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Knee OsteoarthritisPhase 2SHAM-PAINNCT06859164

Genicular Artery Embolization for Reducing Pain in Medically Refractory Symptomatic Knee Osteoarthritis

A Phase 2 study testing Genicular Artery Embolization, Lipiodol and Simple angiogram in people with Knee Osteoarthritis and Knee Osteoarthritis (Knee OA), run by University of Utah at 1 site in United States.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

Genicular Artery Embolization for Reducing Pain in Symptomatic Knee Osteoarthritis: A Pilot Randomized Sham-Controlled Study (SHAM-PAIN) is a NIH-NIAMS funded project designed to assess enrollment feasibility and detect any differences between GAE and a similar sham intervention in reducing KOA-related pain at 3… Read more about this study

Who is it for?
Ages 40 to 80 years
What is being tested?
Genicular Artery Embolization, Lipiodol and Simple angiogram
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
40 participants
Where
1 siteUnited States
Study dates
1 Jul 2026to 31 Aug 2028
Phase
Phase 2
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 40 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patients aged 40-80
  • Bilateral or unilateral knee pain attributed to osteoarthritis (treat the knee with greater pain-if equal, patient chooses)
  • Grade 2-4 osteoarthritis on standing weight-bearing knee radiographs per the Kellgren-Lawrence grading scale
  • Knee pain > 6 months, refractory to conservative non-operative management, and scored ≥ 4 on Visual Analog Scale (VAS) (e.g., rest, activity modification, weight control, bracing, supervised physical therapy, nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen, oral opiates, intra-articular hyaluronic acid, PRP, stem cells, and/or oral/injectable corticosteroids)
  • Refusal of intra-articular corticosteroid injection

Who cannot join

  • Active malignancy
  • Active infection of the affected knee
  • Corticosteroid injection of the affected knee within 3 months of enrollment
  • Rheumatoid arthritis or other seronegative arthropathy
  • Previous surgery of the affected knee (e.g., meniscus repair, meniscectomy, anterior cruciate ligament (ACL)/posterior cruciate ligament (PCL) reconstruction, chondroplasty, microfracture, loose-body removal, synovectomy, lateral release, patellar/quadriceps tendon repair, total or partial knee replacement, osteotomy, cartilage transplant), except diagnostic arthroscopy
  • Grade 0-1 osteoarthritis per Kellgren-Lawrence grading scale of the affected knee
Show all 24Show fewer
  • Pregnancy or expected pregnancy
  • GFR < 60 mL/min/1.73 m²
  • Anaphylactic reaction to iodinated contrast
  • Moderate to severe pain in other ipsilateral lower-limb joints (ankle, hip) with VAS > 4
  • Body weight > 400 lbs (unsafe for angiography)
  • Peripheral arterial disease of the treated extremity (Rutherford Grade 2 or greater)
  • Type 1 diabetes mellitus
  • Long-acting corticosteroid use within 6 months (3 months for short-acting)
  • History or other evidence of acute kidney injury (AKI)
  • History of reaction to contrast media, bronchial asthma, or allergic disorders
  • History of hypersensitivity to gadolinium-based contrast agents (GBCAs)
  • Chronic widespread generalized pain >4 on VAS pain scale, including neuropathic pain
  • Major depressive disorder within 2 years before screening
  • Other severe psychiatric disorder (e.g., schizophrenia, bipolar disorder)
  • Suicide attempt or suicidal behavior within 30 days before screening
  • Diagnosis of fibromyalgia
  • Considering total knee replacement in the next year
  • Any other condition, unwillingness, or inability that, in the investigator's opinion, could jeopardize the subject's safety or protocol compliance

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Osman Ahmed, MD contact

8478124513

osman.ahmed@utah.edu

Layth Alkhani, BS contact

layth.alkhani@utah.edu

United States1 site, 1 recruiting
  • University of Utah

    Salt Lake City, Utah, 84112

    Osman Ahmed, MD, 8478124513, osman.ahmed@utah.edu

    Layth Alkhani, BS, layth.alkhani@utah.edu

    Recruiting

Other trials in United States

About this study

Official title: Genicular Artery Embolization for Reducing Pain in Symptomatic Knee Osteoarthritis: A Pilot Randomized Sham-Controlled Study

Genicular Artery Embolization for Reducing Pain in Symptomatic Knee Osteoarthritis: A Pilot Randomized Sham-Controlled Study (SHAM-PAIN) is a NIH-NIAMS funded project designed to assess enrollment feasibility and detect any differences between GAE and a similar sham intervention in reducing KOA-related pain at 3 months as measured by the Knee injury and Osteoarthritis Outcome Score (KOOS) pain subscore. Additionally, this study aims to determine the magnitude of difference in pain response between GAE and sham to adequately power a larger, more definitive randomized sham-controlled trial (RCT). The influence of psychosocial and psychocognitive factors, changes in analgesic use, and conditions of knee joint cartilage and effusion will similarly be explored to determine their impacts on perceived pain response to GAE.

