Overview

Osteoarthritis is a wear-related condition of the knee joint that causes pain, stiffness and difficulty walking, climbing stairs or sitting cross-legged. Initial treatment includes exercise, weight management, painkillers and injections.

Some patients continue to have significant pain despite these measures, yet are not ready for, or not suitable for, knee replacement. Genicular Artery Embolization (GAE) is a newer minimally invasive procedure that may be considered for selected patients in this situation.

When to consider evaluation

• Long-standing knee pain with activity, such as walking or climbing stairs

• Pain not adequately controlled with medicines, physiotherapy or injections

• Mild to moderate osteoarthritis on X-ray

• Reluctance, or unsuitability, for knee replacement surgery

• Pain limiting day-to-day activities and quality of life

How the Treatment Works

In osteoarthritis, the lining of the knee joint can become inflamed and develop an abnormal increase in tiny blood vessels, which is thought to contribute to pain.

In GAE, a thin catheter is guided through a small puncture to the small genicular arteries that supply the inflamed lining of the knee. Tiny particles are used to reduce blood flow to these abnormal vessels, which may reduce inflammation and pain.

Who May Be a Candidate?

• Adults with chronic knee pain from mild to moderate osteoarthritis

• Patients who have tried conservative treatment without enough relief

• Patients who want to delay or avoid knee replacement, or who cannot undergo it

GAE treats pain; it does not regrow cartilage or correct deformity. It may be less suitable for advanced, bone-on-bone arthritis, where knee replacement may be the better option. Your X-rays and examination will guide this.

What to Expect

Before the procedure

Your history, examination and knee X-rays or MRI are reviewed to confirm that arthritis is the cause and that GAE may be suitable.

During the procedure

The procedure is done through a small puncture, usually under local anaesthesia with or without light sedation. There is no incision.

Afterwards

Most patients go home the same day. Temporary knee soreness or skin changes around the knee can occur. Pain relief is often gradual, over several weeks, and exercise and physiotherapy remain important.

Possible Benefits

• No joint surgery or implant

• Day-care procedure for most patients

• May reduce knee pain in selected patients

• Does not prevent knee replacement later, if needed

Risks and Limitations

Risks include bruising at the puncture site, temporary skin discolouration or tenderness around the knee, and, rarely, injury to the artery or damage to non-target tissue. The degree and duration of pain relief vary between patients, and some may need further treatment. Evidence for GAE is still evolving.

Frequently Asked Questions

Will GAE cure my arthritis?

No. It aims to reduce pain, not to reverse joint wear.

How soon will I feel better?

Some patients notice improvement within days to weeks, though it can build up gradually over a couple of months.

Can both knees be treated?

This is possible in some patients and is decided on an individual basis.

What if I need knee replacement later?

GAE does not rule out knee replacement in the future.

Been advised surgery for this condition?

Share your scans and reports with our clinical team for a specialist second opinion. Every patient is different, and we will tell you honestly whether a minimally invasive approach may be right for you.

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