Knee Osteoarthritis & GAE
A comprehensive guide

Knee osteoarthritis (OA) affects an estimated five million people, gradually wearing away the cartilage that cushions the knee joint. As the disease progresses, the bones may begin to rub directly against each other, causing debilitating pain, stiffness, and loss of mobility.

Can GAE actually delay knee replacement?

Yes. For many patients, Genicular Artery Embolization (GAE) offers lasting relief from knee osteoarthritis pain, potentially delaying or even avoiding the need for knee replacement surgery. Clinical studies show that 87% of patients who underwent GAE experienced significant improvements in pain and mobility within 12 months all without surgery, without hospital stays, and with minimal downtime.

While total knee replacement is an effective solution for end-stage osteoarthritis, many patients are not ready or ineligible for major surgery. Individuals with comorbidities such as advanced age, obesity, uncontrolled diabetes, cardiovascular disease, or kidney failure often face increased surgical risks. Others simply wish to avoid the extended recovery time and permanent implant associated with knee replacement. For such patients, Genicular Artery Embolization (GAE) offers a promising, image-guided alternative that can safely delay the need for joint replacement.

GAE targets the abnormal blood vessels that contribute to chronic knee inflammation. By embolizing these arteries, the procedure significantly reduces joint pain, allowing patients to regain mobility and delay surgery.

Treatment Type	Time to Initial Relief	Peak Improvement	Duration of Effect
Genicular Artery Embolization (GAE)	2–4 weeks	3–6 months	Up to 2 years or more
Painkillers (NSAIDs)	Same day	Short-term only	Hours; no long-term effect
Physical Therapy	6–12 weeks	3–6 months	Ongoing effort needed
Steroid or HA Injections	1–2 weeks	4–6 weeks	Temporary; repeat every 3–6 months

What is the recovery like after GAE?

Genicular Artery Embolization (GAE) is an outpatient procedure that typically takes between one and two hours. Following the intervention, patients are observed briefly and are usually able to walk and return home on the same day.

In the first one to two days after GAE, it is normal to experience mild discomfort, minor bruising, or swelling at the catheter entry site—usually in the groin or upper thigh. These effects are temporary and generally self-limited.

Day 2 onward most patients can safely resume light activities such as walking short distances or performing basic daily tasks.

By day 3 patients typically return to normal activity levels, although it is advised to avoid heavy lifting, stair climbing, or high-impact movements.

By week 2, full recovery is expected. At this point, most patients begin to notice a reduction in knee pain and stiffness, as well as improved joint mobility.

Following GAE, side effects are generally mild and transient. Within two weeks:

• Swelling and discomfort diminish
• Stiffness subsides
Functionality and range of motion begin to improve

While GAE is not a curative treatment for osteoarthritis, many patients experience meaningful and lasting pain relief—often for up to 12 months or longer. Recovery is typically uneventful, and the gradual improvement in symptoms allows individuals to return to daily life with less dependence on medications or assistive devices.

Who is a good candidate for GAE?

Knee replacement surgery is typically recommended for individuals with advanced osteoarthritis or extensive joint damage. The procedure involves removing diseased cartilage and bone from the knee and replacing them with artificial components designed to restore joint function. While effective, knee replacement requires hospitalization, carries surgical risks, and necessitates a prolonged period of physical rehabilitation.

However, not all patients are ideal candidates for surgery. Certain medical conditions may increase surgical risk, compromise healing, or reduce the success of the implant. These include:

• Severe cardiovascular disease
• Poorly controlled diabetes
• Advanced peripheral vascular disease
• Morbid obesity (BMI > 40)
• Severe osteoporosis
• Frailty or advanced age

In such cases, surgery may carry a higher risk of complications such as infection, poor wound healing, or blood clots. Additionally, patients in the early stages of osteoarthritis or those with milder symptoms may not yet require a surgical intervention and may benefit from exploring less invasive options.

