Exchange — related image 1

Author: Bow Wang, M.D.

Today, I am honored to participate in the 111th Annual Quarterly Symposium of the Taiwan Society of Interventional Radiology, where I shared a review of recent important literature on the application of vascular embolization for pain relief and related experience in treatment at National Cheng Kung University.

Research indicates that pain in osteoarthritis of the knee is related to abnormally newly formed microvessels and… Closely related to inflammatory cells, these abnormal, capillary-like blood vessels lead to the formation of inflammatory cells and tiny, pain-related nerves, resulting in joint swelling and chronic pain.

【Transarterial Microembolization (TAME)】By clearing the proliferating abnormal capillaries (angiogensis), inflammation is inhibited, and the proliferation and stimulation of sensory nerves are slowed, thus relieving pain. Ref: Heller et al. Geniculate Artery Embolization: Role in Knee Hemarthrosis and Osteoarthritis. Radiographics 2021:210159.

"Transarterial Microvascular Embolization"Technique"Treatment via arterial intervention, using a microcatheter to select the pain location and corresponding patellar artery."Ref: Okuno et al. Transcatheter arterial embolization as a treatment for medial knee pain in patients with mild to moderate osteoarthritis. CVIR 2015;38(2):336-343.

"Transarterial Microvascular Embolization"Technique"Embryostasis blocks the abnormal new hair-like microvascular formation caused by arthritis." The procedure targets fine blood vessels and related pain nerves, thereby improving pain caused by chronic joint inflammation.Ref: Okuno et al. CVIR 2015;38(2):336-343.

The table above shows the results of this treatment in Japan, South Korea, the UK, and the US. The vertical axis represents the patient's subjective pain score, and the horizontal axis represents the time after treatment. The graph shows that "Transarterial Microvascular Embolization" is more suitable forMild to moderate (KL1-3) degree osteoarthritis of the knee.This treatment is less effective for severe osteoarthritis of the knee (KL4) (dark blue dashed line). Ref: Heller et al. Radiographics 2021:210159.

Severity staging of osteoarthritis of the knee: Grades 1-2 are mild, Grade 3 is moderate, and Grade 4 is severe. Ref: Severity grading and corresponding treatment of osteoarthritis of the knee. Orthopedic Soul - Joint Degeneration and Osteoporosis - Dai Dawei;https://bonedavid.com/1885/；Kellgren and Lawrence system for classification of osteoarthritis

Bow Wang, M.D. reminds that transarterial embolization (TAE) for "degenerative knee osteoarthritis" also has its limitations. The main indications are mild to moderate (KL1-3) degenerative arthritis with a pain index exceeding 5 points, and who have received various traditional treatments (https://bonedavid.com/1885/)) for more than three months without significant improvement.

Furthermore, this treatment is not suitable in the following situations:

1. Severe tendon or ligament damage or rupture

2. Pain accompanied by other symptoms of nerve compression

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

4. Low platelet count, abnormal coagulation function

5. Patient unable to lie flat for two hours

6. Pregnancy

Treatment side effects include possible local hematoma and bruising at the puncture site; temporary local discoloration at the embolization site, which will improve and disappear within minutes to a month.

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

Bow Wang, M.D. Clinic Online Appointment

This page is for medical education and academic communication. It does not replace individual diagnosis or treatment advice.

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