Transcatheter Arterial Embolization of Abnormal Neovessels for Patellar Tendinopathy: A Safety Evaluation: A Proof-of-Concept Study.

Background: Patellar tendinopathy (PT) is common among athletes, and the current care is largely palliative.

Purpose: To evaluate the safety of transcatheter arterial embolization (TAE) in patients with PT refractory to nonoperative treatments.

Study design: Case series; Level of evidence, 4.

Methods: This was a multicenter, retrospective study in which recalcitrant PT was treated using TAE. TAE was performed by infusing temporary embolic material through a catheter inserted into the targeted genicular artery. Complications, numeric rating scale (NRS) for pain, Victorian Institute of Sport Assessment for the patella (VISA-P), time to return to training, and ultrasound findings were reported.

Results: Between March 2017 and February 2023, a total of 98 patients with PT underwent TAE. Nine patients were lost to follow-up, and the remaining 89 patients (69 male; mean age, 26.1 ± 11.9 years) were followed up for 1 to 7 years (mean, 31.2 ± 16.1 months) after TAE. No major complications were observed. Mean VISA-P score improved from 24.9 ± 15.3 at baseline to 43.2 ± 21.6, 55.2 ± 22.3, and 67.4 ± 24.7, at 1, 3, and 6 months of follow-up, respectively. Mean NRS for pain improved from 7.6 ± 1.4 at baseline to 4.5 ± 2.3, 3.5 ± 2.4, and 2.7 ± 2.4 at the corresponding time points. VISA-P and NRS scores were 74.6 ± 26.2 and 2.3 ± 2.7, respectively, at the final follow-up. Mean times for return to light and full training were 7.8 ± 8.7 and 14.3 ± 11.5 weeks, respectively. Ultrasound demonstrated decreased patellar tendon thickness (9.5 ± 1.8 mm at baseline vs 6.6 ± 1.3 mm at the final follow-up) without tendon ruptures.

Conclusion: TAE can be considered a safe alternate to existing treatment options for recalcitrant PT. A randomized controlled trial is required to elucidate its efficacy.