Genicular artery embolization (GAE): Patient Guide
What it is
In knee arthritis, the lining of the joint (synovium) can become inflamed, and the body may grow extra small blood vessels to it. This extra blood flow is linked with swelling and pain. GAE slows that blood flow. A very thin tube (catheter) is placed at the wrist or groin and guided to the small genicular arteries around the knee, where tiny particles are released. Nothing is placed in the knee joint, and there is no cut into the knee. GAE does not repair cartilage or reverse arthritis.
Who it may help
- Moderate to severe knee osteoarthritis pain for 3 months or more
- Pain that has not improved enough with exercise, physical therapy, weight management, medicines or knee injections
- People who want to avoid or delay knee replacement, or who are not candidates for it
- Pain that limits walking, stairs, sleep or daily tasks
Who may not be a good fit
- Infection in or near the knee
- A knee replacement in the same knee (needs a separate evaluation)
- Knee pain mainly from another cause, such as a meniscus tear, the hip or the spine
- Serious kidney disease or a severe allergy to contrast dye
- A bleeding problem or severe artery disease in the leg
- Pregnancy
Before
- Bring your X-rays, MRI reports and a list of your medicines.
- Tell us about blood thinners, diabetes, kidney problems, or an allergy to contrast dye or iodine.
- We may order a blood test to check your kidneys.
- Do not stop any medicine on your own. We will tell you what to do.
- Arrange a driver for the day of the procedure.
During
- Light sedation and numbing medicine at the wrist or groin.
- A thin catheter is guided with X-ray to small arteries near the knee.
- Tiny particles slow the extra blood flow.
- It often takes about 1 to 2 hours. Most people go home the same day.
After and recovery
- Keep the access site clean and dry. Avoid heavy lifting with that arm or leg for a few days.
- Most people return to light activity within a day or two.
- Some soreness in the joint, bruising at the access site, or a short-term skin color change over the joint can happen and usually fades.
- If pain improves, the change often builds over several weeks. Some people notice little or no change.
- Keep up with exercise or physical therapy as advised.
Risks
- Bruising, bleeding or a small lump where the catheter went in (wrist or groin)
- A reaction to the contrast dye, or strain on the kidneys from the dye
- Short-term skin color change, tenderness or a warm feeling over the treated joint
- Rarely, particles reach an area that was not intended, which can injure skin or other tissue
- Infection is uncommon
- Pain may not improve
When to call us
- Bleeding or a growing lump at the wrist or groin
- Fever over 101°F or chills
- A cold, pale, numb or very painful hand or foot
- Skin over the joint that becomes dark, blistered or open
- Pain much worse than before
Call 911 for chest pain or trouble breathing.
Questions people ask
Is GAE surgery?
No. It is a minimally invasive procedure done through a thin catheter at the wrist or groin. There is no cut into the knee.
Does it fix the knee?
No. It does not repair cartilage. It aims to reduce the abnormal blood flow linked with inflammation and pain.
How soon might I feel a change?
If it helps, the change often builds over several weeks. Results vary, and some people notice little or no change.
Will I stay overnight?
Most people go home the same day after a period of rest and monitoring. Plan to have a driver.
Can I still have other treatments later?
Yes. Embolization does not rule out physical therapy, injections or joint replacement later.
Insurance
Coverage for embolization varies. Many insurers consider genicular artery embolization, and embolization for the shoulder or hip, investigational, so it may not be covered. Our team will check your plan and talk with you about costs before anything is scheduled.
This handout is general information and is not a substitute for medical advice. Individual results vary. Photo: Wolfgang Halliwell / Pexels.