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Clinical issue <p>Osteoarthritis-related chronic joint pain substantially impairs function and quality of life. A&#xa0;clinically relevant subgroup of patients remains insufficiently controlled by conservative care and is not yet eligible for, or declines, arthroplasty (“treatment gap”).</p> Standard treatment <p>First-line management includes weight reduction and physiotherapy, analgesics/nonsteroidal anti-inflammatory drugs (NSAIDs), intra-articular injections, and—when indicated—surgical options up to joint replacement.</p> Treatment innovations <p>Transarterial periarticular embolization (TAPE) targets abnormal periarticular neovascularity/hypervascularity via superselective, blush-guided devascularization using temporary crystalline agents or resorbable/permanent microspheres.</p> Diagnostic work-up <p>Accurate pain localization to the target joint and radiographic osteoarthritis (OA) grading are mandatory. Magnetic resonance imaging (MRI)/ultrasound may support selection by demonstrating inflammatory activity (synovitis/hypervascularity). Angiography identifies the pathological blush as the procedural endpoint.</p> Evidence <p>Across studies, technical success is near 100% with clinically meaningful improvements (typically ~30–40&#xa0;point pain reduction on a&#xa0;0–100 visual analog scale) and gains in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)/Knee Injury and Osteoarthritis Outcome Score (KOOS); however, sham-controlled randomized controlled trials (RCTs) show mixed results. Adverse events are uncommon and mainly mild/self-limited; major complications are rare.</p> Conclusion <p>TAPE is a&#xa0;promising minimally invasive option, but its incremental benefit over placebo and optimal selection criteria require confirmation.</p> Practical recommendations <p>Consider TAPE in specialized centers for refractory mild-to-moderate OA (strongest evidence for the knee; emerging data for hip/hand), using standardized protocols, particle sizes ≥ 100 µm when applicable, and strict nontarget prevention (e.g., skin cooling).</p>

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Transarterielle periartikuläre Embolisationen als Behandlungsoption chronischer Gelenkschmerzen

  • 期刊论文

  • 发表日期：

    2026年4月27日

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  • Elif Can,
  • Martin Jonczyk,
  • Katharina Vogt,
  • Wibke Uller

摘要

Clinical issue

Osteoarthritis-related chronic joint pain substantially impairs function and quality of life. A clinically relevant subgroup of patients remains insufficiently controlled by conservative care and is not yet eligible for, or declines, arthroplasty (“treatment gap”).

Standard treatment

First-line management includes weight reduction and physiotherapy, analgesics/nonsteroidal anti-inflammatory drugs (NSAIDs), intra-articular injections, and—when indicated—surgical options up to joint replacement.

Treatment innovations

Transarterial periarticular embolization (TAPE) targets abnormal periarticular neovascularity/hypervascularity via superselective, blush-guided devascularization using temporary crystalline agents or resorbable/permanent microspheres.

Diagnostic work-up

Accurate pain localization to the target joint and radiographic osteoarthritis (OA) grading are mandatory. Magnetic resonance imaging (MRI)/ultrasound may support selection by demonstrating inflammatory activity (synovitis/hypervascularity). Angiography identifies the pathological blush as the procedural endpoint.

Evidence

Across studies, technical success is near 100% with clinically meaningful improvements (typically ~30–40 point pain reduction on a 0–100 visual analog scale) and gains in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)/Knee Injury and Osteoarthritis Outcome Score (KOOS); however, sham-controlled randomized controlled trials (RCTs) show mixed results. Adverse events are uncommon and mainly mild/self-limited; major complications are rare.

Conclusion

TAPE is a promising minimally invasive option, but its incremental benefit over placebo and optimal selection criteria require confirmation.

Practical recommendations

Consider TAPE in specialized centers for refractory mild-to-moderate OA (strongest evidence for the knee; emerging data for hip/hand), using standardized protocols, particle sizes ≥ 100 µm when applicable, and strict nontarget prevention (e.g., skin cooling).