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Exploring GAE: An Alternative to Knee Replacement Surgery

Jun 04, 2025
Animated image of knee and joint pain showing the bones beneath the skin.

Genicular Artery Embolization (GAE) is a promising minimally invasive alternative to knee replacement surgery for patients with chronic knee pain, especially those with mild to moderate osteoarthritis who haven’t found relief through traditional treatments like physical therapy or medication. Unlike surgical procedures that require joint removal and lengthy recovery, GAE targets inflammation by reducing abnormal blood flow to the knee, helping to relieve pain while preserving joint function. The procedure is performed by an interventional radiologist—a highly trained specialist in image-guided techniques—whose expertise is critical for ensuring safe, precise, and effective results.

Who Needs an Alternative to Knee Replacement Surgery

Knee replacement surgery, also known as knee arthroplasty, is a major procedure in which a damaged or worn-out knee joint is replaced with an artificial implant made of metal and plastic components. Typically recommended for patients with severe osteoarthritis or joint damage, the surgery involves removing the damaged cartilage and bone from the surface of the knee joint and replacing it with a prosthesis designed to replicate the movement and function of a healthy knee. The procedure generally takes one to two hours and requires a hospital stay, followed by several weeks of physical therapy to restore mobility and strength.

Some people are not ideal candidates for surgery because of their age, weight, heart conditions, or other health concerns, such as:

  • Severe cardiovascular disease
  • Uncontrolled diabetes
  • Advanced peripheral vascular disease
  • Morbid obesity (BMI greater than 40)
  • Severe osteoporosis
  • Frailty with advanced age

These conditions can increase the risk of complications,  infection, or blood clots; impede healthy blood flow needed for proper healing; and reduce implant success.

Others, such as patients with minimal symptoms or early-stage arthritis for whom surgery may be premature, may want to explore every non-surgical option before committing to a permanent solution. 

The GAE Procedure

GAE targets abnormal blood vessel growth (angiogenesis) that contributes to persistent pain and inflammation in osteoarthritic knees. It is performed by an interventional radiologist. 

During the procedure, the doctor guides a small catheter through an artery in your upper leg and into the tiny blood vessels (genicular arteries) that supply the synovium, the lining of the knee joint. Once the catheter is in place, the doctor injects microscopic beads to block these vessels. The goal is to reduce abnormal blood flow that contributes to inflammation in the joint without affecting the function of the knee.

Benefits of GAE

GAE doesn’t restore lost cartilage or reverse joint degeneration, but by reducing inflammation, it can ease pain and improve your quality of life. Moreover, the procedure can be repeated if your symptoms return. Other benefits of GAE include:

  • A minimally invasive procedure. No large incisions or general anesthesia required.
  • A low risk of complications. GAE has a much lower risk profile than surgery.
  • Quick recovery. Most patients return to normal activities within a few days.
  • Significant and sustained pain relief. Many people experience reduced pain and improved function within weeks.
  • The potential to delay or prevent surgery. GAE is ideal for those who want to postpone knee replacement.
  • No long-term adverse effects or events.
  • The potential to reduce or eliminate the need for chronic pain medications, including NSAIDs or opioids.

GAE has a success rate of approximately 99.7%, with studies showing that roughly 72% of patients surveyed maintained significant pain relief and functional improvement 24 months after the procedure.

Who is a good candidate for GAE?

GAE is most often used for patients with mild-to-moderate knee osteoarthritis who have not responded to physical therapy, medications, or injections.

Other candidates may include:

  • Patients with chronic knee pain due to inflammation
  • Older adults or high-risk surgical candidates
  • Patients who are not ready or willing to undergo a knee replacement
  • Patients with persistent knee pain despite showing only mild to moderate joint degeneration
  • Patients who want an outpatient procedure, a shorter recovery period, and less downtime

GAE can also be a good option for people who are not candidates for surgery because of age, health conditions, or personal preference.

GAE is not intended for those with severe joint damage, where replacement is the only option, or for patients who have:

  • Bleeding disorders or are on blood thinners, unless these can be managed or temporarily stopped
  • Poor vascular anatomy, such as genicular arteries that are too small, damaged, or anatomically atypical
  • Severe kidney dysfunction, as the contrast dye used in the procedure can worsen kidney function
  • Pain not primarily due to inflammation, such as pain from mechanical damage or bone-on-bone contact

Your doctor may recommend imaging studies to confirm that your pain is because of inflammation and not another cause. 

The Importance of Specialized Physicians for GAE

The success of your GAE procedure relies heavily on the precision and experience of the interventional radiologist performing it. Choosing a highly trained specialist like Dr. Blake Parsons of CardioVascular Health Clinic ensures you receive expert care tailored to your individual needs. Interventional radiologists are uniquely equipped to perform minimally invasive, image-guided procedures that require an in-depth understanding of vascular anatomy and advanced imaging tools. With Dr. Parsons’ expertise and CardioVascular Health Care’s state-of-the-art facilities, you benefit from a safer procedure, reduced recovery time, and improved outcomes—even in complex cases.

Additional Non-Surgical Alternatives to Treating Knee Pain

Other non-surgical alternatives to knee replacement, like genicular nerve blocks and radiofrequency ablation (RFA), play a valuable role in managing knee pain by targeting the nerves responsible for transmitting pain signals. These treatments can offer significant relief with minimal recovery time and may help patients delay or avoid more invasive procedures like joint replacement.

Genicular Nerve Blocks for Knee Pain

Genicular nerve blocks are a diagnostic and therapeutic procedure used to manage chronic knee pain by targeting the nerves responsible for transmitting pain signals from the joint. A small amount of local anesthetic is injected near the genicular nerves under image guidance to temporarily block pain. This minimally invasive approach not only provides immediate relief but also helps determine whether a patient may benefit from longer-lasting treatments like radiofrequency ablation.

Radiofrequency Ablation (RFA) for Knee Pain

Radiofrequency ablation (RFA) is a non-surgical procedure that offers longer-term relief for patients with knee pain, especially those with osteoarthritis who aren’t ready for or cannot undergo joint replacement. If a genicular nerve block proves successful, RFA may be the next step. Using targeted heat generated by radio waves, the procedure disrupts the pain signals by deactivating the genicular nerves. RFA is performed on an outpatient basis and can provide relief that lasts several months or more.

Discover Non-Surgical Relief From Your Knee Pain with CardioVascular Health Clinic

If you’re living with chronic knee pain and haven’t found lasting relief from traditional treatments, the specialists at CardioVascular Health Clinic are here to help. Committed to innovation and minimally invasive care, our multidisciplinary team of physicians—led by experts like interventional radiologist Dr. Blake Parsons—offers a range of advanced, image-guided procedures that target pain at its source. Whether you're looking to avoid surgery or simply want a better quality of life, our personalized approach ensures your treatment plan fits your specific needs and goals.CardioVascular Health Clinic is dedicated to delivering leading-edge care across Oklahoma, combining the latest medical advancements with compassionate, patient-centered service. With a focus on accessibility and excellence, we bring transformative treatments like nerve blocks, radiofrequency ablation, GAE, and other non-surgical solutions to communities statewide. Don’t settle for living in pain—schedule a consultation today and discover how our expertise can make a difference in your life.

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