Genicular Artery Embolization

1 in 3 Americans over 60 have osteoarthritis (OA) of the knee, and of those, 40% report bothersome symptoms. If you have experienced inflammation within your knee, you already know how painful it can be. While total knee replacement surgery is the only way to treat the underlying cartilage destruction, 2 out of 3 patients are unwilling to have this surgery.

Treating this chronic pain with a lifelong medication regimen is not a viable option for many people. For others, their OA may be resistant to conservative treatment.

Fortunately, there is another option: Genicular artery embolization (GAE)

Recently, new information has come to light about the causes of OA within the knee. A condition called synovitis is now accepted as a critical driver of OA. As bone cartilage breaks down, it releases debris into the synovium, the lining of the knee which produces fluid to nourish and lubricate the knee joint. The debris triggers an increase in the production of T-cell lymphocytes and white blood cells that inflame the synovium and eat away at the cartilage within the joint.

The GAE procedure reduces the flow of blood to the synovium, which in turn decreases inflammation and the associated pain. A clinical study performed in 2021 demonstrated that the average pain scores decreased from 8 out of 10 to 3 out of 10 within the first week of the procedure.

The GAE procedure

GAE is performed by an interventional radiologist who inserts a tiny catheter into an artery in your upper thigh or wrist, and then uses imaging to guide it through the body’s blood vessels to the genicular artery that supply blood to the synovium, where inflammation occurs. Tiny particles are injected through the catheter into the artery, reducing the flow of blood. The effect is a significant reduction in the inflammation associated with osteoarthritis, and a reduction in pain.

GAE is performed by the interventional radiologists of Ascend Pain & Wellness. We perform GAE in our convenient outpatient setting, without general anesthesia. No overnight stay is required, and you can resume most normal activities after the procedure.

Genicular artery embolization is recommended if you:

• Are between 30-90 years of age
• Have moderate to severe knee pain
• Are diagnosed with osteoarthritis based on X-ray or other imaging, but without bony deformity/sclerosis
• Experience local knee tenderness
• Have resistant or failed conservative treatment (medication, physical therapy, joint injections)

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1. Hawker G.A., Guan J., Croxford R., Coyte P.C., Glazier R.H., Harvey B.J., et al. A prospective population-based study of the predictors of undergoing total joint arthroplasty. Arthritis Rheum. 2006;54:3212–3220. doi: 10.1002/art.22146. [PubMed] [CrossRef] [Google Scholar]
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