The procedure worked "remarkably" well.
Seventy‑four‑year‑old Cynthia Schraf‑Fletcher says genicular artery embolization (GAE) has greatly lowered her chronic knee pain. One year after the outpatient treatment on her right knee, she feels the result is almost as good as the total knee replacement she had on her left side.
She chose Dr. Leigh Casadaban, an assistant professor of radiology at the University of Colorado Anschutz School of Medicine, for the treatment.
Now everyday tasks like gardening, riding a stationary bike, and other hobbies cause far less pain.
A New Choice Between Injections and Knee ReplacementGAE works by cutting off blood flow to inflamed parts of the knee. Less blood means less inflammation, swelling, and pain.
This can help people with osteoarthritis who have tried simple treatments but are not ready for major surgery.
"For knee osteoarthritis we usually think of medication, physical therapy, maybe a steroid shot, and then a total knee replacement at the far end," says Dr. Casadaban, a vascular interventional radiologist. "GAE is a promising minimally invasive option for patients who have failed other treatments but do not want big surgery yet."
Osteoarthritis is a joint disease where cartilage breaks down over time. In the knee this causes pain, stiffness, swelling, and trouble walking.
People with mild to moderate knee osteoarthritis are the best candidates for GAE. Those with severe disease can also try it, but the pain relief may not last as long.
About 70% of patients see a big drop in pain scores—often cutting them in half or more. Some report no pain at all after the procedure.
For Cynthia, avoiding another big knee operation was very important. After complications from her earlier knee replacement, she was eager to try GAE and is glad she did.
How the Procedure Is DoneGAE usually takes one to two hours and is done with conscious sedation. The patient is relaxed but not fully asleep.
The radiology team makes a tiny cut in the leg crease. A thin tube (catheter) is threaded through the femoral artery while X‑ray images guide it.
When the catheter reaches the genicular arteries around the knee, tiny beads are released into the abnormal vessels that feed the inflamed area. The beads block blood flow to those spots.
Because no joint is replaced and there is no large incision, recovery is much quicker than after a knee replacement.
Patients are observed for a few hours and usually go home the same day. They are advised to rest for a few days.
Growing Interest in GAEGAE was first created in Japan a little over ten years ago and is gaining attention worldwide.
In the United States, the FDA gave “breakthrough device status” to several tools used for GAE after 2021, speeding up their development and review.
Early studies are encouraging. Four‑year data from Japan show that a single outpatient GAE can keep pain down for up to four years. Recent two‑year U.S. data show similar lasting relief for patients who respond well.
Researchers are studying how GAE changes the knee joint. Dr. Casadaban leads trials at CU Anschutz that look at fluid changes inside the knee after GAE and test a temporary device called Nexsphere‑F that blocks tiny vessels for a short time.
While GAE is now used mainly for knees, the same idea is being explored for other painful conditions such as frozen shoulder, tennis elbow, and plantar fasciitis.
If ongoing research continues to show long‑lasting benefits, GAE could become a key option for patients stuck between simple treatments and major joint surgery.