Minimally Invasive Therapies for Knee Osteoarthritis

Author:

Osuala Uchenna1ORCID,Goh Megan H.2ORCID,Mansur Arian2ORCID,Smirniotopoulos John B.13ORCID,Scott Arielle4ORCID,Vassell Christine4,Yousefi Bardia4ORCID,Jain Neil K.3ORCID,Sag Alan A.5,Lax Allison6,Park Kevin W.7,Kheradi Alexander8,Sapoval Marc9,Golzarian Jafar1011,Habibollahi Peiman12,Ahmed Osman13,Young Shamar14ORCID,Nezami Nariman11516ORCID

Affiliation:

1. Georgetown University School of Medicine, Washington, DC 20007, USA

2. Harvard Medical School, Cambridge, MA 02115, USA

3. Division of Vascular and Interventional Radiology, MedStar Washington Hospital Center, Washington, DC 20010, USA

4. Department of Bioengineering, University of Maryland College Park, College Park, MD 20742, USA

5. Division of Vascular and Interventional Radiology, Department of Radiology, Duke University Medical Center, Durham, NC 27705, USA

6. Department of Radiology, MedStar Georgetown University Hospital, Washington, DC 20007, USA

7. Department of Orthopaedic Surgery, MedStar Georgetown University Hospital, Washington, DC 20007, USA

8. Department of Emergency Medicine, MedStar Georgetown University Hospital, Washington, DC 20007, USA

9. Hôpital Européen Georges-Pompidou, 75015 Paris, France

10. North Star Vascular and Interventional Institute, Minnesota, MN 55427, USA

11. Department of Radiology, Division of Vascular and Interventional Radiology, University of Minnesota Medical School, Minneapolis, MN 55455, USA

12. Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA

13. Division of Interventional Radiology, Rush University Medical Center, Chicago, IL 60612, USA

14. Division of Interventional Radiology, Department of Medical Imaging, University of Arizona Medical Center, Tucson, AZ 85712, USA

15. Division of Vascular and Interventional Radiology, MedStar Georgetown University Hospital, Washington, DC 20007, USA

16. Lombardi Comprehensive Cancer Center, Washington, DC 20007, USA

Abstract

Knee osteoarthritis (KOA) is a musculoskeletal disorder characterized by articular cartilage degeneration and chronic inflammation, affecting one in five people over 40 years old. The purpose of this study was to provide an overview of traditional and novel minimally invasive treatment options and role of artificial intelligence (AI) to streamline the diagnostic process of KOA. This literature review provides insights into the mechanisms of action, efficacy, complications, technical approaches, and recommendations to intra-articular injections (corticosteroids, hyaluronic acid, and plate rich plasma), genicular artery embolization (GAE), and genicular nerve ablation (GNA). Overall, there is mixed evidence to support the efficacy of the intra-articular injections that were covered in this study with varying degrees of supported recommendations through formal medical societies. While GAE and GNA are more novel therapeutic options, preliminary evidence supports their efficacy as a potential minimally invasive therapy for patients with moderate to severe KOA. Furthermore, there is evidentiary support for the use of AI to assist clinicians in the diagnosis and potential selection of treatment options for patients with KOA. In conclusion, there are many exciting advancements within the diagnostic and treatment space of KOA.

Funder

TLTC innovation grant at the University of Maryland at College Park

Publisher

MDPI AG

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