Knee osteoarthritis affects over 365 million adults globally, according to the World Health Organization. For many, treatment options are limited. Conservative care like injections often fails, while joint replacement is not always feasible. A new study in Radiology highlights a minimally invasive alternative: genicular artery embolization (GAE).
GAE targets abnormal blood vessels around the knee joint. These vessels contribute to inflammation and pain. During the procedure, interventional radiologists use a catheter to inject tiny particles, blocking the vessels. This reduces inflammation without surgery. The technique uses rapidly resorbable gelatin-based microspheres, which dissolve within hours.
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The study involved 194 participants, mostly over 69 years old, who didn’t respond to at least three months of conservative treatment. They were treated between July and November 2024. Nearly 240 GAE sessions were conducted, with 45 patients undergoing two procedures for bilateral knee issues.
Procedures were technically successful. Only 6.7% of patients experienced mild, self-limited reactions. No moderate or severe adverse events were reported. Follow-up rates remained high: 94% at six weeks, 89% at three months, and 79% at 12 months.
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Pain scores dropped significantly. On a 0-to-10 scale, median scores fell from 7 at baseline to 3 at 12 months. Functional outcomes also improved. Daily activity scores rose from 53 to 71.5, while sports and recreation scores climbed from 15 to 36. Quality of life scores increased from 19 to 40.
Eighty percent of participants met or exceeded the minimum clinically important difference in pain and function scores. These thresholds define meaningful improvements. “We saw a notable reduction in pain and a marked improvement in function,” said Dr. Florian Nima Fleckenstein, lead researcher. The team found it notable that such a high percentage of patients experienced significant benefits.
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It offers a middle ground between traditional treatments. Injections provide temporary relief, while surgery carries risks. GAE normalizes vascular and neuronal structures in the knee, potentially slowing disease progression. The study is the largest to date on this technique using resorbable microspheres.
Dr. Fleckenstein stated that the results allow them to speak about safety and efficacy with confidence. For patients who cannot undergo surgery or find injections insufficient, GAE may provide lasting relief. The results come from real-world data, reflecting the diverse patient population seen in clinical practice.