Genicular artery embolizationQuieting pain at its blood supply.

Painful, inflamed joints and tendons often grow tiny abnormal blood vessels. These vessels are thought to bring inflammation and pain-sensing nerve fibers with them. In GAE, an interventional radiologist guides a thin catheter through an artery, usually from the groin or wrist, to the small arteries around the knee. Tiny particles are released to reduce blood flow to the inflamed areas while the main blood supply stays open.

The procedure is done under local anesthesia and light sedation, and patients go home the same day.

The same technique, sometimes called transcatheter arterial embolization, is being studied for other painful conditions:

• Frozen shoulder (adhesive capsulitis). In a study of 100 patients, 80% had relief of night pain one month after treatment. Okuno Y, et al. J Vasc Interv Radiol. 2022.
• Tennis elbow. In an early study of 24 patients whose pain hadn't responded to other treatment, 88% were treatment successes at six months. Iwamoto W, et al. J Shoulder Elbow Surg. 2017.
• Plantar fasciitis, hand arthritis and other tendinopathies. Early studies have reported encouraging pain relief. Sasaki K, et al. Foot Ankle Surg. 2024. Kubo T, et al. Cardiovasc Intervent Radiol. 2023. Epelboym Y, et al. Skeletal Radiol. 2024.
• Hip pain, including hip bursitis and arthritis, is a newer area of interest, and there isn't yet enough published research to know how well it works.

Most of these studies are small and did not compare embolization with a placebo procedure.

• Promising pain relief. A 2026 analysis of 45 studies and 2,205 patients found average knee pain scores fell by about 37 points on a 100-point scale at one month and stayed lower at 12 months. Most of these studies had no comparison group. Taheri Amin A, et al. Cardiovasc Intervent Radiol. 2026;49(9):1682–1697.
• Mixed results against a placebo procedure. A small U.S. trial of 21 patients found much greater pain relief with GAE than with a sham procedure at one month. A larger Dutch trial of 58 patients found no significant difference at 12 months. Bagla S, et al. J Vasc Interv Radiol. 2022. van Zadelhoff TA, et al. Eur Radiol. 2026.
• Side effects. Temporary skin discoloration over the knee was the most common side effect, in about 11% of patients. Bruising at the catheter site occurred in about 3%. Taheri Amin A, et al. 2026.

GAE is still considered an emerging treatment. The particles used do not yet have FDA approval specifically for this use, and many insurance plans consider it investigational.

The best candidates generally have mild to moderate knee arthritis with pain that hasn't responded to physical therapy, medication or injections, and either aren't ready for knee replacement or aren't good candidates for surgery. It tends to work less well in severe, bone-on-bone arthritis.

Dr. Akhtar will evaluate your joint, review your imaging and all of your options, from PRP to joint replacement, and coordinate with the interventional radiologists at LMG Interventional Radiology, part of Loudoun Medical Group, if embolization makes sense for you.