About half of all Americans develop osteoarthritis in at least one knee during their lifetime. Although this condition is common, it may also reduce quality of life significantly. Knee osteoarthritis (OA) may cause challenges with walking, caring for your family, exercising, climbing stairs and even sleeping.
If knee pain from OA continues even if you’ve tried pain medications and physical therapy, you may be considering another way to treat it that doesn’t involve undergoing a total knee replacement. That’s where genicular artery embolization (GAE) may come in, says Cherng H. Chao, M.D., an interventional radiologist at City of Hope® Cancer Center Duarte.
Read on to discover how GAE may help treat osteoarthritis of the knee, including:
- What is genicular artery embolization?
- Genicular artery embolization success rate
- Is a knee replacement common after GAE?
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What Is Genicular Artery Embolization?
Genicular artery embolization is a minimally invasive outpatient procedure performed under twilight sedation that provides rapid and long-term pain relief to patients with knee osteoarthritis, says Dr. Chao, who performs GAE procedures in the Los Angeles area.
During the procedure, a physician uses imaging guidance to identify sites where abnormal vessels and inflammation are found in and around the knee. The doctor guides a tiny catheter to these sites through a small incision in the skin. Using tiny particles, abnormal vessels that cause pain are blocked so the patient no longer experiences pain, Dr. Chao says.
Who Gets GAE?
Most patients who receive GAE have already tried medications and physical therapy for osteoarthritis, but found that their knee pain didn’t subside, Dr. Chao says. “Typically when a patient develops osteoarthritis, they get conservative therapy, which would include nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen. The next level up would typically be a steroid injection, and those are usually limited to twice a year because of the risk of steroids that can cause injury to the bone long-term.”
The next step up from those medications would be receiving a total knee replacement, which is a major surgery that the majority of patients aren’t willing to consider. This is particularly true for younger patients, since knee replacements typically only last between 10 and 20 years.
“Genicular artery embolization offers a bridge for those patients who aren't quite ready for total knee replacement surgery,” Dr. Chao says. “And it doesn’t limit their ability to get a knee replacement in the future.”
Genicular Artery Embolization Versus Ablation
Other than oral and injected medications or total knee replacement, radiofrequency ablation is another potential alternative to GAE. In this procedure, a physician ablates, or burns, specific nerves that are causing pain in the knee.
“One big difference is that in GAE, we don’t burn any tissue,” Dr. Chao notes. But some patients eventually receive both ablation and GAE. “Getting ablation doesn’t limit a patient’s ability to get GAE, either at the same time or later.”
Genicular Artery Embolization Success Rate
The majority of osteoarthritis patients experience pain relief within a week after undergoing the GAE procedure, with that pain relief typically lasting up to a year, Dr. Chao says.
“One study showed that 60% to 70% of people who had GAE responded,” he adds.
Advantages
Genicular artery embolization is typically offered to patients between the ages of 40 and 79 with mild to moderate osteoarthritis who haven’t yet had knee surgery. Advantages of GAE over more invasive procedures include:
- Twilight/moderate sedation is used instead of general anesthesia
- Outpatient procedure, allowing the patient to go home a few hours afterward
- Very little pain after the procedure
- No surgical incision
- Pain relief occurs quickly, usually within one week
Side Effects
Genicular artery embolization is a safe procedure. Side effects may include skin discoloration and temporary pain that may last a few days, Dr. Chao says.
Is a Knee Replacement Common After GAE?
Because genicular artery embolization is used to treat knee pain before patients are candidates for a total knee replacement, some patients eventually receive a knee replacement procedure. One study found that within two years after GAE, about 5% of patients underwent a knee replacement. Another 8% received GAE again.
If you’re interested in receiving genicular artery embolization, speak with your care team about whether it might be helpful for relieving your knee pain. Your care team will develop a personalized treatment plan for your osteoarthritis that takes into account such factors as your pain location, how long you’ve been experiencing symptoms and your overall health.
If you or a loved one is concerned about possible signs or symptoms of cancer and would like an initial appointment or a second opinion, call us 24/7 877-460-4673.