KNEE osteoarthritis (OA) remains a prevalent and debilitating condition, often resistant to conservative management and with limited non-surgical options. In recent years, genicular artery embolisation (GAE) has emerged as a minimally invasive technique to manage knee pain by reducing inflammation and blood flow to affected joint structures. A recent study explored the novel use of mesenchymal stem cells (MSCs) as embolic agents in GAE, assessing both the feasibility and safety of this approach in patients with bilateral knee OA. A key finding is that all procedures achieved technical success without serious complications.
The study enrolled thirty patients with clinically and radiographically confirmed bilateral knee OA. Each participant underwent unilateral GAE, with the contralateral knee acting as an internal control. A dose of 70 million mesenchymal stem cells was delivered per procedure, most commonly via the descending genicular artery. Technical success was defined as the successful intra-arterial delivery of MSCs. Safety was assessed by monitoring for adverse events related to the procedure or occurring during the 12-month follow-up. Clinical efficacy was evaluated using the Visual Analog Scale (VAS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), with MRI imaging performed at baseline and at three months.
GAE was technically successful in all 30 patients. Only two patients experienced minor, self-limiting adverse events (Society of Interventional Radiology Grade A), specifically temporary skin discolouration. No further complications were recorded throughout the follow-up period. Statistically significant improvements were observed in both WOMAC scores (from a mean of 29.6±11.5–4.6±4.5 at 12 months; p<0.001) and VAS scores (from 6.8±1.6–2.0±1.5 at 12 months; p<0.001), indicating marked reductions in pain and functional impairment.
In conclusion, genicular artery embolisation using mesenchymal stem cells was found to be both feasible and safe in this pilot cohort. The procedure demonstrated strong preliminary efficacy, with no major adverse events and significant improvements in pain and function over 12 months. However, limitations include the small sample size, lack of randomisation, and absence of long-term imaging outcomes beyond three months. Larger, controlled studies will be essential to confirm these findings and determine whether this technique can be adopted more broadly into clinical practice as a regenerative treatment option for OA.
Reference
Ghanaati H et al. Genicular Artery Embolization Using Mesenchymal Stem Cells for the Treatment of Knee Osteoarthritis: A Prospective Study. J Vasc Interv Radiol. 2025;DOI: 10.1016/j.jvir.2025.05.031.
