A new, minimally invasive technique called genicular artery embolisation (GAE) could give people with osteoarthritis a middle ground between medication, physiotherapy and full knee replacement.
GAE blocks tiny blood vessels that feed the inflamed tissue around the knee. By cutting off the blood supply, the procedure reduces inflammation and the pain that follows, according to recent research published by the scientific community.
Patients who respond well to the treatment report little or no knee pain for up to four years.
In studies involving a handful of participants, the relief lasted between two and four years. The reports note that the technique is performed under local anaesthetic, using a catheter inserted through a small puncture in the thigh or calf.
Osteoarthritis is the most common joint disorder in adults, affecting an estimated 10 per cent of people over 45 worldwide. Most sufferers start with non‑pharmacological measures – exercise, weight loss and physical therapy – before moving to pain‑relieving drugs, corticosteroid injections or, eventually, joint replacement surgery.
Knee replacement is a major operation that requires a recovery period of several months. It also carries risks of infection, prosthetic loosening and revision surgery later in life. A less invasive alternative that can postpone or even avoid the need for a prosthesis would therefore be welcome to patients and health systems alike.
Health‑economic studies suggest that a treatment that can keep patients out of the operating theatre for a few extra years could save hospitals tens of thousands of pounds per case, not to mention the indirect costs of lost work and reduced mobility.
The clinical evidence for GAE remains early. The current trials are small, non‑randomised and have follow‑up periods of only a few years. Regulatory authorities have not yet approved the procedure for routine use, and it is currently offered only in specialised centres that have the required interventional radiology expertise.
Future research will aim to confirm the durability of pain relief, optimise the embolisation materials and establish clear selection criteria for patients who are most likely to benefit. The next phase of work is a multicentre randomised trial set to recruit patients across Europe and North America in early 2027.
For now, patients and doctors are cautiously optimistic that genicular artery embolisation may become a useful tool in the fight against knee osteoarthritis – a possibility that could spare millions of people from the long road to joint replacement.
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