Overview
In knee arthritis, the lining of the knee joint can become inflamed. Over time, the body may grow extra blood vessels to that lining. This extra blood flow is linked with swelling and pain. Genicular artery embolization, or GAE, is a procedure that cuts down this extra blood flow. It is done through a very thin tube, called a catheter, placed at the wrist or groin. The tube is guided to the small arteries around the knee, and tiny particles are released. GAE may help some people with moderate to severe knee arthritis pain that has not improved with other care. Results vary.
What it is
The genicular arteries are small blood vessels that supply the knee. In GAE, tiny particles are placed into the branches that feed the inflamed knee lining (synovium). The particles slow the abnormal blood flow to those areas. This is meant to calm inflammation and reduce pain.
GAE is image-guided and done through a small catheter. It does not involve a cut into the knee, and nothing is placed inside the knee joint. It does not repair cartilage or reverse arthritis. Research on GAE is still growing.
Who it's for
GAE may help people who have:
- Moderate to severe knee osteoarthritis pain
- Pain that has not improved enough with exercise, physical therapy, weight management, medicines or knee injections
- People who are not ready for knee replacement, or who are not good candidates for it
- Pain that limits walking, stairs, sleep or daily tasks
What the procedure involves, step by step
- Before: we review your exam, knee X-rays and sometimes an MRI. We also check your kidney function, allergies (including to contrast dye) and medicines, such as blood thinners.
- Getting ready: the procedure is done as an outpatient. You usually receive light sedation, and the skin at the wrist or groin is numbed.
- Access: your physician places a very thin catheter into an artery through a small opening at the wrist or groin.
- Mapping: using live X-ray and contrast dye, the catheter is guided to the genicular arteries, and the abnormal blood vessels around the knee are found.
- Embolization: tiny particles are released into the target vessels to reduce the abnormal blood flow.
- Finish: the catheter is removed and pressure or a closure device is used at the access site. The procedure often takes about one to two hours.
- Going home: after a period of rest and monitoring, most people go home the same day with a driver.
Recovery and what to expect
- Keep the access site clean, and avoid heavy lifting with that arm or leg for a few days.
- Most people return to light activity within a day or two.
- Some knee soreness, bruising at the access site or a short-term change in skin color over the knee can happen and usually fades.
- Any change in pain, if it happens, often builds over several weeks. Some people notice little or no change.
- Staying active and keeping up with exercise or physical therapy remains important.
Candidacy: who may or may not be a good fit
May be a good fit: adults with moderate to severe knee osteoarthritis pain that has not responded to conservative care or injections, including people who are not ready for, or are not candidates for, knee replacement.
May not be a good fit: people with an infection in or near the knee, a knee replacement in the same knee (which needs a different evaluation), knee pain mainly from another cause (such as a torn meniscus or the hip or spine), serious kidney disease, a severe allergy to contrast dye, a bleeding problem, severe artery disease in the leg, cancer in the area or pregnancy.
Risks in brief
Risks include bruising, bleeding or a lump at the access site, short-term skin color changes or tenderness over the knee, a reaction to contrast dye and kidney strain from contrast. Rarely, particles can travel to an area that was not intended, which may cause skin or tissue injury. Infection is uncommon. Pain may not improve. We will review your specific risks.
Alternatives
Other options may include exercise and physical therapy, weight management, a knee brace, medicines, steroid or hyaluronic acid (gel) injections, genicular nerve radiofrequency ablation, peripheral nerve stimulation, PRP (usually self-pay) or a referral to discuss knee replacement.
Frequently asked questions
Is GAE surgery?
No. It is a minimally invasive procedure done through a thin catheter placed at the wrist or groin. There is no cut into the knee.
Does GAE fix arthritis?
No. GAE 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 GAE 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 a knee replacement later?
Yes. GAE does not rule out knee replacement or other treatments later.
Is GAE the same as genicular nerve ablation?
No. Genicular nerve ablation uses heat to calm the nerves that carry pain signals. GAE reduces abnormal blood flow to the knee lining.
Does insurance pay for GAE?
Because GAE is a newer procedure, insurance coverage can vary. Please call 732-202-3000 so our team can check your plan.
Insurance
GSMC participates with all Aetna plans, including Aetna HMO, and with many other insurance plans. Coverage for a specific procedure depends on your plan and may need prior authorization; call 732-202-3000 to verify. Our team can help check your benefits before treatment. Because GAE is a newer procedure, insurance coverage can vary. Please call 732-202-3000 so our team can verify your benefits before treatment.
Book an appointment
One phone number for all 7 GSMC offices in Ocean and Monmouth County.
Our offices
- Whiting
- Toms River (1314 Hooper Ave)
- Brick
- Barnegat
- Manahawkin
- Freehold (322 Professional View Dr)
- West Long Branch
Telehealth visits are available for second opinions and imaging reviews only, by phone. Please call 732-202-3000 to book one.
This page is general patient education and does not replace advice from your own clinician. Individual results vary, and no outcome can be promised.