Genicular Artery Embolization (GAE) for Knee Osteoarthritis: How It Works, Procedure and Recovery
Updated: 3 days ago
Written and medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: November 2026 · How we review
Quick Answer: What is genicular artery embolization?
Genicular artery embolization (GAE) is a minimally invasive treatment for knee osteoarthritis that relieves pain without surgery. Through a catheter in a blood vessel in the groin, a doctor injects beads that block abnormal blood vessels around the knee, reducing inflammation and pain. You go home the same day, and most people notice less pain within a few weeks. [1]
What the research says
Most people reach a meaningful drop in knee pain. A meta-analysis of 9 studies (270 patients, 339 knees) found 99.7% technical success, and 78% of patients met the threshold for a clinically important improvement in pain at 12 months. Over two years, 5.2% had a knee replacement and 8.3% had a repeat GAE; the most common side effect was temporary skin discoloration (11.6%). (Taslakian et al., Osteoarthritis and Cartilage Open, 2023) [2]
GAE outperforms a sham procedure. In a randomized, sham-controlled trial of 21 people with mild to moderate knee osteoarthritis, pain fell by 50.1 mm more on a 100-mm scale and disability by 24.7 points more on the WOMAC scale after GAE than after sham at one month, with only minor side effects. (Bagla et al., Journal of Vascular and Interventional Radiology, 2022) [3]
Early results showed large, lasting pain reductions. In a 20-patient pilot study, average pain scores fell from 76 to 29 mm at six months. Self-limiting skin discoloration occurred in 65%, and 10% had foot numbness or tingling that resolved within 14 days. (Bagla et al., Journal of Vascular and Interventional Radiology, 2020) [4]
Key takeaways
GAE is a minimally invasive treatment that relieves knee osteoarthritis pain and other arthritis symptoms without surgery. [1]
Arthritis inflammation makes new arteries grow inside the knee that shouldn't be there; GAE blocks them to reduce inflammation and pain. [1]
The procedure takes an hour or two, and you're awake but shouldn't feel pain. [1]
You usually go home soon after, and most people notice less pain within a few weeks. [1]
GAE is relatively new and still being studied, so it may not be available everywhere. [1]
What is genicular artery embolization?
Genicular artery embolization is a minimally invasive treatment for osteoarthritis in the knee. It relieves pain and other arthritis symptoms without surgery. [1]
Knee osteoarthritis causes painful inflammation inside the knee joint. It happens when the natural cartilage cushioning wears down and the bones in the knee rub together. The inflammation causes new arteries to grow inside the knee that shouldn't be there, and that uncontrolled growth causes pain. GAE reduces inflammation inside the knee by blocking off those new arteries, which reduces pain. [1]
What does genicular artery embolization mean?
Word | What it means |
Genicular | Around the knee |
Artery | A type of blood vessel; the genicular arteries are a group of vessels near the knees |
Embolization | A treatment in which a provider safely and intentionally stops blood flow in a vessel. It's different from an embolism, a dangerous clot or blockage. |
Sources: [1]
Put together, GAE means a provider intentionally blocks blood flow in abnormal arteries around the affected knee. The restricted blood flow reduces inflammation and relieves pain. [1]
Who is genicular artery embolization for?
GAE can help people with moderate or severe knee arthritis that doesn't respond to other treatments, giving noticeable pain relief. It can also be an option to try before surgery such as a knee replacement. [1]
Because it's a relatively new treatment, it may not be available to everyone, and experts are still studying it. Your doctor can tell you whether GAE is a good option for you. [1]
How do you prepare for genicular artery embolization?
Your healthcare provider will help you get ready. Preparation usually includes: [1]
X-rays and/or an MRI of your knee, so your provider has up-to-date pictures of the joint and the area around it
Instructions on whether to stop any medicines or supplements before the procedure
A ride home on the day of the procedure, because you won't be able to drive right after
Otherwise, you shouldn't need any special preparation in the days before your appointment. [1]
What happens during genicular artery embolization?
GAE takes an hour or two from start to finish. It usually follows these steps: [1]
You receive a sedative and/or local anesthesia. You'll be awake throughout but shouldn't feel pain.
Your provider inserts a thin needle and a catheter into a blood vessel in your groin.
A dye is injected into your blood vessels. It flows through the vessels in your leg and knee and makes them stand out on fluoroscopy (live X-ray) imaging, which guides your provider.
Once the vessels that need to be blocked are visible, your provider injects an embolic agent into them. These tiny pieces of material work like little beads that stay in place and reduce blood flow through the abnormal vessels.
The catheter is removed and the hole in your groin is plugged. A bandage may be placed over the site.
Genicular artery embolization at a glance
Item | Typical detail |
Type of treatment | Minimally invasive, without surgery |
Anesthesia | A sedative and/or local anesthesia (you stay awake) |
Access point | A blood vessel in the groin |
Imaging guidance | Contrast dye with fluoroscopy |
Time | An hour or two |
Going home | Soon after the procedure, once sedatives wear off |
When pain improves | Usually within a few weeks |
Sources: [1]
What are the side effects of genicular artery embolization?
