Doctors Discover “Minimally Invasive Treatment” That Can Delay a Knee Replacement

Knee pain can stop you in your tracks, but a new, minimally invasive treatment is giving patients reason to jump for joy. Performed in less than two hours under only mild sedation, this new approach could relieve chronic knee pain caused by osteoarthritis and delay more invasive knee replacement surgery, an NYU Langone Health study shows.

RELATED: The No. 1 Walking Change That Can Help You Delay a Knee Replacement.

Knee replacement surgery is becoming more common.

Every year, nearly 900,000 Americans undergo knee replacement surgery, and that number is expected to rise as the population ages, according to Cleveland Clinic. The procedure involves replacing all or some of a patient’s damaged knee joint with an artificial joint made of metal and plastic.

One of the most common conditions requiring knee replacement surgery is osteoarthritis, which affects over 32 million Americans, or roughly 10 percent of the adult population of the U.S. Though anyone can develop osteoarthritis over time, people who are overweight, put prolonged stress on the joints, or have experienced past knee injuries are at the greatest risk.

“Osteoarthritis of the knee happens when the cartilage in your knee joint breaks down, causing the bones to rub together,” Cleveland Clinic further explains. “This friction causes pain and swelling in your knee, leading to stiffness.”

But a potential new treatment is significantly less invasive.

In this latest advancement, announced on Aug. 12 in the Journal of Vascular Interventional Radiology, scientists were able to curb the symptoms of osteoarthritis by reducing inflammation. They did this by delivering chemical beads through an image-guided plastic tube, thereby blocking blood flow to selected arteries to the knee—a procedure known as genicular artery embolization.

“As they gradually break down, knee joints in people with osteoarthritis are known to become inflamed, which triggers the growth of small blood vessels (angiogenesis) and increased blood flow to joints,” the study authors explain.

The results were impressive. Over 60 percent of the total subjects—a group of 25 men and women aged 50 to 78—experienced significant improvements in their pain levels one year after the procedure.

“Our study shows that genicular artery embolization is a safe and effective, minimally invasive treatment for those with moderate to severe symptomatic knee pain tied to osteoarthritis,” said study co-investigator and interventional radiologist Ryan Hickey, MD, via news release.

RELATED: Can You Delay a Knee Replacement? New Treatment Approach May Eliminate Pain.

The treatment could offer other benefits, too.

“This work also provides evidence that genicular artery embolization is offering more than just pain relief and could be modifying the diseases process itself,” Hickey added, referring to several important changes in the body that the researchers observed one year after surgery.

One of them was a 12 percent drop in the amount of a protein called VEGF in the blood. This protein helps the body grow new blood vessels, and past studies have shown it may also be linked to changes in the knee caused by osteoarthritis.

Though the researchers also used surveys to assess the patients’ knee pain, stiffness, and functionality, Bedros Taslakian, MD, MA, study principal investigator and lead author, noted that tracking VEGF levels after the procedure could serve as a biomarker to assess the success of the surgery.

Another protein called IL-1Ra also went down by about 15 percent, helping to reduce inflammation in the body.

“Our study findings also indicate that genicular artery embolization may, if further larger clinical trials prove successful, slow down the progression of osteoarthritis by observing significant decreases in signaling proteins, specifically vascular endothelial growth factor and interleukin 1 receptor agonist, one year after the procedure,” said Taslakian.

Ultimately, this intervention could help to stave off a full knee replacement in those with moderate to severe osteoarthritis who have been unresponsive to first-line therapies, such as corticosteroid injections, fluid aspiration, and physiotherapy.

“This procedure is particularly suited to those patients who are either not yet ready for knee replacement surgery or for whom surgery is not an option because of age or other risk factors, such as obesity, uncontrolled diabetes or heart disease, or smoking,” Hickey said.

Other helpful interventions include maintaining a healthy weight, changing how you walk, focusing on flexibility, and strengthening the muscles surrounding the knee.