Vascular surgery development helping those with knee pain

15 Aug 2022

A new vascular surgery treatment available at St John of God Subiaco Hospital is offering patients a minimally invasive option to help reduce knee pain and improve function in arthritic knees or following joint replacement surgery.

The technique, known as geniculate artery embolization, uses a microcatheter to stop the flow of blood in tiny inflamed vessels that may have developed abnormally after a total knee replacement or as a result of arthritis.

The surgery was developed internationally about five years ago, and is currently offered in Perth by St John of God Subiaco Hospital Vascular Surgeon Dr Stefan Ponosh who has completed more than 180 treatments over the past two years.

Dr Ponosh said the surgery was designed to reduce pain, inflammation and stiffness in the knee, specifically for patients who continue to experience symptoms after a total knee replacement or those who have arthritis and want to delay major orthopaedic surgery.

“Over the past two years, we have found that 80 per cent of patients have reported a functional improvement in their knee after undergoing this treatment,” Dr Ponosh said.

The results of Dr Ponosh’s work in this field have formed a clinical research paper which is being reviewed for publishing in the coming year. 

In about five to 15 percent of total knee replacements, people continue report ongoing limiting symptoms after undergoing surgery and their options are usually limited to either managing the pain or undergoing the major surgery again.

Dr Ponosh said this new vascular surgery offered an alternative option with patients usually only needing a local anaesthetic and an overnight stay in hospital, and able to return to their daily activities within five to seven days.

“Over the past two years, we have found that 80 per cent of patients have reported a functional improvement in their knee after undergoing this treatment,” he said.
“People don’t have to live with a sub optimal knee.

“The most important thing that people who are experiencing knee pain, particularly after total knee replacements, should know is that this option may be suitable for them as an alternative to another major surgery.”

Former rugby league player Matt Fuller, who now runs his own personal training business underwent the procedure in December 2021 on his right knee.

While he had previously had a total knee replacement on his left knee, it was his right joint that had started to cause pain which was impacting on his sleep and enjoyment of life.

“About two weeks after surgery I really noticed the improvement and I am now back doing what I love and most importantly I am pain free so I feel like myself again,” he said.

“I am always nervous going into surgery but everyone listened to my concerns and I felt really supported at the hospital and by Dr Ponosh.”