Intra-Articular Injection Use and Total Knee Arthroplasty After Genicular Artery Embolization for Knee Osteoarthritis: A Matched National Claims Analysis.

Abstract

Purpose: To characterize intra-articular injection use before and after genicular artery embolization (GAE) for knee osteoarthritis (OA) and to compare progression to total knee arthroplasty (TKA) with matched knee OA patients.

Materials and methods: This retrospective cohort study used the Merative MarketScan Commercial and Medicare Supplemental databases, 2014-2024. Patients undergoing GAE for knee OA were identified by CPT code 37242 with a knee OA diagnosis within 7 days, excluding non-OA indications. Annualized steroid and any intra-articular injection use was compared for the 12 months before and 6 months after GAE. Progression to TKA at 6 and 12 months was analyzed against non-GAE knee OA patients matched 10:1 on age, sex, region, index year, and baseline injection frequency.

Results: Of 436 patients with GAE for knee OA, 126 met enrollment criteria for the injection analysis (mean age, 64.2 years; 57.9% female). Mean annualized steroid injection use decreased from 0.96 to 0.48 per patient-year (-50.4%; P = .004) and any intra-articular injection from 2.88 to 1.60 (-44.4%; P < .001). Among 52 baseline steroid injection users, 36 (69.2%) stopped and 46 (88.5%) had fewer injections. TKA did not differ from matched comparators at 6 months (5.8% vs 6.8%; P = .858) or 12 months (13.1% vs 12.8%; P = 1.000).

Conclusion: Steroid injection use decreased after GAE, while early progression to TKA did not differ from matched comparators. Prospective studies with longer follow-up and clinical outcomes are needed to determine whether GAE reduces the need for injections or affects long-term TKA rates.