GAE is most appropriate for:

• Patients with moderate to severe knee osteoarthritis experiencing pain and reduced function despite conservative treatments
• Individuals who are not ideal candidates for surgery due to medical comorbidities
• Patients who prefer to delay or avoid surgery, especially when symptoms are significant but joint damage is not yet end-stage
• Those who have exhausted first-line therapies such as medications, injections, and physical therapy without adequate relief

By targeting the abnormal blood vessels contributing to inflammation and pain, GAE offers a minimally invasive approach that can improve quality of life while preserving future treatment options, including surgery, if needed later.

What happens if GAE doesn’t work?

While the success rate is high, GAE does not regenerate cartilage or reverse osteoarthritis. In cases where pain relief is partial or short-lived, patients have several options:

• Repeat GAE: In select cases, a second embolization may improve outcomes.
• Alternative minimally invasive procedures: Options include genicular nerve ablation or viscosupplementation.
• Surgical referral: GAE does not compromise a patient’s ability to undergo future knee replacement surgery.

Predictors of limited response include extensive cartilage loss, severe synovitis, or advanced bone changes visible on imaging. Your interventional radiologist will evaluate imaging findings and symptom patterns to help determine next steps.

How can I integrate GAE into my long-term care plan?

One of the advantages of Genicular Artery Embolization (GAE) is the rapid recovery timeline compared to surgical alternatives. While each patient’s healing journey is unique, most individuals can expect a gradual and steady return to normal walking and physical activity within a short period.

Key recommendations during the early recovery phase include:

Rest: Prioritize rest to support early healing and reduce inflammation. Limit unnecessary movement and avoid strenuous activity. Rest allows the treated area to stabilize, reduces swelling, and supports the body’s natural healing response. Mild discomfort, bruising, or localized swelling at the catheter insertion site is common and typically resolves on its own.

Ice application: Intermittent use of cold compresses (e.g., 15 minutes on, 15 minutes off) may help reduce localized swelling and ease discomfort. Always confirm with your care provider before applying ice.

Pain management: Your physician may recommend over-the-counter analgesics or prescription medications as needed. It is essential to follow dosage instructions carefully.

By the end of the second week, you should be able to resume your normal daily routine, with noticeable improvement in knee pain, stiffness, and overall joint function. However, high-impact or strenuous activities such as stair climbing, heavy lifting, or running should still be avoided during this time.

Signs that GAE is working:

Most patients report a gradual reduction in knee pain and stiffness within the first few weeks following GAE. You may begin to notice:

• Decreased joint swelling
• Improved range of motion
• Greater ease with walking, climbing stairs, or standing for longer periods

Pain relief typically continues to improve over the following 2–3 months, as inflammation within the knee subsides.

Activities that support recovery

To optimize your outcome after GAE, your care team may recommend the following:

Gentle physical therapy: Early sessions focus on range-of-motion exercises. Over time, strength-building and endurance training are introduced.

Consistent movement: Avoid prolonged periods of sitting or inactivity.

Home exercises: Simple movements prescribed by your therapist can help maintain flexibility and reduce stiffness.

Consistency is key. Gradual progress, paired with adherence to physical therapy, contributes significantly to long-term mobility and symptom control.

When to contact your healthcare provider:

While complications after GAE are rare, it’s important to monitor your recovery and report any concerning symptoms promptly. Contact your provider if you experience:

• Persistent or excessive bleeding at the puncture site
• Fever over 100°F or chills
• Sudden, severe pain that is not relieved by medication
• Increased swelling or redness

RIVEA Vascular Institute for advanced knee care

At RIVEA Vascular Institute, your care is led by Dr. Arjun Reddy, one of Hyderabad’s leading Interventional Radiologists, known for delivering cutting-edge, non-surgical treatments with precision and compassion. His expertise allows us to offer advanced solutions for patients who are not ready or are unable to undergo surgery, especially for conditions like knee osteoarthritis.