What is the effectiveness of Genicular Artery Embolization (GAE)?

Success stories are being heard about GAE as a novel non-surgical treatment for chronic knee pain and patients are interested in learning about about success rates. In the following paragraphs, we will outline the statistics concerning this minimally invasive treatment for knee osteoarthritis. But before delving into the details, let's explain the procedure itself.

What is genicular artery embolization? Genicular artery embolization or GAE, is a non-surgical treatment for chronic knee pain as an alternative to knee replacement surgery. It is particularly beneficial for individuals cautious about to undergoing complete knee joint replacement. For patients with mild arthritis, GAE stands as an intermediary treatment—less invasive than surgery yet more effective than traditional conservative alternatives such as anti-inflammatory drugs or physical therapy. But how does this technique work? Essentially, GAE involves limiting blood flow to the hyper-vascular inflamed joint lining, known as the synovium.

Why is this treatment help alleviate symptoms of osteoarthritis? The theory behingd this treatment lies in the synovium which is the lining of the joint which becomes inflamed in the setting of osteoarthritis and causes pain. The synovium, which is vascular in nature, becomes inflamed and thickens with the onset of osteoarthritis, releases inflammatory mediators, leading to pain and discomfort. To alleviate this pain, we decrease the amount of bloodflow to the synovium, resulting in decreased inflammation, reduction of inflammatory mediators and reduction in pain.

This is done by inserting a small catheter into a leg artery. Utilizing x-ray guidance (angiogram), we then pinpoint the sources of inflammation by looking for where the synovium is very vascular and appears inflamed. We then inject microspheric particles via the catheter to reach the inflamed areas of the synovium, thereby reducing blood flow.

What are the success rates of genicular artery embolization? It is worth noting that GAE is a minimally invasive outpatient procedure, with minimal recovery without the need for hospitalization or prolonged bed rest. Patients can resume their routine activities the day after the procedure, without surgical incisions, stitches, or staples. Moreover, GAE eliminates the need for general anesthesia, ensuring patient comfort with mild sedation. Notably, the procedure mitigates the risk of surgical and post-surgical complications and can be repeated, if needed, without added health risks, significantly postponing the need for knee joint replacement surgery.

In randomized controlled studies out of UCLA, patients saw benefits as soon as three days after the procedure. Average pain scores decreased from 8 out of 10 before GAE to 3 out of 10 within the first week. Additionally, seven in 10 patients reported more than 50% reduction in pain scores at the one-year follow up.

Regarding the efficacy of genicular artery embolization, clinical observations suggest that most patients experience durable relief from osteoarthritis pain post-procedure. Supported by recent studies indicating a technical success rate of 99.7%, with minimal contraindications and risks, genicular artery embolization emerges as a highly effective treatment for knee osteoarthritis. For those considering this alternative, reach out to us to explore if you may be a good candidate for GAE.