Ready to shake up hip pain management? In this episode of BackTable MSK, we unpack how embolization is opening a new frontier for patients caught between conservative care and surgery. Interventional radiologist Dr. Kavi Krishnasamy hosts Brazilian interventionalists, Dr. Mateus Correa and Dr. Joaquim Filho, to discuss hip embolization for Greater Trochanteric Pain Syndrome (GTPS) and early hip Osteoarthritis (OA). The doctors highlight building multidisciplinary referrals, reimbursement, and the availability of embolic agents. They also address pre-procedure workup, including imaging and physical exam findings.

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Timestamps

00:00 - Introduction
02:37 - Guest Background in MSK Embolization
08:14 - Availability of Embolics and Preferences in Brazil
10:31 - Reimbursement and Access Hurdles
13:55 - Hip Etiologies Treated by Embolization
16:54 - Imaging Workup and the Role of MRI
24:23 - Offering Conservative Treatment Options Prior to Embolization
26:52 - Scoring Systems and Physical Exam
34:44 - Procedure Access Strategy
39:16 - When to Utilize Temporary vs. Permanent Embolics
46:34 - Post-Procedure and Follow-Up Guidelines
58:05 - Discussion of Current Evidence

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More about this episode

At the time of the procedure, Drs. Correa and Filho explain why they prefer certain vascular access points and specify arterial targets, favoring temporary embolic agents due to potential risk of Avascular Necrosis (AVN) of the femoral head. Furthermore, the doctors detail awake procedures with intraprocedural palpation and blush/pain-based endpoints, post-embolization pain flare management, follow-up schedules, and re-treatment criteria; all with consideration for current published evidence.

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Resources

Dr. Mateus Correa
https://www.researchgate.net/profile/Mateus-Correa-4

Dr. Joaquim Filho
https://www.researchgate.net/profile/Joaquim-Da-Motta-Leal-Filho

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BackTable Musculoskeletal (MSK) is the go-to podcast for musculoskeletal radiologists, interventional pain specialists, and orthopedic surgeons.
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Ep. 98 MSK Hip Embolization: Patient Selection & Technique with Dr. Mateus Correa and Dr. Joaquim Filho