Genicular Artery Embolization (GAE): A Minimally Invasive Option for Chronic Knee Pain

Are you living with chronic knee pain and stiffness because of osteoarthritis (OA)? Does your knee pain and limited range of motion persist despite conservative care measures like activity modification, physical therapy, viscosupplementation, or corticosteroid injections?    

If you’re not ready for a total knee replacement just yet, our expert team at Advanced Vascular Surgery has an innovative new solution: genicular artery embolization (GAE). 

Learn how this minimally invasive, maximally effective treatment can ease OA knee pain, improve joint function, and help you be your active self once again — for up to two years. 

A short tutorial on osteoarthritis 

One in five adults in the United States lives with some form of arthritis-related joint pain and stiffness. Osteoarthritis (OA), the most common type, accounts for two in three arthritis diagnoses. Also known as degenerative joint disease or wear-and-tear arthritis, OA:

• Gradually destroys the joint’s “cartilage cushion”
• Causes bone-on-bone contact within the joint
• Inflames and irritates the joint lining (synovium) 
• Increases capsule fluid production and swelling

The result? Joint pain and stiffness that leads to reduced range of motion and — when it occurs in a weight-bearing joint like the knee — restricted mobility. As it advances, OA can limit your activity level, make it harder to sleep, sour your mood, and disrupt your life. 

A closer look at GAE for knee OA

OA tends to develop in weight-bearing, high-use joints more often, with knees being the most-affected joints. Physical therapy, joint injections, bracing, and other front-line OA treatments can make a big difference early on, but eventually, over half of people with knee OA wind up needing a total knee replacement. 

Unfortunately for many people with knee OA, there’s a big “gray zone” in between. 

When OA becomes less responsive to your usual pain relief methods, you’re left looking for alternative solutions. You’re not ready for joint replacement surgery. However, you still need relief — and joint injections, which can wind up accelerating OA progression when they’re repeated often, simply aren’t a limitless option.  

That’s where genicular artery embolization (GAE) comes in.  

What it is

OA-related knee pain that no longer responds to conservative therapies is often driven by inflammation. How? Chronic joint inflammation leads to the development of abnormal blood vessels around the joint, which perpetuate inflammatory nerve pain.  

GAE targets and “closes” these abnormal blood vessels with pinpoint precision, selectively blocking blood flow to the inflamed joint lining. With a relatively rapid effect (within a week), the treatment reduces inflammation and pain, helping restore joint function, range of motion, and mobility. 

How it works

Done with the aid of conscious IV sedation, GAE is a minimally invasive treatment that involves making a tiny incision in your upper thigh/groin area to insert a thin, hollow tube (catheter) in one of your arteries.

Using live X-ray guidance (fluoroscopy) and special contrast imaging dye, we carefully thread the catheter to the arteries that supply blood to the joint lining in your knee. Next, we deliver microscopic beads through the catheter into the targeted arteries, drastically reducing blood flow to the inflamed synovium.  

After we withdraw the catheter, we bandage the access site; the incision is so small it doesn’t need stitches. The entire in-office procedure takes 45-90 minutes, and you can return home immediately afterward. 

Results

GAE recovery is quick, though you may experience soreness at the access site for a few days. Once the blood vessels that “feed” the inflamed synovial lining have been blocked, the inflammation dies down, and your pain diminishes. 

In most cases, patients feel significant knee pain relief and restored joint function by the two-week mark. Up to 80% of those who undergo GAE for knee OA experience substantial pain relief — and reduced reliance on pain relief medications — for six to 12 months. Some people experience continued relief from OA-related knee pain for two years or longer. 

Candidates

GAE is an ideal option for people with knee OA who:

• Have mild to moderate disease progression
• Have knee pain that persists despite the usual therapies
• Want to avoid a knee replacement for the time being 
• Aren’t yet a candidate for knee replacement surgery

GAE is also an option for people who still have persistent knee pain following a total knee replacement. In such cases, GAE can be a good front-line alternative before considering a revision knee replacement.   

GAE doesn’t work as well for people who have severe knee OA that would benefit most from a joint replacement. In those cases, the treatment tends to deliver only minimal, short-term pain relief. 

Can GAE resolve your knee pain?

If you’ve been living with ongoing arthritis-related knee pain for far too long, GAE may be the pain-alleviating, function-restoring joint treatment you’ve been waiting for. 

To find out how you can benefit, schedule your visit at your nearest Advanced Vascular Surgery office in Kalamazoo, Allegan, Battle Creek, Coldwater, Sturgis, or Three Rivers, Michigan, today.