In this double blind randomized sham controlled study the investigators want to establish the efficacy of transcatheter arterial embolization of neovessels for patients with symptomatic mild to moderate knee osteoarthritis after 4 months compared to a sham-embolization.
Rationale: Transcatheter arterial embolization has recently been proposed as an efficacious therapy for therapy-resistant osteoarthritis of the knee, providing substantial pain reduction at short-term as well as long-term follow-up up till 4 years. A potential working mechanism of treatment effect is that the normalization of the amount of blood vessels and blood flow achieved by embolization reduces inflammation, resulting in pain reduction Objective: The main objective is to assess whether transcatheter arterial embolization of neovessels in patients with symptomatic knee OA results in significant pain reduction after 4 months compared to sham treatment. The investigators hypothesize that novel transcatheter arterial embolization of neovessels is a feasible, effective, and safe treatment for patients with symptomatic radiographic knee OA, resulting in significant improvement of pain symptoms in a period of 4 months follow-up compared to sham embolization. Secondary objectives are 1. to assess whether reduction of neovessels is related to pain relief, 2. to explore whether decrease of inflammation is a mediating factor between neovessel reduction and pain relief, 3. to assess whether transcatheter arterial embolization reduction of neovessels decreases peripheral and central pain sensitization and 4. to assess whether transcatheter arterial embolization improve the outcome at 1, 4, 8 and 12 months compared to placebo of the: ICOAP, painDETECT, EQ-5D-5L questionnaires and NRS for pain.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
58
transcatheter arterial embolization of neovessels around the knee
Sham transcatheter arterial embolization of neovessels in the knee
ErasmusMC
Rotterdam, South Holland, Netherlands
KOOS pain sub score
KOOS pain sub score after 4 months
Time frame: 4 months
Total KOOS
Total KOOS result
Time frame: 1,4,8,12 month(s)
painDETECT questionnaire
painDETECT questionnaire results
Time frame: 1,4,8,12 month(s)
ICOAP questionnaire
ICOAP questionnaire results
Time frame: 1,4,8,12 month(s)
Pain Score 0-10 Numerical Rating Scale (NRS)
The Numeric Pain Rating Scale (NPRS) is a unidimensional measure of pain intensity in adults. The 11-point numeric scale ranges from '0' representing one pain extreme (e.g. "no pain") to '10' representing the other pain extreme (e.g. "pain as bad as you can imagine" or "worst pain imaginable").
Time frame: 1,4,8,12 month(s)
EQ-5D-5L questionnaire
EQ-5D-5L questionnaire results
Time frame: 1,4,8,12 month(s)
Pressure pain threshold testing
Pressure pain threshold testing results
Time frame: 1,4,8,12 month(s)
Knee MRI
Knee MRI scan results
Time frame: 1 and 4 month(s)
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