Hand Arthritis Embolization Research: What Studies Show

Quick Answer

Five small, uncontrolled studies with 204 patients in total report that pain scores fell by roughly half after hand or finger embolization, with follow-up of 6 to 24 months. No randomized or sham-controlled trial has been published, so these results cannot yet be separated from placebo response and the natural ups and downs of arthritis.

This article is for readers who want the numbers. It goes through every published clinical study of embolization for hand and finger osteoarthritis, one at a time, then explains how to read it. For a plain overview of the procedure itself, start with our hand and finger arthritis embolization page.

The evidence at a glance

A literature search through October 2026 found five clinical outcome studies. Together they include 204 patients. All five are single-group, uncontrolled series, and three of the five looked back at patients already treated instead of following a plan set in advance.

Study	Design	Patients	Joints	Longest follow-up
Inui, Japan, 2021	Prospective, no control group	31	Thumb base	24 months
Liang, Taiwan, 2023	Retrospective, no control group	58	Finger joints	18 months (6 patients)
Kubo, Japan, 2023	Retrospective, no control group	92	Finger joints	12 months
Lee, Taiwan, 2024	Retrospective pilot, no control group	9	Mixed hand joints	6 months
Konduru, United States, 2026	Prospective, no control group	14	Thumb base	6 months

Two come from the same research group in Tokyo. We could read the full paper for only one (Lee). For the other four we rely on the published abstracts, so details such as minor side effects and patients lost to follow-up are not available.

The two thumb-base studies

Inui and colleagues, 2021

This prospective series enrolled 31 people with thumb-base osteoarthritis, symptoms for more than six months, and no relief from at least three months of conservative treatment. The embolic agent, imipenem/cilastatin, was infused through a fine needle placed in the wrist artery.

Pain on a 0 to 10 scale averaged 7.2 before treatment, 3.1 at 2 months, 2.8 at 6 months and 2.5 at 24 months. QuickDASH, a hand and arm function questionnaire on which lower is better, averaged 49.2 before treatment, 22.1 at 2 months, 20.9 at 6 months and 19.5 at 24 months. The share of patients who rated themselves improved was 84% at 2 months, 81% at 6 months and 77% at 24 months. No major adverse events were encountered.

The results are timed "after the first procedure," which tells us some patients had more than one. The abstract does not say how many.

Konduru and colleagues, 2026

This prospective series from one U.S. clinic followed 14 people with thumb-base osteoarthritis. Average pain went from 8.0 before treatment to 3.1 at 1 month and 2.6 at 6 months. Eleven of 14 (79%) had at least a 50% improvement by the end of the study, and no major adverse outcomes were reported. The abstract does not name the embolic agent, the number of sessions, or any minor side effects. We look at both of these studies from the patient's side in thumb arthritis embolization.

The two finger joint studies

Liang and colleagues, 2023

This retrospective series from a university hospital in Taiwan included 58 people with painful finger joint osteoarthritis that had not responded to medical treatment. All 58 were followed for at least 6 months. After that the numbers thin out quickly: 30 patients reached 12 months and only 6 reached 18 months.

Average pain went from 6.0 to 2.8 at 1 month, 2.2 at 3 months and 2.4 at 6 months. Among those still being followed, it was 2.8 at 12 months and 2.9 at 18 months. A hand function score (FIHOA, lower is better) went from 9.8 to 4.1 at 3 months, and was 4.5 at 12 months in the 30 remaining patients.

Success, as rated by patients themselves, was 62.1% at 1 month, 77.6% at 3 months, 70.7% at 6 months, 63.4% at 12 months and 50.0% at 18 months. The 18-month figure describes 6 people. The authors call the procedure "a potential treatment option."

Kubo and colleagues, 2023

This is the largest hand study: a retrospective series of 92 patients with osteoarthritis of the end and middle finger joints and a pain score of at least 4 out of 10. Ninety-two percent were women and the average age was 55. Two procedures were planned for each patient, with the second one to two months after the first.

The main result was that 77% of patients had a pain reduction of at least 2 points at 12 months. The 95% confidence interval was 68% to 85%. Average pain went from 7.8 to 3.8 at 3 months, 3.9 at 6 months and 4.0 at 12 months. QuickDASH went from 27 to 19 at 12 months. No major adverse events were observed.

Note that success meant a 2-point drop, not the 50% drop used in two other studies, and that average pain at one year was still 4.0 out of 10.

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This article is part of our Embolization Guide.

The small pilot with the most detail

Lee and colleagues (2024) treated only 9 patients, but theirs is the one paper we could read in full. Patients were 40 or older with X-ray confirmed hand osteoarthritis and pain above 50 on a 0 to 100 scale despite at least three months of conservative care. Each had two sessions one month apart.

