Knee pain relief without surgery
Genicular artery embolization (GAE) treats knee pain from osteoarthritis by calming the abnormal blood vessels that drive inflammation in the joint lining. It is done through a pinhole in an artery, with no incision and no general anesthesia, and you go home the same day.
Call to book: 737-241-2184 How GAE worksWhy does arthritis hurt, and how does GAE help?
In knee osteoarthritis, the cartilage that cushions the joint gradually wears down. But much of the pain comes from inflammation in the lining of the joint (the synovium), not only from the worn cartilage.
This inflamed lining grows a network of tiny abnormal blood vessels. These vessels feed the inflammation and are accompanied by new sensory nerve fibers that send pain signals.1,2
The knee is supplied by small arteries called the genicular arteries. In GAE, tiny particles are placed in the branches that feed the abnormal vessels. This reduces the inflammation and pain, while the normal blood supply to the knee is preserved.
Who is a good candidate?
In 2026, the Society of Interventional Radiology (SIR) issued a position statement supporting GAE for appropriately selected patients with symptomatic knee osteoarthritis, performed by trained interventional radiologists.1 GAE is often a good fit if you:
- Have knee pain from osteoarthritis that has not improved enough with medication, exercise, physical therapy or injections.1
- Have mild to moderate arthritis on X-ray, which is the group studied in Dr. Bagla's trials.2,3
- Are not a candidate for knee replacement, or want to delay it.1
- Want a joint-preserving option that does not rule out surgery later.
GAE does not rebuild cartilage or straighten a deformed joint. It is less likely to help when arthritis is severe ("bone on bone"), and it is not used when there is an active infection or a different cause of knee pain, such as a fresh injury.
How we decide whether GAE is right for you
We confirm that osteoarthritis is the cause of your pain and that GAE is a sensible next step.
Consultation & exam
We review your symptoms and past treatments, examine your knee to find where it hurts, and you complete a pain and function score (such as WOMAC) that we use to track your progress.
Knee X-rays
Standing X-rays grade the severity of your arthritis. MRI may be used when another cause of pain, such as a torn meniscus, needs to be ruled out.
Treatment plan
We explain all of your options, including physical therapy, injections and knee replacement, so you can choose what is right for you.
How GAE compares with other options
Most people with knee arthritis start with simple measures. GAE fills the gap between these and knee replacement.
| Option | How it works | Things to know |
|---|---|---|
| Exercise, weight loss & medication | Strengthening, physical therapy and pain relievers | The foundation for everyone; anti-inflammatory medicines can have side effects with long-term use |
| Joint injections | Steroid or other injections into the knee | Can help for weeks to months; often need repeating |
| Knee replacement | The damaged joint surfaces are replaced surgically | Very effective for advanced arthritis, but major surgery with a recovery of several months |
| Genicular artery embolization | Abnormal vessels in the joint lining are treated through a pinhole in an artery | No incision, light sedation, same-day discharge, joint preserved; a newer treatment with growing evidence1,3 |
What happens during GAE
GAE typically takes about an hour. You are awake but relaxed throughout.
Preparation
You receive light sedation and local anesthetic at the access site. No general anesthesia is needed.
A pinhole in the upper thigh or ankle
A thin tube (catheter) is placed through a tiny puncture into the artery in your upper thigh or, in some cases, a small artery at your ankle (pedal access). No incision is made.
Mapping the arteries
Using X-ray guidance and contrast dye, a microcatheter is steered into the genicular arteries around the knee to find the areas of abnormal blood flow, which usually match where you feel pain.
Embolization
Microscopic particles are slowly injected into the branches feeding the abnormal vessels, while preserving the normal blood supply to the knee.2
Recovery
The catheter is removed and a small dressing applied. You rest for 30 to 60 minutes and go home the same day.
