Genicular artery embolization (GAE) is emerging as a promising minimally invasive outpatient alternative to total knee replacement surgery for osteoarthritis patients. The procedure, which takes one to two hours under conscious sedation, reduces blood flow to inflamed areas of the knee using tiny beads. Clinical data shows that 70% of patients experience a 50% or greater reduction in pain, with relief lasting up to four years. The FDA has granted breakthrough device status to several GAE devices since 2021.
How the procedure works
- ▪Genicular artery embolization is a minimally invasive outpatient procedure that works by releasing tiny beads to reduce blood flow to targeted, abnormal blood vessels associated with painful, inflamed areas inside the knee joint.
- ▪The clinical theory behind genicular artery embolization is that reducing blood flow to inflamed areas calms inflammation, which in turn reduces swelling and pain inside the knee joint.
Performing the procedure
- ▪Genicular artery embolization typically takes one to two hours and is performed under conscious sedation rather than full general anesthesia.
- ▪During genicular artery embolization, an interventional radiology team guides a catheter through the femoral artery using X-ray imaging and contrast dye to release tiny beads into abnormal blood vessels around the knee.
Recovery after the procedure
- ▪Because genicular artery embolization does not involve replacing the joint or making a large surgical incision, the recovery period is generally much shorter than after total knee replacement surgery.
- ▪Patients undergoing genicular artery embolization are monitored for several hours post-procedure, typically return home the same day, and are advised to rest for the next few days.
Treatment efficacy and pain relief
- ▪Approximately 70% of patients undergoing genicular artery embolization experience a reduction in their pain scores by half or more, according to Leigh Casadaban, MD, MS.
- ▪Published data from Japan shows pain relief from genicular artery embolization can last for four years, while United States data shows pain relief can last for two years.
Patient Candidacy
- ▪Genicular artery embolization offers an intermediate option for knee osteoarthritis patients who have failed conservative treatments like physical therapy but are not ready for major surgery.
- ▪People with mild to moderate knee osteoarthritis are considered the best candidates for genicular artery embolization, though patients with advanced disease can also undergo the procedure with potentially shorter-lasting benefits.
Future Applications
- ▪Clinical trials led by Leigh Casadaban, MD, MS, at the University of Colorado Anschutz School of Medicine are evaluating changes in knee fluid and testing a temporary treatment device called Nexsphere-F.
- ▪Researchers are exploring the use of embolization techniques similar to genicular artery embolization to treat other painful conditions, including frozen shoulder, tennis elbow, and plantar fasciitis.
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