A New Way to Treat Knee Arthritis Without Surgery—and You Go Home the Same Day

Genicular artery embolization (GAE) is a minimally invasive procedure that blocks abnormal blood vessels in the knee to reduce arthritis pain, allowing patients to return home the same day with pain relief lasting one to three years. More than one in three Americans over 60 have knee osteoarthritis, and approximately 40% report bothersome symptoms that interfere with daily life. While traditional treatments like physical therapy and injections help some patients, many find long-term relief elusive. Total knee replacement remains the standard surgical option for severe cases, but only 9% to 33% of eligible patients are willing to undergo surgery, and up to 20% report persistent pain even after the procedure.

What Is Genicular Artery Embolization and How Does It Work?

GAE is a precision-targeted procedure performed by interventional radiologists using advanced imaging to guide a tiny catheter through the femoral artery to the genicular arteries—blood vessels that feed the knee joint. During the procedure, embolic agents are injected to block abnormal blood vessels associated with inflammation and pain. The technique works by reducing synovial blood flow, which decreases knee pain related to inflammation, abnormal nerve growth, and excessive blood vessel formation. The entire procedure typically lasts two to three hours and is performed under local anesthesia and moderate sedation, allowing patients to return home the same day.

"By precision-targeting the abnormal blood vessels involved in knee osteoarthritis, GAE provides a novel alternative that calms overactive blood flow to restore joint comfort and mobility through a simple, same-day outpatient procedure," said Bedros Taslakian, M.D., associate professor of clinical interventional radiology at the University of Miami Miller School of Medicine.

What Are the Key Benefits and Safety Profile?

GAE offers several advantages for patients seeking alternatives to surgery or those not ready for knee replacement:

• Rapid Pain Relief: Clinical studies show average pain scores drop 40% to 50% within the first week, with sustained improvements for one to three years.
• Minimal Invasiveness: No large incisions, stitches, or overnight hospital stays required; most patients resume normal activities within days.
• Low Risk Profile: Adverse events are rare and typically minor, such as transient skin discoloration (11.6%) and mild knee pain (1.2%).
• Delay or Avoid Surgery: GAE is ideal for patients not ready for knee replacement or those with medical contraindications to surgery.
• Improved Mobility and Quality of Life: Many patients report significant improvements in mobility and reduced reliance on pain medications.

What Do the Research Results Show?

Dr. Taslakian led a comprehensive meta-analysis published in Osteoarthritis and Cartilage Open that evaluated the safety and effectiveness of GAE across nine studies involving 270 patients and 339 knees. The findings demonstrate strong efficacy and durability. Technical success—meaning the procedure was completed as intended—occurred in 99.7% of cases. Clinical success, defined as a 50% or more reduction in pain scores, was achieved in 65% to 85% of patients.

Over 12 months, patients experienced a weighted mean reduction of 34 to 39 points on the pain scale and 28 to 34 points on the WOMAC Total Score, a standardized measure of pain and function. At the 12-month mark, 78% of patients met the minimal clinically important difference for pain reduction, and 92% met it for functional improvement. Long-term durability is particularly impressive: only 5.2% of patients needed knee replacement and 8.3% required repeat GAE over two years.

Research also suggests that patients with greater baseline pain severity were more responsive to GAE, indicating the procedure may be particularly beneficial for those with moderate to severe symptoms. In a separate study published in the Journal of Vascular and Interventional Radiology, 60% of clinical trial participants experienced significant pain relief, with evidence suggesting GAE may provide long-term improvement.

"Our study findings also indicate that genicular artery embolization may, if further larger clinical trials prove successful, slow down the progression of osteoarthritis by observing significant decreases in signaling proteins, specifically vascular endothelial growth factor and interleukin 1 receptor agonist, one year after the procedure," Dr. Taslakian explained.

Who Is a Good Candidate for This Procedure?

GAE is suitable for a broad patient population, including people from 40 to 80 years old, athletes, and individuals with persistent pain after knee replacement. The procedure is particularly valuable for patients experiencing chronic knee pain from osteoarthritis that limits their participation in work, exercise, and social activities. As one expert noted, "Chronic knee pain from osteoarthritis often leads to a gradual loss of autonomy, limiting participation in work, exercise and social activities. This loss of function and confidence is frequently as debilitating to patients as the pain itself," said Victor Hugo Hernandez, M.D., professor and chief in the Division of Arthroplasty and Adult Joint Reconstruction at the University of Miami Miller School of Medicine.

Knee osteoarthritis care at the University of Miami Health System involves a multidisciplinary team approach, allowing physicians to select the best possible treatment for each patient's unique situation. As adoption of GAE continues to grow, the health system participates in ongoing clinical trials and research collaborations to further refine patient selection and optimize outcomes.