Being tested
Genicular Artery Embolization, Lipiodol, Simple angiogram
Keywords
Osteoarthritis, Knee pain, MSK pain, Musculoskeletal Pain, Osteoarthritis of the knee, GAE, Genicular artery embolization, Geniculate artery embolization, MSK embolization, Musculoskeletal Embolization, Embolization, Musculoskeletal, Temporary Embolization
Medical subject headings
Osteoarthritis, Knee, Osteoarthritis, Musculoskeletal Pain

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Genicular Artery EmbolizationProcedure or surgery

    Also called GAE, Geniculate Artery Embolization

    Embolization of genicular arteries that demonstrate neoangiogenesis or blush on angiogram.

  • LipiodolDevice

    3:1 emulsion of Lipiodol to Optiray

  • Simple angiogramProcedure or surgery

    Simple angiogram of the genicular arteries

Study groups in NCT06859164
Study groupRoleWhat they receive
GAE ArmExperimentalIn this study, GAE is performed using the Lipiojoint technique described by Sapoval et al. This method utilizes a 3:1 emulsion of Lipiodol® (a transient embolic agent that penetrates distally to about 30 microns) and Optiray® to target the genicular arteries supplying areas of synovial hypervascularity and neo-angiogenesis. The embolic effect is temporary-lasting roughly 10 minutes-after which angiographic imaging shows resolution of the embolization with no damage to the surrounding skin, tendon, or bone. The endpoint of the procedure is to achieve complete stasis in the targeted vessels. 20 participants will be randomly allocated to this arm.
Receives: Procedure: Genicular Artery Embolization; Device: Lipiodol; Procedure: Simple angiogram
Sham ArmSham comparatorParticipants assigned to the sham group undergo a similar preparatory process, including angiography and catheterization of all genicular arteries. However, no embolic agent is administered. Instead, after performing selective angiograms, these participants do not receive any embolization. 20 participants will be randomly allocated to this arm.
Receives: Procedure: Simple angiogram

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Reduction in KOOS pain subscore

    Percent change in KOOS pain subscale score, scaled to a range of 0-100, from baseline to 3 months post-randomization of both GAE and sham groups.

    Measured: 3 months

Secondary outcomes (9)
  1. WOMAC knee pain and dysfunction

    Reduction in knee pain and dysfunction (WOMAC) at 1, 3, 6, 9, and 12 months.

    Measured: 1, 3, 6, 9, and 12 months.

  2. KOOS pain and dysfunction

    Absolute reduction in knee pain and dysfunction (KOOS) at 1, 3, 6, 9, and 12 months

    Measured: 1, 3, 6, 9, and 12 months

  3. VAS Score

    Visual Analog Score (VAS) for pain at 0, 1, 6, 9, and 12 months post treatment

    Measured: 0, 1, 6, 9, and 12 months

  4. Crossover

    Rate of cross-over from sham to GAE at 3 months

    Measured: 3 months

  5. Analgesic Reduction

    Usage of opiate/analgesic medications at baseline, 1, 3, 6, 9, and 12 months post intervention

    Measured: Baseline, 1, 3, 6, 9, and 12 months post intervention

  6. Whole Knee Synovitis Scoring

    Contrast Enhanced MRI with Whole Knee Synovitis Scoring at baseline and 3 months

    Measured: Baseline and 3 months

  7. Perfusion

    Perfusion quantification using pre and post embolization using CT-Perfusion scanning

    Measured: Procedure

  8. Knee replacement

    Rate of total knee replacement at 3 months

    Measured: 3 months

  9. Corticosteroid injection usage

    Corticosteroid injection rate usage at baseline, 1, 3, 6, 9, and 12 months post intervention

    Measured: Baseline, 1, 3, 6, 9, and 12 months post intervention

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted5 Mar 2025
  2. Study start1 Jul 2026
  3. Primary completion31 Aug 2027 (estimated)
  4. Study completion31 Aug 2028 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Triple blind
Who is masked
Participant, Care provider, Outcomes assessor
Enrolment
40 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06859164
Sponsor's protocol ID
IRB24-1674
Other IDs
1R21AR082123-01A1
Acronym
SHAM-PAIN
Status last verified
Jun 2026
First submitted
23 Feb 2025
Last updated
30 Oct 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
Yes
Individual data sharing
Undecided: Will need to be considered on an individual basis given the desire to protect PHI

Publications

  • Ahmed O, Block J, Mautner K, Plancher K, Anitescu M, Isaacson A, Filippiadis DK, Epelboym Y, Bercu Z, Mitchell JW, Cristescu M, White SB, Prologo JD. Percutaneous Management of Osteoarthritis in the Knee: Proceedings from the Society of Interventional Radiology Research Consensus Panel. J Vasc Interv Radiol. 2021 Jun;32(6):919.e1-919.e6. doi: 10.1016/j.jvir.2021.03.409. Epub 2021 Mar 6. No abstract available.

