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Researching GAE for knee pain? The new GRAVITY randomized trial found that half of patients improved by 50% or more after genicular artery embolization, compared with about 1 in 10 without it.
A key question about genicular artery embolization has been how it compares with simply continuing standard care. A new randomized trial gives a clear answer. In September 2026, Dr. Siddharth Padia of UCLA presented the first results of GRAVITY, a randomized controlled trial comparing GAE with standard care alone for knee osteoarthritis, at the CIRSE Annual Congress in Copenhagen. GAE came out clearly ahead.
GRAVITY enrolled 119 patients aged 40 to 79 with knee osteoarthritis (Kellgren-Lawrence grade 2 or higher) whose pain had not improved with conservative treatment. Patients were randomized to GAE or to observation with standard supportive care.
The trial set a deliberately high bar for success: at least a 50% improvement in the WOMAC score, a standard measure of knee pain, stiffness and function. As Dr. Padia put it, "We set the bar high, as it's almost impossible to exceed a 50% improvement" with placebo alone.
"At all timepoints, GAE was superior to observation in terms of WOMAC score and pain," Dr. Padia reported. Follow-up continues to two years.
There were no serious treatment-related complications. Twelve procedure-related events were recorded. Most were skin ulcers (eight). The others were bruising at the access site, nausea from an anti-inflammatory medicine taken afterward, one small bone infarct, and one case of leg swelling.
Earlier sham-controlled trials of GAE produced mixed results. A 2026 trial from Rotterdam, for example, found that patients improved after both GAE and a sham procedure, and the difference at one year was not statistically significant. GRAVITY is the first randomized trial to compare GAE with observation and find it clearly superior. Dr. Padia's stated goal is for GAE to be included in treatment guidelines as an established option before knee replacement.
GRAVITY follows Dr. Padia's earlier UCLA study of 40 patients who were not candidates for knee replacement, published in the Journal of Vascular and Interventional Radiology in 2024. About two-thirds had at least a 50% improvement at one year, and 72% of those responders kept that benefit at two years. Most minimally invasive knee treatments, such as injections, give relief measured in weeks or months.
Other recent studies point the same way. A study from Charité in Berlin, published in Radiology in 2026, followed 194 patients: median pain fell from 7 out of 10 to 3 at one year, and 80% had a meaningful improvement. A small NYU study published in 2025 found that blood levels of VEGF, a signal that drives abnormal blood vessel growth in the joint, fell after GAE. That fits the theory behind the procedure.
GAE is not a cure for osteoarthritis, and it does not rebuild cartilage. It treats the pain and inflammation. Good candidates typically have moderate to severe knee pain that has not responded to physical therapy, medication or injections, and are not ready for knee replacement or want to delay it. GRAVITY gives patients like this much stronger evidence that the procedure itself is helping.
Results depend on careful patient selection and technique. Dr. Golowa was among the first physicians in New York City to perform GAE for knee pain, and he can review your imaging and history to see whether it makes sense for you.
To learn more, call our office at (212) 991-9991 or book an appointment.
GAE is a recognised procedure supported by randomised trials and multi-year follow-up, not a fringe treatment. Here is what the published evidence does and does not establish.
Read the articleGAE treats chronic knee pain by reducing blood flow to the inflamed joint lining. Compared with steroid injections it can hold pain at bay for years rather than months.
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