Knee
Genicular artery embolization (GAE)
A minimally invasive procedure for osteoarthritis: the small inflammatory vessels of the knee are closed. Indicated when injections and physiotherapy are not enough and replacement surgery is not yet indicated.
How it is performed
In osteoarthritis the synovial membrane becomes inflamed and develops a network of small abnormal vessels, accompanied by new nerve endings that amplify pain. Through an arterial access point of a few millimetres, a microcatheter reaches the genicular arteries that supply the painful area of the knee; injection of microparticles reduces this inflammatory vascularisation and, with it, the pain. It is the most studied variant of the technique also known as TAME (transcatheter arterial micro-embolization).
Who it is for
- Mild to moderate gonarthrosis with pain resistant to medication, physiotherapy and injections
- Patients who are not candidates for joint replacement or who wish to postpone it
- Persistent pain after knee replacement, in selected cases
Recovery
Same-day discharge. Light activity for a few days; benefit develops progressively and reaches its maximum within 1-3 months.
Conditions treated in this area: knee osteoarthritis (gonarthrosis), persistent pain after knee replacement, chronic tendinopathies, refractory anteromedial pain.
Scientific evidence
A multicentre randomised controlled trial against a sham procedure and systematic reviews of sham-controlled trials document a clinically significant reduction in pain and improved function in knee osteoarthritis, maintained at follow-up. Complications are generally minor and transient (access-site haematoma, self-limiting skin lesions).
References on PubMed
- Multicenter Randomized Sham Controlled Study of Genicular Artery Embolization for Knee Pain Secondary to Osteoarthritis
Bagla S, Piechowiak R, et al. — J Vasc Interv Radiol, 2022 · PMID 34610422
- Genicular artery embolization for knee osteoarthritis: A systematic review of sham-controlled randomized trials
Milhem F, Takhman M, et al. — J Orthop, 2025 · PMID 40766107
- GAUCHO Trial: Genicular Artery Embolization Using Imipenem/Cilastatin vs. Microsphere for Knee Osteoarthritis: A Randomized Controlled Trial
Correa MP, Motta-Leal-Filho JM, et al. — Cardiovasc Intervent Radiol, 2022 · PMID 35304614
Published data describe average results in groups of patients and are not a prediction of an individual outcome. The indication for treatment must always be assessed during a consultation.
Risks, costs and opinions
The three questions patients ask most often before deciding, with clear answers.
What are the risks of genicular artery embolization (GAE)?
It is a minimally invasive endovascular procedure performed as a day-case, under local anaesthesia. The most common issues are transient: a small bruise or soreness at the access point, and in some cases a post-embolization syndrome with pain, a feeling of being unwell or a low-grade fever in the following days, manageable with medication. Relevant complications (contrast reaction, unintended embolization of nearby vessels, problems at the puncture site) are rare and are discussed one by one during the consultation, with the informed consent in hand.
How much does the genicular artery embolization (GAE) cost?
The cost depends on the setting in which the procedure is performed: some treatments are available through the National Health Service or under agreement, others privately or through insurance. The quote is given clearly before scheduling the treatment, and includes the assessment, the procedure and the planned follow-up. During the consultation I tell you which pathway is available in your case: you do not have to decide before knowing the cost.
Does it really work? What patients and the literature say
The most frequent questions are "does it really work?" and "how long does the result last?". The honest answers come from the scientific literature cited on this page, not from online stories: they describe average results in groups of patients and do not guarantee an individual outcome. Reviews and experiences found in forums concern cases different from yours, often with different indications and techniques. During the consultation we review your imaging and I tell you frankly whether you are a good candidate, what alternatives exist and when another pathway is preferable.
Want to know if it is right for you?
At the first consultation we review your clinical history and previous imaging together.