Results
Some of the key U.S. research on GAE comes from Dr. Sandeep Bagla and colleagues, including a multicenter randomized trial comparing GAE with a sham (placebo) procedure.2,3
Average knee pain score (out of 100) before and 6 months after GAE in Dr. Bagla's 20-patient two-center study, with disability scores improving by about half.2
Greater pain reduction (on a 100-point scale) with GAE than with a sham procedure at 1 month in Dr. Bagla's randomized trial. None of the sham patients improved enough, and all chose to cross over to GAE.3
Major adverse events in a review of 14 studies of embolization for joint pain, with pain continuing to improve up to 1 year.5
Most patients notice improvement within the first few weeks to months. Not every study has been positive: in an Australian sham-controlled trial of early knee arthritis, both groups improved, and GAE was better than sham only in patients in whom all of the target arteries were treated.4 SIR has called for larger randomized trials to confirm the results.1 Individual results vary, and no treatment can guarantee success.
Risks and side effects
Side effects of GAE have been mild and temporary in published studies.3,5 We discuss all risks with you in detail beforehand:
- Temporary skin discoloration over the knee, which fades on its own. In Dr. Bagla's 2020 study this affected about two-thirds of patients.2
- Temporary numbness or tingling in the sole of the foot, which resolved within 2 weeks in the 10% of patients who had it2
- Bruising or tenderness at the puncture site in the upper thigh or ankle
- A mild ache in the knee for a few days
- Reaction to contrast dye or sedation
- Pain that does not improve enough, or returns over time
Frequently asked questions
Is the procedure painful?
It is performed under local anesthesia with light sedation. Most patients feel only the small needle at the access site. A mild ache in the knee for a few days is common.
Can I walk afterward?
Yes. You walk out the same day. Your physician will give you specific instructions about exercise and activity in the first days.
How soon will my knee feel better?
Many patients notice less pain within a few weeks, and improvement often continues over the following months.2,5
Does GAE repair the cartilage?
No. GAE treats the inflammation that causes pain; it does not rebuild cartilage. Staying active and continuing your exercises remain important.
Can I still have a knee replacement later?
Yes. GAE preserves the joint and does not rule out a knee replacement in the future.1
Is it covered by insurance?
Coverage varies by policy. We will navigate out-of-pocket costs with you. Call us at 737-241-2184 with questions.
Find out whether GAE is right for you
If knee arthritis pain is limiting your life and other treatments have not helped enough, an evaluation can show whether genicular artery embolization is a good option.
Call 737-241-2184 to scheduleReferences
- Society of Interventional Radiology. Position statement on genicular artery embolization for knee osteoarthritis. J Vasc Interv Radiol. 2026. SIR announcement
- Bagla S, Piechowiak R, Hartman T, et al. Genicular artery embolization for the treatment of knee pain secondary to osteoarthritis. J Vasc Interv Radiol. 2020. doi:10.1016/j.jvir.2019.09.018
- Bagla S, Piechowiak R, Sajan A, et al. Multicenter randomized sham controlled study of genicular artery embolization for knee pain secondary to osteoarthritis. J Vasc Interv Radiol. 2022;33(1):2–10.e2. doi:10.1016/j.jvir.2021.09.019
- Landers S, Hely R, Hely A, et al. Genicular artery embolization for early-stage knee osteoarthritis: results from a triple-blind single-centre randomized controlled trial. Bone Jt Open. 2023;4(3):158–167. doi:10.1302/2633-1462.43.BJO-2022-0161.R2
- Kim GH, Shin JH, Nam IC, et al. Transcatheter arterial embolization for benign chronic inflammatory joint pain: a systematic review and meta-analysis. J Vasc Interv Radiol. 2022;33(5):538–545. doi:10.1016/j.jvir.2022.01.013
This page provides general information and does not replace a personal medical consultation. Study results describe groups of patients and cannot predict the outcome for an individual. Urology Austin and IR Centers · 8701 N. Mopac, Suite 100, Austin, Texas 78759 · 737-241-2184