Genicular Artery Embolization (GAE)

Knee osteoarthritis can be exhausting. Many patients move from physical therapy and anti-inflammatory medications to steroid or gel injections—only to find that relief becomes shorter or less effective over time. Yet the idea of major knee replacement surgery can feel overwhelming or premature.

At Radiant Vascular Institute, we offer Genicular Artery Embolization (GAE) as a minimally invasive treatment option for patients who want meaningful pain relief without undergoing joint replacement. GAE is designed to reduce inflammation and improve function—often helping patients delay the need for surgery.

What Is Genicular Artery Embolization?

Osteoarthritis pain is not just “bone-on-bone.” In many patients, arthritis causes chronic inflammation within the joint lining. The body responds by forming tiny abnormal blood vessels around the knee, which can contribute to ongoing pain.

GAE works by targeting these small inflamed vessels. Using real-time X-ray guidance, a small catheter is inserted through a pinhole in the wrist or groin and carefully guided to the arteries supplying the painful areas of the knee. Tiny particles are delivered to reduce abnormal blood flow associated with inflammation.

There are:

• No surgical incisions
• No joint replacement
• No hardware placed in the knee

The procedure is performed on an outpatient basis, and patients go home the same day.

How GAE Compares to Other Treatments

Many patients consider GAE after trying:

• Pain medications or anti-inflammatories, which may provide temporary relief but are not ideal long-term solutions for many individuals.
• Steroid injections, which often provide short-term improvement but may lose effectiveness over time.
• Viscosupplement (“gel”) injections, which can help some patients but do not work for everyone.
• Knee replacement surgery, which is highly effective but involves major surgery, anesthesia, and months of recovery.

GAE offers an option in between: a minimally invasive treatment that addresses inflammation directly, without the recovery and risks associated with major orthopedic surgery.

What Does the Research Show?

GAE is an emerging treatment with growing clinical evidence:

• A 2024 systematic review and meta-analysis (21 studies, 633 patients) demonstrated significant reductions in knee pain and improvements in function after GAE, with benefits maintained at follow-up intervals up to approximately 12 months.
• The GENESIS prospective study (2024) reported sustained improvements in pain and function at 2 years, along with decreased inflammation on MRI. Some patients later underwent knee replacement, and researchers reported no added surgical difficulty from prior GAE.
• Additional 24-month outcome studies published in the Journal of Vascular and Interventional Radiology (JVIR) demonstrate continued evaluation of durability and safety.

While GAE does not reverse arthritis or rebuild cartilage, studies consistently show meaningful pain reduction in appropriately selected patients.

What Recovery Is Like

One of the greatest advantages of GAE is the recovery profile.

• The procedure typically takes 1–2 hours.
• Patients go home the same day.
• Mild soreness or swelling around the knee may occur for several days.
• Most patients resume light activity within 1–3 days.
• Improvement in pain often begins within 2–6 weeks, with continued benefit over several months.

Because there is no surgical incision into the joint, recovery is significantly faster than knee replacement surgery.

Will I Still Need Knee Replacement Someday?

Possibly.

GAE does not “cure” arthritis, and osteoarthritis may continue to progress over time. However, for many patients, GAE provides meaningful symptom relief and improved quality of life—allowing them to delay knee replacement surgery until it is truly necessary.

Delaying surgery can be especially valuable for:

• Younger patients who want to postpone joint replacement
• Patients with medical conditions that increase surgical risk
• Individuals who simply are not ready for major surgery

Importantly, current evidence suggests that undergoing GAE does not make future knee replacement more complicated.

Is GAE Right for You?

You may be a candidate if you:

• Have chronic knee osteoarthritis pain
• Have not achieved adequate relief from conservative treatments
• Are not ready for or wish to delay knee replacement
• Want a minimally invasive, outpatient solution

At Radiant Vascular Institute, we provide comprehensive, extended consultations to determine whether GAE is appropriate for your specific situation. We carefully review your symptoms, prior treatments, and imaging, and discuss all options—including continued conservative care, surgical alternatives, and minimally invasive therapies.

Our goal is always the same:
Reduce risk. Preserve function. Improve quality of life.