All You Need To Know About Genicular Artery Embolization For Knee Pain

If you’ve been diagnosed with osteoarthritis of the knee, commonly known as a degenerative joint disease (DJD), you may have been told that your only treatment options, short of joint replacement surgery, are anti-inflammatories and joint injections. Did you know, however, that genicular artery embolization (GAE), a non-surgical outpatient treatment, is being used to successfully relieve the pain caused by DJD?

What is Genicular artery embolization (GAE)?

Genicular artery embolization (GAE) is a relatively new and effective minimally invasive interventional radiology treatment used to treat knee pain due to osteoarthritis.  The GAE procedure reduces blood flow to the knee lining (synovium). Osteoarthritis causes friction in the knee joint because the bones rub against each other. This leads to an increased flow of blood to the knee due to inflammation.

While the procedure does not treat the underlying cartilage damage, it does provide relief from the symptoms of knee arthritis. Additionally, unlike knee surgery, After the Genicular artery embolization (GAE) treatment, no physical therapy is required.

GAE blocks blood flow to the synovium (the lining of the knee), which becomes inflamed or damaged as a result of arthritis. The amount of inflammation associated with arthritis is reduced when these arteries are blocked, which can ease or eliminate the related knee pain. This is especially helpful if you have arthritis that is exacerbated by going up and down stairs, up and down incline or decline terrain.

Who is a Candidate for Genicular Artery Embolization?

The following conditions make for a good candidate for GAE:

  • Patients who are not ready for knee replacement surgery or contraindications for immediate knee replacement surgery
  • Patients who suffer from moderate to severe symptomatic knee pain.
  • Patients who are confirmed to have osteoarthritis.
  • Patients who have not responded to conservative treatments.
  • Pain or limitation of activity resistant to medicines/ physiotherapy/ joint injections

The following conditions may but not always disqualify a patient as a candidate for GAE:

  • Current or previous history of cigarette smoking
  • Severe peripheral arterial disease
  • Advanced arthritis based on x-ray, Infection or malignancy
  • Severe instability of the knee joint (most common reason to choose traditional surgery)

Diagnosis:

An Interventional Radiologist will take a detailed history, review provided chart notes, perform a complete physical exam and analyze and/or order imaging studies that include:

  • radiographs (X-rays)
  • computed tomography (CT)
  • magnetic resonance imaging (MRI)

After careful evaluation, the surgeon will determine whether the candidate is suitable for genicular artery embolization (also called geniculate artery embolization).

How is Genicular artery embolization (GAE) performed?

The Interventional Radiologist usually uses x-ray imaging to make an incision in the groin to access the femoral artery. After making the incision, The Interventional Radiologist will insert a catheter into the femoral artery, which carries the blood to your knee lining. The catheter injects tiny beads (called microspheres) into the arteries, blocking them and reducing blood flow to the area of inflammation. Knee osteoarthritis is relieved by reduced blood flow, which reduces inflammation, pain, and discomfort. The surgeon Using fluoroscopic visual guidance, usually views the patient’s leg images in real-time during the treatment, making them precise and effective. The duration of a genicular artery embolization (GAE) treatment varies depending on the amount of damage, but it usually takes around 1-2 hours to complete.

After the procedure:

  • You may resume light activities within the first week right after GAE
  • You will experience knee pain following the GAE, which will gradually lessen as the procedure takes effect.
  • After the GAE, you should avoid doing any high-impact activities for at least two weeks.

What are the benefits of genicular artery embolization?

The Benefits of GAE include:

  • Reduced knee pain
  • Reduced swelling
  • Reduced stiffness
  • Improved function
  • Shorter recovery time

Conclusion:

Research on GAE shows that the procedure has low risk and much faster recovery. It is the ideal treatment option for patients with moderate to severe osteoarthritis who are not candidates for knee replacement surgery and who are not willing for surgery. Additionally, the procedure has a very high success rate, with eighty-five percent of patients treated with Genicular artery embolization (GAE) reporting significant pain and discomfort relief within the first month, and in 70 % of patients, the relief of the symptoms may last up to 1 year.

Frequently Asked Questions:

Q: What are genicular arteries?

A: Genicular artery (from Latin geniculum, “knee”) may allude to one of six arteries in the human leg, the vast majority of which anastomose in the knee region.

Q: Is genicular artery embolization safe for osteoarthritis Patients?

A: For patients with osteoarthritis, genicular artery embolization is a safe, effective, and minimally invasive procedure for reducing knee pain.

Q: How long does genicular artery embolization last?

A: The procedure generally takes between 45 and 90 minutes, and the patient can go home the same day.

Q: What are some complications of GAE?

A: GAE has some minor complications which include:

  • Minor bruising or bleeding in the groin
  • Focal skin changes ( temporary)
  • Radiation exposure

About the Author:

Name: DR . SURESH GIRAGANI

INTERVENTIONAL RADIOLOGIST

DR. SURESH GIRAGANI CONSULTANT INTERVENTIONAL RADIOLOGIST at Apollo hospitals Jubilee Hills has more than sixteen years of clinical experience in vascular interventions with a special interest in neurovascular and peripheral vascular disease interventional procedures.

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