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Knee Osteoarthritis

Knee Osteoarthritis (OA) is a leading cause of disability and chronic pain reducing physical activity and quality of life. OA affects nearly 30 million people in the US, with the knee being the most common site. Due to an aging population and obesity epidemic, the prevalence of knee OA has been rising. While traditionally OA has been considered the “wear and tear” disease; it is now considered a much more complex disease of low-grade inflammation caused by inflammatory markers released by cartilage, bone, and the lining of the knees known as synovium. Risk factors for knee OA are age, obesity, family history of knee osteoarthritis, or trauma. 

 

Although anti inflammatories, injections or knee replacement have been traditionally used to treat, Geniculate artery embolization has risen as a viable options for patients who wish to delay undergoing knee replacement.  Here at Houston Vein and Vascular, we offer this procedure to the patients seeking a minimally invasive relief from knee OA. 

Patient suffering from knee arthritis

Geniculate Artery Embolization

Genicular artery embolization (GAE) is a minimally invasive treatment that targets the low-grade inflammation associated with knee arthritis. GAE reduces the blood flow to the lining of the knee, the synovium, that are inflamed. By targeting these arteries, the inflammation associated with osteoarthritis decreases which in turn can help or eliminate the associated knee pain. Initial trials shows the promise this technique holds for patients with debilitating knee pain who are not ready or willing to undergo knee replacement surgery. Although, GAE does not repair the underlying destroyed cartilage destruction, research has shown that this may be an effective way to manage the symptoms. In an article published in the Society of Interventional Radiology in March 2021, average pain scores decreased from 8 out of 10 before GAE to 3 out of 10 within the first week.  We offer this minimally invasive treatment at Houston Vein and Vascular.

Why GAE is Effective:

  • Direct Targeting: By focusing on the genicular arteries, GAE directly addresses the source of pain and inflammation in knee osteoarthritis.

  • Tissue Response: With reduced blood flow, the inflammation and associated pain in the knee decrease significantly.

Benefits of GAE:

  • Minimally Invasive: With just a small incision, there's less risk of complications and faster healing compared to open surgeries.

  • Avoidance of Surgery: Patients can sidestep more invasive surgical interventions, like knee replacement.

  • Quick Recovery: Most patients experience pain relief within days and return to their regular activities swiftly.

How Is GAE Performed?

GAE is performed with moderate sedation as an outpatient procedure. This mean that the patient will go home after the procedure. The procedure generally takes one to two hours. Our vascular and interventional specialist will insert a small catheter (a thin hollow tube) into the artery of the patient’s upper thigh and, with the use of live X-rays, guide a smaller catheter to the arteries supplying the lining of the knee. Small particles are then injected through the catheter into these arteries, reducing the blood supply. This in turn reduces the inflammation associated with osteoarthritis, which alleviates the pain.

Genicular artery embolization, Pre for knee arthritis
Genicular artery embolization, Post for knee arthritis

Am I A Candidate For GAE?

GAE is a minimally invasive treatment option available for patients with knee pain due to osteoarthritis who have failed conservative therapy and who do not wish to undergo or are not eligible for knee replacement.

The following conditions make for a good candidate for GAE:

  • Age: 40-80 years

  • Moderate to severe knee pain

  • Osteoarthritis based on x-ray

  • Local knee tenderness

  • Lack of relief from conservative treatment (NSAIDS/Physical therapy/joint injection)

What Happens After The GAE Procedure?

Patients go home typically 1-2 hours after the procedure. Pain relief starts to occur typically two weeks after the procedure. This is because it takes time for the inflammation in the lining of the knee to be reduced, relieving the knee pain associated with osteoarthritis.

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