    PubMed 33689834
  • Ahmed O, Epelboym Y, Haskal ZJ, Okuno Y, Taslakian B, Sapoval M, Nikolic B, Golzarian J, Gaba RC, Little M, Isaacson A, Padia SA, Sze DY. Society of Interventional Radiology Research Reporting Standards for Genicular Artery Embolization. J Vasc Interv Radiol. 2024 Aug;35(8):1097-1103. doi: 10.1016/j.jvir.2024.04.018. Epub 2024 Apr 27.

    PubMed 38685470
  • Dariushnia SR, Redstone EA, Heran MKS, Cramer HR Jr, Ganguli S, Gomes AS, Hogan MJ, Himes EA, Patel S, Schiro BJ, Lewis CA. Society of Interventional Radiology Quality Improvement Standards for Percutaneous Transcatheter Embolization. J Vasc Interv Radiol. 2021 Mar;32(3):476.e1-476.e33. doi: 10.1016/j.jvir.2020.10.022. No abstract available.

    PubMed 33640083
  • Parry E, Ogollah R, Peat G. Significant pain variability in persons with, or at high risk of, knee osteoarthritis: preliminary investigation based on secondary analysis of cohort data. BMC Musculoskelet Disord. 2017 Feb 14;18(1):80. doi: 10.1186/s12891-017-1434-3.

    PubMed 28196504
  • Derkach M, Al Sayah F, Ohinmaa A, Svenson LW, Johnson JA. Comparative performance of the EuroQol EQ-5D-5L and the CDC healthy days measures in assessing population health. J Patient Rep Outcomes. 2022 Jun 13;6(1):64. doi: 10.1186/s41687-022-00474-7.

    PubMed 35696002
  • Binkley JM, Stratford PW, Lott SA, Riddle DL. The Lower Extremity Functional Scale (LEFS): scale development, measurement properties, and clinical application. North American Orthopaedic Rehabilitation Research Network. Phys Ther. 1999 Apr;79(4):371-83.

    PubMed 10201543
  • Salaffi F, Leardini G, Canesi B, Mannoni A, Fioravanti A, Caporali R, Lapadula G, Punzi L; GOnorthrosis and Quality Of Life Assessment (GOQOLA). Reliability and validity of the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index in Italian patients with osteoarthritis of the knee. Osteoarthritis Cartilage. 2003 Aug;11(8):551-60. doi: 10.1016/s1063-4584(03)00089-x.

    PubMed 12880577
  • Little MW, O'Grady A, Briggs J, Gibson M, Speirs A, Al-Rekabi A, Yoong P, Ariyanayagam T, Davies N, Tayton E, Tavares S, MacGill S, McLaren C, Harrison R. Genicular Artery embolisation in Patients with Osteoarthritis of the Knee (GENESIS) Using Permanent Microspheres: Long-Term Results. Cardiovasc Intervent Radiol. 2024 Dec;47(12):1750-1762. doi: 10.1007/s00270-024-03752-7. Epub 2024 May 31.

    PubMed 38819473
  • Padia SA, Genshaft S, Blumstein G, Plotnik A, Kim GHJ, Gilbert SJ, Lauko K, Stavrakis AI. Genicular Artery Embolization for the Treatment of Symptomatic Knee Osteoarthritis. JB JS Open Access. 2021 Oct 21;6(4):e21.00085. doi: 10.2106/JBJS.OA.21.00085. eCollection 2021 Oct-Dec.

    PubMed 34703964
  • Sapoval M, Querub C, Pereira H, Pellerin O, Boeken T, Di Gaeta A, Ahmar MA, Lefevre-Colau MM, Nguyen C, Daste C, Lacroix M, Laredo JD, Sabatier B, Martelli N, Chatellier G, Dean C, Rannou F. Genicular artery embolization for knee osteoarthritis: Results of the LipioJoint-1 trial. Diagn Interv Imaging. 2024 Apr;105(4):144-150. doi: 10.1016/j.diii.2023.12.003. Epub 2023 Dec 14.

    PubMed 38102013
  • Lim WB, Al-Dadah O. Conservative treatment of knee osteoarthritis: A review of the literature. World J Orthop. 2022 Mar 18;13(3):212-229. doi: 10.5312/wjo.v13.i3.212. eCollection 2022 Mar 18.

    PubMed 35317254
  • Heidari B. Knee osteoarthritis prevalence, risk factors, pathogenesis and features: Part I. Caspian J Intern Med. 2011 Spring;2(2):205-12.

    PubMed 24024017
  • GBD 2021 Osteoarthritis Collaborators. Global, regional, and national burden of osteoarthritis, 1990-2020 and projections to 2050: a systematic analysis for the Global Burden of Disease Study 2021. Lancet Rheumatol. 2023 Aug 21;5(9):e508-e522. doi: 10.1016/S2665-9913(23)00163-7. eCollection 2023 Sep.

    PubMed 37675071

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Genicular Artery Embolization, Lipiodol and Simple angiogram in people with Knee Osteoarthritis and Knee Osteoarthritis (Knee OA), run by University of Utah at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 24 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 30 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Osman Ahmed, MD (8478124513, osman.ahmed@utah.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Reduction in KOOS pain subscore (time frame: 3 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06859164, which also lists 13 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 30 Oct 2026.

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