A minimally invasive procedure that targets abnormal blood vessels around the knee is providing significant, lasting pain relief for people with osteoarthritis, according to a new study of nearly 200 patients. The treatment, called genicular artery embolization (GAE), uses tiny resorbable particles to block problematic blood vessels, reducing inflammation and pain while improving function for at least 12 months.

What Is Genicular Artery Embolization and How Does It Work?

Genicular artery embolization is an image-guided procedure that targets the root cause of osteoarthritis pain rather than just masking symptoms. The treatment uses rapidly resorbable, gelatin-based microspheres, which are tiny spherical particles designed to dissolve within hours, to block abnormal blood vessels around the knee joint.

The procedure works by addressing what researchers call pathological hypervascularity, or excessive abnormal blood vessel growth around the joint. By reducing these problematic vessels, the treatment modulates the neurovascular environment of the knee, decreasing both inflammation and pain signals. Unlike permanent embolization agents, the resorbable microspheres offer a unique advantage: they integrate the benefits of temporary and permanent treatments while avoiding their limitations.

What Did the Research Show About Pain Relief and Function?

Researchers at Charité-Universitätsmedizin Berlin conducted a prospective study involving 194 participants, including 114 women and 80 men with an average age of 69 years. All participants had osteoarthritis-related knee pain that had not responded to at least three months of conservative treatment, such as physical therapy, anti-inflammatory medications, and intra-articular injections.

The results were striking. On a pain scale from 0 to 10, median pain scores dropped from 7 at baseline to 4 at six weeks, and further improved to 3 at both the six-month and 12-month follow-ups. This sustained reduction in pain persisted throughout the entire year of follow-up.

Beyond pain relief, participants experienced meaningful improvements in daily function and quality of life:

• Daily Activity: Median scores increased from 53 at baseline to 71.5 at 12 months, reflecting improved ability to perform everyday tasks.
• Sports and Recreation: Scores more than doubled, rising from 15 to 36, allowing patients to return to activities they had abandoned due to knee pain.
• Osteoarthritis Symptoms: Overall symptom scores improved from 51 to 68, indicating reduced swelling, stiffness, and other joint-related complaints.
• Quality of Life: Scores more than doubled from 19 to 40, demonstrating a substantial improvement in overall well-being.

At the 12-month follow-up, 80 percent of study participants achieved improvements that exceeded the minimum clinically important difference, a threshold used by medical professionals to determine whether a treatment produces meaningful real-world benefits.

"For many patients with knee osteoarthritis, there is a real treatment gap today. Conservative measures such as intra-articular injections no longer provide sufficient relief, but joint replacement is not an option for medical or personal reasons," said Florian Nima Fleckenstein, MD, deputy head of Interventional Radiology at Charité-Universitätsmedizin Berlin.

Florian Nima Fleckenstein, MD, Deputy Head of Interventional Radiology, Charité-Universitätsmedizin Berlin

How Safe Is the Procedure?

Safety was a key focus of the study. All 239 procedures performed were technically successful, with no moderate or severe adverse events reported. Only 6.7 percent of participants experienced mild, self-limited reactions that resolved on their own. This safety profile is particularly important for patients who may be concerned about the risks of more invasive surgical interventions.

The study also had strong follow-up rates, with 94 percent of participants returning for assessment at six weeks, 89 percent at three months, 89 percent at six months, and 79 percent at 12 months. These high retention rates suggest that patients found the procedure worthwhile and were willing to participate in long-term monitoring.

How Does GAE Compare to Other Treatment Options?

Knee osteoarthritis affects over 365 million adults worldwide and is a leading cause of disability, according to the World Health Organization. Current treatment options typically fall into two categories: conservative measures like injections and physical therapy, or surgical joint replacement.

Genicular artery embolization fills a critical gap between these options. For patients whose symptoms have progressed beyond what injections can manage, but who are not yet ready for or suitable candidates for joint replacement surgery, GAE offers a minimally invasive middle ground. The procedure can be performed in an outpatient setting under image guidance, avoiding the recovery time and risks associated with major surgery.

"For the right patient, it can mean lasting relief from a single, minimally invasive procedure, a meaningful new option between injections and joint replacement," explained Dr. Fleckenstein.

Florian Nima Fleckenstein, MD, Deputy Head of Interventional Radiology, Charité-Universitätsmedizin Berlin

Steps to Understanding If GAE Might Be Right for You

• Assess Your Current Treatment Response: GAE is designed for patients whose pain has not adequately improved with at least three months of conservative treatment, including physical therapy, anti-inflammatory medications, and intra-articular injections.
• Evaluate Your Surgical Candidacy: The procedure is most appropriate for patients who are not yet ready for joint replacement surgery or who have medical or personal reasons that make surgery unsuitable.
• Discuss with Your Orthopedic Team: Ask your healthcare provider whether you might be a candidate for this emerging minimally invasive option, and inquire about access to centers offering the procedure.
• Consider the Timeline: The study showed sustained benefits for at least 12 months, though longer-term outcomes are still being evaluated as the procedure gains wider adoption.

What Makes This Study Particularly Significant?

This is the largest body of evidence to date for genicular artery embolization using rapidly resorbable microspheres, with nearly 200 participants. The study's inclusive design means the participants closely resemble the patients that physicians encounter in everyday clinical practice, rather than highly selected research volunteers.

"We believe these results carry real weight because they come from real-world data. With this broad, inclusive study design, our participants are exactly the patients that physicians encounter every day in their practices," stated Dr. Fleckenstein.

Florian Nima Fleckenstein, MD, Deputy Head of Interventional Radiology, Charité-Universitätsmedizin Berlin

The findings were published in Radiology, a peer-reviewed medical journal, and represent a significant advancement in how physicians approach osteoarthritis treatment. By targeting the underlying pathological blood vessels rather than simply managing pain symptoms, GAE may represent the first procedure capable of altering the disease course and slowing its progression.

As knee osteoarthritis continues to affect millions of people worldwide and generate billions in healthcare costs, this emerging treatment offers hope for patients caught between inadequate conservative care and the major commitment of joint replacement surgery.