Overall pain: 76 before treatment, then 34 at 1 week, 32 at 1 month, 21 at 3 months and 18 at 6 months.
Night pain: 58 before treatment, then 22, 20, 10 and 8 at the same points.
Patients with at least a 50% pain drop: 6 of 9 at 1 week, 7 of 9 at 1 month, and 8 of 9 at 3 and 6 months.
Returning pain: 4 of 9 at 1 month, milder than at the start, and 1 of 9 at 3 and 6 months.
Function: better at 1 week and 1 month, but not significantly better at 3 and 6 months.
Stiffness: no significant change at any point.
Side effects: the treated hand turned pale in all 9 patients and looked normal again after about 30 minutes. Four had a temporary spasm of the wrist artery. No tissue damage, tendon rupture, weakness or numbness occurred.

The authors list their own limits: a small group, no control group, a possible placebo effect, and patients who were free to continue other treatments. They state that sham-controlled trials are warranted. See our recovery timeline for what this means week by week.

What is missing from the evidence

No randomized trial. No study has assigned hand patients by chance to embolization or something else.
No sham comparison. No study has compared the real procedure with a placebo version.
No comparison arm of any kind. Embolization has not been tested against splints, steroid injections or surgery.
Small numbers late. The longest follow-up is 24 months in 31 patients. Most data stop at 6 to 12 months, and one study had 6 patients left at 18 months.
Thin side effect reporting. Minor event rates are missing from the abstracts of the three largest studies.
No joint damage outcomes. No study reports whether the arthritis itself progressed differently.
No data in special groups. Nothing has been published on erosive hand osteoarthritis as a separate group, on Raynaud's or scleroderma, or on rheumatoid arthritis.

The one registered hand trial

A search of ClinicalTrials.gov found one trial designed specifically for hand arthritis embolization (NCT06611007), at University Hospital Grenoble in France. It is a single-group safety pilot planning to enroll 15 patients with finger joint osteoarthritis. It uses a different agent, Lipiodol, instead of the antibiotic used in the earlier studies. Its main goal is to count procedure-related adverse events over 6 months. As of its May 2026 update it was still recruiting, with completion estimated for July 2028.

That trial will add safety information. With no comparison group, it will not show whether embolization works better than a placebo. We found no registered randomized hand trial.

How to read uncontrolled results

In these studies, pain scores fell by roughly half. That is encouraging, but several things besides the procedure could explain part of it.

Placebo response. The authors of the 9-patient study name it as a possible explanation. Only a sham comparison can measure it.
Natural ups and downs. Hand arthritis pain fluctuates. The American Academy of Orthopaedic Surgeons notes that some people with thumb arthritis find that symptoms go away over time, with or without treatment.
Other treatments. In the one study that reports it, patients could keep using their usual conservative care.
Different yardsticks. "Success" meant a patient's own rating in two studies, a 2-point drop in one, and a 50% drop in two. The reported rates run from 50.0% to 88.9% depending on the definition and the time point, so they cannot be averaged into one figure.

The knee offers a useful lesson. Knee embolization has the most research of any joint, and where sham-controlled trials have been done, a 2026 review describes the results as mixed. See the latest knee embolization research.

What independent reviewers and guidelines say

A 2026 review that graded embolization by body area put finger joints and the thumb base in its "hypothesis-generating" group: very limited early reports, technique not yet standardized, durability unknown, and joint-specific vascular safety not fully defined. A second 2026 review describes the strongest evidence as being for the knee, with "emerging data" for the hip and hand.

Embolization does not appear in the American College of Rheumatology's 2019 guideline, its 2026 update summary, or the 2018 European hand osteoarthritis recommendations.

The honest reading: hand embolization is an experimental, early-stage option with encouraging but unproven results. If you are weighing it, our candidate guide and the embolization guide are good next reads, and Dr. Fox evaluates patients for hand and finger embolization in Manhattan.

Frequently Asked Questions

How many patients have been studied?

Five published studies include 204 patients in total: 31, 58, 92, 9 and 14. Only one of the five, with 14 patients, was done in the United States.

Is there a randomized trial of hand arthritis embolization?

No. As of October 2026, no randomized or sham-controlled hand trial has been published, and we found none registered on ClinicalTrials.gov. The one hand-specific registered trial is a 15-patient safety pilot in France with no comparison group.

How long do results last?

The longest follow-up is 24 months in a 31-patient thumb-base study, where 77% of patients still rated themselves improved. Most other data stop at 6 to 12 months, and one study had only 6 patients left at 18 months.

Why can the success rates not be combined into one number?

Each study defined success differently, such as a patient's own rating, a 2-point pain drop or a 50% pain drop, and measured it at different times. The reported rates range from 50.0% to 88.9%, and averaging them would be misleading.

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Sources

Medically reviewed by David Fox, MD, FACS, RPVI. This article is general information, not a substitute for a medical evaluation.

Living with joint or tendon pain that hasn’t improved? Schedule a consultation with Dr. David Fox at Fox Vein & Vascular in Manhattan to find out whether embolization is right for you. Call (212) 362-3470 or request an appointment online.

Hand Arthritis Embolization Research: What the Studies Show