Genicular Artery Embolisation (GAE)

1) What is Genicular Artery Embolisation?

Genicular Artery Embolisation (GAE) is a procedure performed by an interventional radiologist to reduce knee pain caused by inflammation. In people with chronic knee arthritis, small abnormal blood vessels develop around the lining of the knee capsule and contribute to ongoing pain and inflammation.

During GAE, these abnormal vessels are selectively treated using tiny particles delivered through a catheter, reducing blood flow to the inflamed areas. This can lead to a reduction in pain and an improvement in knee function.

2) Why might GAE be recommended?

GAE may be considered for people who:

• Have chronic knee pain, most commonly in the setting of mild and moderate osteoarthritis
• Have ongoing symptoms despite treatments such as physiotherapy, pain medication, weight management, or injections
• Are not ready for, not suitable for, or wish to delay knee replacement surgery

GAE does not replace joint replacement surgery when this is clearly indicated, but it may be an option for symptom control in selected patients.

3) What happens during the procedure?

GAE is performed in an interventional radiology suite and usually takes 60–90 minutes.

• The procedure is performed under local anaesthetic, sometimes with sedation. Anaesthetic support is provided in the private hospital setting and anaesthetic options can be individualised in discussion with the anaesthetist.
• A small catheter is inserted into an artery in the groin or ankle
• Using X-ray guidance, the catheter is guided to the small arteries supplying the painful areas of the knee (the genicular arteries)
• Microscopic particles are injected to reduce blood flow to the inflamed tissue

There are no surgical cuts to the knee itself.

4) Recovery and aftercare

Most patients:

• Go home the same day
• Experience mild discomfort or bruising at the catheter entry site
• Notice some temporary knee soreness or a flare of pain for a few days

Normal daily activities are usually resumed within a few days. Pain relief may improve gradually over weeks, with some patients noticing benefit earlier than others.

5) Expected benefits

GAE has been shown to:

• Reduce chronic knee pain in many patients
• Improve function and ability to engage in daily activities
• Reduce reliance on regular pain medications in some people

The degree and timing of pain relief varies between individuals.

6) Risks and side-effects

GAE is generally safe, but as with any procedure, risks exist.

Common or minor effects

• Bruising or discomfort at the catheter insertion site
• Temporary increase in knee pain or inflammation

Uncommon risks

• Skin irritation or temporary skin changes around the knee
• Non-target embolisation (minimised by careful technique and imaging)

Serious complications are uncommon. Your interventional radiologist will discuss risks specific to you before the procedure.

7) Frequently asked questions

Will this cure my arthritis?
No. GAE does not reverse arthritis. It aims to reduce pain and improve function by reducing blood flow to the inflamed areas in the knee joint capsule.

How long do the results last?
This varies. Some patients experience lasting benefit, while others may notice symptoms return over time.

Can I still have a knee replacement later?
Yes. GAE does not prevent future knee surgery if it becomes necessary and is often used as a bridge to surgery.

When can I return to normal activity?
Light activity is usually possible within a day or two. Strenuous exercise should be avoided for several days.

Prepared for patients of Dr James Hillhouse, Interventional Radiologist.

This information is general and should be discussed with your treating clinicians.