Genicular artery embolization

The technique involves embolizing (blocking) small arteries around the knee, specifically the genicular arteries, to reduce inflammation and development of new blood vessels that may contribute to pain.^[1]

GAE is indicated for people having:

• Moderate to severe knee osteoarthritis (Kellgren–Lawrence grade 2-4)
• Persistent knee pain not responsive to conservative treatments (e.g., physiotherapy, NSAIDs, corticosteroid injections)
• Recurrent hemarthrosis after total knee arthroplasty
• People who are not suitable candidates for knee replacement surgery or prefer non-surgical management

During the procedure, a catheter is inserted through a small puncture, typically in the femoralor radial artery, and advanced under fluoroscopic guidance to the arteries supplying the knee joint. Embolic agents (microspheres) are injected into the genicular arteries to block abnormal vessels and reduce inflammation. This interruption in blood flow helps decrease synovial hyperplasia and pain associated with chronic inflammation.^[2]

GAE is usually conducted as an outpatient procedure under local anesthesia. The duration is between 1–2 hours. Patients can generally walk the same day and return to normal activities within 1–2 days. Post-procedural care involves monitoring for minor side effects, such as skin discoloration or transient pain.^[3]

Clinical studies have demonstrated that GAE results in significant reductions in pain scores (e.g., visual analogue scale or WOMAC). It can also lead to improved functional ability and quality of life, with high patient satisfaction.^[4]

Although generally safe, the procedure carries risks, including skin discoloration or bruising, temporary numbness or tingling, and rare instances of non-target embolization (where embolic material is inadvertently deposited in unintended vessels or organs).^[5]

• Embolization
• Knee osteoarthritis
• Interventional radiology