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New First in Wales, Minimally Invasive Procedure to Help Combat Pain from Osteo-arthritis

Tuesday 21st February 2023

A Radiology team at Aneurin Bevan University Health Board has become the first in Wales to undergo a new procedure that helps people who suffer from mild to moderate Osteoarthritis (OA), a condition of musculoskeletal (MSK) pain.

The procedure is a geniculate artery embolization, which helps people by aiming to relieve pain through embolising the pathological new vessels while maintaining the larger vascular supply to the bone. Ultimately minimising the pain to levels that patients may find more manageable in their day-to-day life.

Approximately 450,000 individuals in Wales live with Osteoarthritis. Many of them, experience mild to moderate knee OA symptoms. Often not severe enough to warrant joint replacement and other nonsurgical options.

This represents a specific challenge that Dr. Nimit Goyal, Consultant Interventional Radiologist, hopes can be helped with this new procedure: “Existing procedures tend to have a short-term benefit outcome. So these patients will hopefully have a much longer pain-free interval.”

The aim is to reduce pressure on primary care and waiting lists for physiotherapy and occupational therapy treatments. The new minimally invasive procedure is also part of a research project to find alternative treatments for osteoarthritis. With the support of the Welsh Government through the Bevan Commission and the teams at Aneurin Bevan University Health Board.

“The more things that we can do as a day case, that is where the innovation of this procedure lies, because we can change the way that we are treating patients. So the hope is that this provides an option to those patients so that they can live pain-free and have a better quality of life.” Dr. Nimit Goyal continued

Genicular artery embolization (GAE) is an Interventional Radiology procedure that aims to relieve pain by embolising the pathological new vessels while maintaining the larger vascular supply to the bone. The fact that it is done as a day case using local anaesthesia makes it a quick and convenient solution for patients

Mr Andrew Miller, Consultant Orthopaedic Surgeon said: “Early intervention for osteoarthritis is almost unheard of. If you can intervene early in the early arthritic process, that will benefit the patient, prevent OA progression, and prevent the need to use healthcare resources and joint replacements. 

"The exciting thing about this trial is that we are actually changing the biology of the joint without surgically changing the mechanical access to it which we could also do. So, this preventative medicine is the future and the only way we can get on top of the huge demand that is in our population rather than waiting for them to have their joints changed." he continued

Although this was its first trial in Wales, it took place with the support of Prof. Mark Little, Consultant Interventional Radiologist, Royal Berkshire Hospital. Who is experienced in carrying out this procedure in England. “Research and data is key to the development of this procedure so that we can ascertain whether we can offer it to patients long term. It has the potential to change how we treat Osteoarthritis of the knee.”

The project will explore the effectiveness of this novel interventional radiological procedure as a treatment option to reduce pain and improve joint mobility, overall quality of life and wellbeing in patients living with mild-moderate knee OA.

As the first known study in Wales to investigate the potential benefits of this procedure, it is hoped the study will realise the benefits of this intervention ultimately leading to widespread adoption within Wales.