SIR 2024
Pain Management/MSK
Fardad Behzadi, MD
Radiology Resident
Brigham and Women's Hospital
Financial relationships: Full list of relationships is listed on the CME information page.
Angiogenesis in knee osteoarthritis (OA) is a progressive process contributing to synovitis and pain {1}. However, the relationship between knee OA severity, genicular artery caliber, and knee vascularity, is not well understood. This study sought to evaluate the relationship between OA severity and caliber of the descending genicular artery (DGA), a commonly embolized artery in genicular artery embolization.
Materials and Methods:
A retrospective review of bilateral lower extremity computed tomographic (CT) angiography was performed from July 2022 to March 2023. The DGA origin and superficial femoral artery (SFA) diameter were measured in double orthogonal planes at the level of the DGA origin. The DGA and SFA diameter, arterial phase popliteal vein attenuation, age, BMI, gender, and Kellgren Lawrence (KL) score were recorded. Participants with fracture, vessel injury, hemorrhage, thrombus, knee arthroplasty, or Bollinger Class > 3 of the SFA were excluded.
Results:
41 subjects met inclusion criteria. A significant correlation between KL grade of the knee and the caliber of the ipsilateral DGA was noted in the right (r = 0.64, p < 0.0001) and left knee, (r = 0.72, p < 0.0001) respectively. When controlling for SFA caliber, a significant correlation between DGA/SFA caliber and KL grade was demonstrated in the right (r = 0.69, p < 0.0001) and left knee (r = 0.68, p < 0.001), respectively. Multivariate regression analysis was conducted to assess if KL grade predicted DGA/SFA ratio after adjusting for age, gender, and BMI. This demonstrated a beta of 0.54 (< 0.0001) on the right, and 0.12 (p< 0.001) on the left. No significant relationship between KL grade and popliteal vein attenuation was demonstrated on the right (p = 0.81) or left (p = 0.71) side.
Conclusion:
Increased severity of kneeĀ OA was positively associated with increased arterial caliber of the DGA origin. While OA is known to contribute to neovascularity at the joint level, these findings suggest that OA severity may also influence upstream vascular changes at the origin of the genicular artery.