Arterial Embolization of Joint Synovitis: The Latino Registry. Midterm Follow-Up of the Latino-Hip Cohort for Greater Trochanteric Pain Syndrome.

Abstract

Purpose: To present the midterm follow-up of a cohort of 31 patients with great trochanteric pain syndrome (GTPS) refractory to conservative management or physical therapy and no indication for surgery treated with embolization of the lateral femoral circumflex artery (LFCA).

Material and methods: Single-center prospective cohort from June 2019 to July 2023. This paper is an update of the initial experience with embolization of LFCA, previously published. Visual analog scale (VAS) was used to compare the symptoms before and after midterm follow-up. Technical success was considered when at least one artery responsible for the hyperemic synovium was embolized. Complications and adverse events were noted.

Results: Thirty-one patients (38 joints) were included; mean age was 68.89 (+ 11.22) years. Thirty-six joints were treated with imipenem/cilastatin (I/C) alone, one with 100-300 μm BeadBlock and one using Microsphere 100-300 μm and I/C combined. 64.5% of the joints showed an association of GTPS with hip osteoarthritis on MRI pre-procedure. On the last FU 21 joints presented VAS 0 to 3, seven joints VAS 4 to 6 and nine did not feel any improvement, with VAS 7 to 10. One patient was lost to follow-up. Two patients present a minor complication (posterior tight numbness), spontaneously improved within 30 days.

Conclusion: Lateral femoral circumflex artery embolization is feasible, and it is an alternative in pain reduction in patients with hip GTPS refractory to clinical treatment and no indication for surgery, in midterm follow-up.