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• W4313366984 abstract "Degenerative joint conditions affect the majority of people, especially with increasing age. Despite decades of research and promising therapies, non-surgical treatments have shown limited benefit and short durability. In many cases, even surgical intervention has shown questionable benefit, and in truth only a subset of people are good surgical candidates. In 2017, Dr. Okuno and colleagues demonstrated marked improvement in pain and function in people with knee osteoarthritis treated with genicular artery embolization. The premise of embolization to reduce hypervascularity of inflamed joints is somewhat counterintuitive to the traditionally accepted pathophysiology of “wear-and-tear” disease. Since then, we have cultivated numerous new minimally invasive treatments for joint disease in the form of arterial embolization. This has the potential to substantially transform the treatment armamentarium for joint disease. If genicular artery embolization shows to be effective in the treatment of knee osteoarthritis, this launches an entirely novel avenue for the practice of embolization. In the United States, over 600,000 people develop osteoarthritis every year, with a relative equal frequency between males and females. Osteoarthritis would potentially be the highest prevalence disease that could be treated by a minimally-invasive image guided procedure such as embolization. This issue of TVIR includes a comprehensive discussion of knee osteoarthritis. Dr. Emily Miller and colleagues review the clinical evaluation of the patient with knee pain. This is followed by technical articles on vascular anatomy, GAE technique, and arterial embolics. Dr. Little and colleagues then review the data to date for GAE. In the latter half of the issue, arterial embolization of the elbow and shoulder are discussed. Finally, Dr. Haber's review on musculoskeletal tumor embolization provides a comprehensive technical guide and literature summary. In no other specialty can a new promising therapy be developed with minimal toxicity in such a short time horizon. However, we must also exercise caution when proceeding to adapt new therapies such as this to the general population. Given that outcomes with respect to pain can be highly variable and subjective, the retrospective nature of many studies do not allow us to rigorously evaluate pain and function at defined timepoints and to define the primary endpoint prior to study initiation. Even in prospective studies, we must acknowledge that a placebo effect will often result in clinical improvement." @default.
• W4313366984 created "2023-01-06" @default.
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• W4313366984 date "2023-03-01" @default.
• W4313366984 modified "2023-09-26" @default.
• W4313366984 title "Introduction" @default.
• W4313366984 doi "https://doi.org/10.1016/j.tvir.2022.100884" @default.
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