A diagnosis of knee osteoarthritis often sounds like “You’ll eventually need knee replacement surgery no matter what you do.”
The pain can be managed only so much in this progressive disease.
But as the condition gets worse over time, is a joint replacement surgery always the inevitable outcome?
Not everyone is ready for a full knee replacement.
Conservative measures such as pain medication, ice packs and therapeutic movements are typically done to delay what many patients see as the inevitable: their natural knee structure being replaced with hardware.
But there’s a new procedure that can help stave off surgery: genicular artery embolization, or GAE.
What is GAE?
GAE is a minimally invasive outpatient procedure.
Instead of replacing the joint, doctors target inflammation inside the knee.
The treatment works by reducing blood flow to abnormal blood vessels that are believed to contribute to inflammation and pain.
By blocking those vessels, swelling may decrease and symptoms may improve.
Keep in mind that GAE does not “fix” the worn-down cartilage or make it grow back.
If there’s bone-on-bone areas in the knee joint, this situation will continue to exist despite GAE. But the reduction in inflammation will reduce pain.
According to Dr. Leigh Casadaban, an interventional radiologist at the University of Colorado Anschutz School of Medicine, GAE may fill an important treatment gap.
Many patients try medications, therapy, and injections before eventually considering surgery.
GAE offers a potential middle ground option for people who aren’t psychologically ready for a TKR despite struggling with pain that’s no longer managed with conservative measures.
GAE appears to work best for people with mild to moderate knee osteoarthritis.
Patients with more advanced joint damage can still undergo GAE, but symptom relief may not last as long — leading to that inevitable decision to have a replacement.
Dr. Casadaban says around 70% of patients experience substantial improvement.
- In many cases, pain scores are reduced by half or more.
- Some patients report little to no pain following treatment.
How the Procedure Is Performed
GAE is usually completed in one to two hours and doesn’t require general anesthesia.
Patients receive conscious sedation while an interventional radiology team makes a tiny incision near the upper leg.
Using X-ray imaging and contrast dye, doctors guide a thin catheter through the femoral artery toward the arteries surrounding the knee.
Once the catheter reaches the target area, microscopic particles are released to block blood flow to the abnormal vessels linked to pain and inflammation.
After a brief recovery period, most patients return home the same day.
Doctors typically recommend limiting strenuous activity for several days afterward.
How Long Does Pain Relief Last?
Early research suggests that symptom relief may persist for years in some patients.
According to Dr. Casadaban, studies from Japan, where the procedure originated, have followed patients for four years after treatment and found lasting improvements among those who responded well.
U.S. research has also produced encouraging results, with studies demonstrating sustained pain relief for at least two years in many successful cases.