You might have some mild side effects after GAE, including: [1]
Bleeding at the injection site
Skin discoloration around your knee
Bruising
Fever
What is recovery like after genicular artery embolization?
You'll be able to go home soon after the procedure. Your care team may have you wait a bit to make sure the sedatives wear off without side effects before they tell you it's safe to leave. [1]
You might have to avoid some physical activities for a week after GAE. Ask your provider when it's safe to return to your usual routine. [1]
How long does genicular artery embolization last?
There's very little recovery time, and GAE works fast. You should notice less pain within a few weeks, and the improvement can last a long time: most people still have less pain for at least several months. [1]
GAE may not last forever. Some people who have it later need other treatments for knee osteoarthritis. Your provider may suggest another GAE procedure to relieve the pain again, and it's possible you might need a knee replacement later on. [1]
When should you talk to your doctor after GAE?
Talk to your healthcare provider if your knee pain comes back, and ask before returning to your usual physical activities. Your provider can explain your options, including repeating GAE or other treatments for knee osteoarthritis. [1]
Conclusion
Genicular artery embolization offers people with painful knee osteoarthritis a way to ease pain without surgery. By blocking the abnormal vessels that drive inflammation inside the knee, it can bring noticeable relief within weeks that often lasts for months.
It may sound worrying to have some blood vessels blocked on purpose, but GAE is a safe, controlled procedure. Because it's still new and not right for everyone, talk with your provider about whether it fits your situation and how it compares with your other options.
Keep learning: Read our guides to knee osteoarthritis, knee gel injections, the genicular nerve block and embolization procedures. For more on knee arthritis, see OrthoInfo's guide to arthritis of the knee.
FAQ
What is genicular artery embolization?
It's a minimally invasive treatment for knee osteoarthritis that blocks abnormal blood vessels around the knee to reduce inflammation and pain without surgery.
How does GAE relieve knee pain?
Osteoarthritis inflammation makes abnormal new arteries grow inside the knee. Blocking them with tiny beads reduces blood flow, inflammation and pain.
Who is a good candidate for GAE?
It may suit people with moderate or severe knee osteoarthritis that hasn't responded to other treatments, including those who want to try an option before knee replacement.
Is genicular artery embolization surgery?
No. It's done through a thin catheter placed in a blood vessel in the groin, so it treats knee pain without surgery.
Are you awake during GAE?
Yes. You get a sedative and/or local anesthesia, so you're awake but shouldn't feel pain.
How long does a GAE procedure take?
It takes about an hour or two from start to finish.
What are the side effects of GAE?
Side effects are usually mild: bleeding at the injection site, skin discoloration around the knee, bruising and fever.
How soon does GAE work?
Most people notice less knee pain within a few weeks.
How long does GAE last?
Most people still have less pain for at least several months, but it may not last forever. Some later need a repeat GAE or a knee replacement.
What is recovery like after GAE?
You usually go home soon after the procedure and may need to avoid some physical activities for about a week.
How do I prepare for genicular artery embolization?
Preparation usually includes X-rays and/or an MRI of your knee, instructions on whether to stop any medicines or supplements, and a ride home, because you won't be able to drive right after. Otherwise, you shouldn't need any special preparation [1].
When should I call my doctor after GAE?
Talk to your provider if your knee pain comes back, and ask before returning to your usual physical activities. Your provider can explain your options, including repeating GAE or other treatments for knee osteoarthritis [1].
Related Reading
Learn more in our guide to What is Knee Osteoarthritis?.
Learn more in our guide to What Is Arthritis of the Knee? Symptoms, Types, and Treatment.
Learn more in our guide to Knee Pain: Symptoms, Causes, Diagnosis, and Treatment Guide.
References
Cleveland Clinic. Genicular Artery Embolization (GAE): What It Is & Procedure. Cleveland Clinic. Last updated February 11, 2026. https://my.clevelandclinic.org/health/procedures/genicular-artery-embolization-gae
Taslakian B, Miller LE, Mabud TS, et al. Genicular artery embolization for treatment of knee osteoarthritis pain: Systematic review and meta-analysis. Osteoarthr Cartil Open. 2023;5(2):100342. PMID 36865988. https://doi.org/10.1016/j.ocarto.2023.100342
Bagla S, Piechowiak R, Sajan A, et al. Multicenter Randomized Sham Controlled Study of Genicular Artery Embolization for Knee Pain Secondary to Osteoarthritis. J Vasc Interv Radiol. 2022;33(1):2-10.e2. PMID 34610422. https://doi.org/10.1016/j.jvir.2021.09.019
Bagla S, Piechowiak R, Hartman T, et al. Genicular Artery Embolization for the Treatment of Knee Pain Secondary to Osteoarthritis. J Vasc Interv Radiol. 2020;31(7):1096-1102. PMID 31837946. https://doi.org/10.1016/j.jvir.2019.09.018
Medical disclaimer
This article is for general education only and does not replace advice from a qualified healthcare professional. Talk to your doctor about your own diagnosis and treatment, and seek emergency care right away for severe or sudden symptoms.
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