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目的:探讨选择性膝动脉栓塞术治疗膝骨关节炎（KOA）继发性疼痛的疗效与安全性。方法:前瞻性纳入2020年10月至2021年7月宁夏医科大学总医院因KOA继发中重度膝关节疼痛的患者17例（23侧膝关节），年龄（68±7）岁，男6例，女11例。术前使用疼痛视觉模拟评分（VAS）及西安大略和麦克马斯特大学骨关节炎指数（WOMAC）量表评估患者膝关节疼痛、僵硬及功能情况，使用Kellgren-Lawrence（K-L）分级评估KOA严重程度，使用磁共振膝骨关节炎评分（MOAKS）评估患膝MR成像特征。所有患者均进行选择性膝动脉栓塞术（GAE）。术后随访6个月，分别于术后1天、1周和1、3、6个月使用VAS、WOMAC量表评估临床结局，包括膝关节疼痛、僵硬及功能改善情况，以及不良反应情况。结果:23侧患膝均超选并栓塞3~7支膝动脉分支，其中7例K-L分级4级患者栓塞4~7支膝动脉分支。术后1个月临床改善率为95.6%（22/23），术后3个月临床改善率为86.9%（20/23），术后6个月临床改善率为91.3%（21/23）。23侧患膝完成6个月随访，术后1、3、6个月VAS评分、WOMAC疼痛评分及WOMAC总评分分别为（2.5±1.3）、（3.4±2.4）、（19.7±9.8）分，（3.0±1.8）、（4.5±3.4）、（22.3±11.3）分，（2.8±1.5）、（4.1±3.0）、（20.5±11.0）分，均低于术前的（6.6±0.9）、（11.4±2.6）、（47.0±12.0）分（均n P<0.001）。随访期间7例患者出现不良反应：3例股动脉穿刺区皮肤瘀斑，4例术后1 d膝关节僵痛感，均在1周内自行缓解；6例患者术后存在伸屈活动时关节弹响，其中3例于术后3个月内自行消退。所有患者均未发生重大手术相关不良事件。n 结论:GAE治疗KOA继发性疼痛临床改善率较高，不良反应发生率低，为保守治疗无效的疼痛患者提供了新的治疗选择。“,”Objective:To evaluate the efficacy and safety of selective genicular artery embolization for the treatment of the knee pain secondary to osteoarthritis.Methods:From October 2020 to July 2021, 17 patients (23 knees) aged (68±7) years with moderate to severe knee pain secondary to knee osteoarthritis were prospectively included in the General Hospital of Ningxia Medical University. There were 6 males and 11 females included in this research. Patients were assessed with knee pain, stiffness, and function with the Visual Analogue Scale (VAS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) at baseline, using the Kellgren-Lawrence (K-L) grading to evaluate the severity of KOA, and using the Magnetic Resonance Knee Osteoarthritis Score (MOAKS) to evaluate the MR imaging characteristics of the affected knee. Selective genicular artery embolization (GAE) was performed in all patients. The patients were followed up for 6 months after the procedure. Patients were assessed with the VAS score and WOMAC scale at 1 d, 1 week and 1, 3 and 6 months after the procedure to evaluate the clinical outcomes, including the improvement of knee joint pain, stiffness and function, as well as the occurrence of adverse reactions.Results:Three to seven genicular artery branches were superselected and embolized in 23 knees, and 4 to 7 genicular artery branches were embolized in 7 patients with K-L grade 4. The clinical improvement was 95.6% (22/23) at 1 month, 86.9% (20/23) at 3 months, and 91.3% (21/23) at 6 months. Twenty-three knees completed the 6-month follow-up, and the VAS score, WOMAC pain score, and total WOMAC score at 1, 3, and 6 months after surgery were (2.5±1.3), (3.4±2.4), and (19.7±9.8) points, (3.0±1.8), (4.5±3.4), and (22.3±11.3) points, (2.8±1.5), (4.1±3.0), and (20.5±11.0) points, which were lower than the (6.6±0.9), (11.4±2.6) and (47.0±12.0) points at baseline (all n P<0.001). During the follow-up period, 7 patients had adverse reactions: 3 cases had skin ecchymosis in the femoral artery puncture area, 4 cases had knee joint stiffness and pain within 1 day after operation, which were relieved spontaneously in 1 week, 6 patients had joint clicking during extension and flexion activities after operation, of which 3 cases subsided spontaneously within 3 months after operation. None of the patients had major procedure-related adverse events.n Conclusion:GAE has a high clinical improvement rate and a low incidence of adverse reactions in the treatment of the pain secondary to knee osteoarthritis, which provides a new treatment option for patients who fail to respond to conservative treatment.