Effect of Genicular Arteries Embolization in Symptomatic Knee Osteoarthritis LipioJoint-2

Inclusion Criteria:

• Diagnosis of primary KOA according to the classification of the American College ofRheumatology (ACR) (5)

• Radiographic Kellgren and Lawrence score ≥ 2 (6)

• VAS pain score ≥ 40 mm (scale 0-100 mm)

• Previous intra-articular injection in the target knee

• Patient not eligible to knee surgery

• For woman of childbearing potential: negative bêta-HCG before randomization

• Social security affiliation

• Signed informed consent

• Good understanding of the French language

Exclusion Criteria:

• Intra-articular injection of any product in the target joint within 3 months beforeembolization

• Prior knee surgery other than ligament repair

• Any inflammatory joint disease other than osteoarthritis

• Any contra-indication to puncture of the ipsilateral femoral artery

• Current treatment with cyclosporine, tacrolimus, cisplatine, vancomycine,amphotericine B or any aminoside

• Ipsilateral symptomatic hip OA

• Treated hyperthyroidism

• Known severe allergy to Lipiodol® and/or iodine contrast medium

• Known moderate to severe kidney failure (creatinine clearance < 30 45 ml/min)

• Known right-to-left cardiac shunt or intra-tumoral vascular shunt

• Asthma attack in the 8 days before randomization

• Exploration or treatment with radioactive iodine scheduled within 1 month afterrandomization

• Symptomatic atheromatous lesion in the ipsilateral limb

• Patient unable or unwilling to comply with the follow-up schedule (at theinvestigator's discretion)

• Vulnerable populations (such as pregnant or breastfeeding women, patient underguardianship curatorship, deprived of liberty)

• Patient under exclusion period in another trial

• Patient on AME (state medical aid)