Genicular Artery Embolization (GAE)

Genicular artery embolization (GAE) is a minimally invasive treatment for osteoarthritis in your knee. It relieves pain and other arthritis symptoms without surgery.

Knee osteoarthritis causes painful inflammation inside your knee joint. It happens when your natural cartilage cushioning wears down, and bones in your knee rub together. This leads to inflammation, causing new arteries to grow inside the knee that shouldn’t. That uncontrolled growth causes pain. GAE reduces inflammation inside your knee by blocking off the new arteries. This will reduce pain.

Knowing what the words in GAE’s name mean can help you understand how it works:

• Genicular is a medical word that means something around your knees.
• An artery is a type of blood vessel. The genicular arteries are a group of vessels near your knees.
• Embolization is a treatment that stops blood flow to part of your body. You might have heard the word embolism to describe blood clots or blockages. They can be dangerous. Embolization is different. This is when a healthcare provider safely and intentionally stops blood flow in a vessel as a treatment.

Taking all the words together, GAE is a treatment where a healthcare provider will intentionally block the blood flow in abnormal arteries around your affected knee. The restricted blood flow reduces inflammation and relieves pain.

Your healthcare provider can tell you if GAE is a good option for you. It’s a relatively new treatment. So, it may not be available for everyone. But it can be an option to try before having surgery, like a knee replacement.

How should I prepare for genicular artery embolization?

Your healthcare provider will help you get ready for GAE. They’ll order X-rays and/or an MRI of your knee. This will give them up-to-date pictures of your joint and the area around it.

Your provider will tell you if you need stop any medications or supplements before the procedure. Otherwise, you shouldn’t need to do any special preparation in the days leading up to your appointment.

Arrange for someone to drive you home the day of your procedure. You won’t be able to drive right after.

What happens during GAE?

GAE takes an hour or two from start to finish. It usually follows these steps:

1. Your healthcare provider will give you a sedative and/or local anesthesia. You’ll be awake throughout the procedure. But you won’t feel any pain.
2. They’ll insert a thin needle and a catheter into a blood vessel in your groin.
3. Next, they’ll inject a dye into your blood vessels. The dye will flow through vessels in your leg and knee. This will make them stand out on fluoroscopy imaging. Your provider will use this to help guide them during the procedure.
4. Once they can see the vessels that need to be blocked, your provider will inject an embolic agent into the target vessels. The agent is tiny pieces of material that block the abnormal vessels they’re injected into. They’re like little beads that stay in place to reduce blood flow through those vessels.
5. Your provider will remove the catheter and plug the hole in your groin. They may put a bandage over the site to protect it.

GAE side effects

You might have some mild side effects after GAE, including:

• Bleeding at the injection site
• Skin discoloration around your knee
• Bruising
• Fever

What happens after this procedure?

You’ll be able to go home soon after your GAE procedure. Your care team may have you wait a bit to make sure the sedatives wear off with no side effects before they tell you it’s safe to leave.

You might have to avoid some physical activities for a week after GAE. Ask your provider when it’s safe to resume your usual routine.

How long does GAE last?

There’s very little recovery time after this procedure. GAE works fast. You should notice less pain within a few weeks. That improvement can last a long time. Most people still have reduced pain for at least several months.

But it’s possible that GAE won’t last forever. Talk to your healthcare provider if you feel pain again. Some people who get GAE end up needing other treatments for knee osteoarthritis in the future. Your provider may suggest doing another GAE procedure to help relieve the pain again. It’s possible that you might end up needing a knee replacement later on.