For people living with knee osteoarthritis, genicular artery embolization (GAE) offers a minimally invasive way to target the inflammation and abnormal blood vessels associated with chronic knee pain. As GAE becomes more widely studied, researchers are looking beyond whether the procedure works and examining how different embolic materials and techniques may improve treatment.
A new 2026 study published in Radiology looked specifically at GAE performed with rapidly resorbable gelatin-based microspheres, an embolic material designed to temporarily reduce blood flow through the abnormal vessels associated with inflammation before dissolving. Researchers followed patients for 12 months and found meaningful improvements in both knee pain and function, adding to a growing body of research on how GAE can be refined and optimized for people with knee osteoarthritis.
Why Does Knee Osteoarthritis Cause Pain?
Osteoarthritis is often described as “wear and tear” of the knee, but what happens inside an arthritic joint is more complicated than cartilage simply wearing down.
Chronic inflammation can develop within the lining of the joint, called the synovium. As part of this inflammatory process, abnormal small blood vessels can form around the affected area. These abnormal blood vessels and the inflammatory changes surrounding them are thought to contribute to ongoing pain.
GAE is designed to interrupt part of this process.
Rather than removing or replacing the knee joint, an interventional radiologist guides a small catheter through the blood vessels to the arteries supplying the painful area of the knee. An embolic material is then delivered to carefully selected abnormal vessels, reducing excessive blood flow and inflammatory activity while preserving normal circulation.
For the right patient, this offers a very different approach to treating osteoarthritis-related knee pain.
What Did the New GAE Study Find?
The new study evaluated genicular artery embolization using rapidly resorbable gelatin-based microspheres in people with osteoarthritis-related knee pain that had not responded adequately to conservative treatment.
Researchers followed 194 patients who underwent 239 GAE procedures, with some patients receiving treatment in both knees. The median age was 69, and 80% of participants had experienced knee symptoms for more than two years.
Patients were evaluated before treatment and again at six weeks, three months, six months, and 12 months after GAE.
The results were encouraging.
Median pain scores decreased from 7 out of 10 before treatment to 3 out of 10 at 12 months. At the one-year follow-up, 80% of participants achieved an improvement in pain that exceeded the study’s threshold for a clinically meaningful change.
Researchers also measured several aspects of knee function using the Knee Injury and Osteoarthritis Outcome Score (KOOS). At 12 months, 55% to 80% of patients achieved clinically meaningful improvements across the different KOOS categories.
Importantly, the improvement was not limited to the first few weeks after treatment. The study found that reductions in pain and improvements in function were sustained through the 12-month follow-up period.
What Was Different About the GAE Technique Used in This Study?
One particularly interesting part of this research was the embolic material used during GAE.
The investigators used rapidly resorbable gelatin-based microspheres. Unlike permanent embolic particles, these microspheres are designed to dissolve within hours after temporarily reducing blood flow to the targeted abnormal vessels.
All 239 procedures in the study were technically successful.
Researchers also reported a favorable safety profile. Temporary skin discoloration occurred following 15 procedures, and one patient developed a superficial groin hematoma. These events resolved without lasting problems, and the study reported no moderate or severe adverse events.
This doesn’t mean every patient will have the same result or that GAE is without risk. It does provide additional evidence that different embolic approaches can be used to target the abnormal vascular activity associated with knee osteoarthritis.
What Are the Limitations of the Study?
The results are promising, but they should be considered in context.
This was a prospective observational study performed at a single center, and there was no control or sham-treatment group. Without a comparison group, researchers cannot determine how much of the improvement was directly attributable to GAE versus factors such as natural changes in symptoms or placebo response.
The study also relied primarily on patient-reported measures of pain and knee function. Follow-up data beyond 12 months will be important for understanding how durable the results are over a longer period.
Even with these limitations, the findings add to a growing body of research examining GAE as a treatment for osteoarthritis-related knee pain.
Who May Be a Candidate for GAE?
GAE is not intended for every type of knee pain.
Before recommending embolization, it is important to determine whether osteoarthritis and associated inflammation are actually responsible for a patient’s symptoms. Knee pain can have several causes, and treating the wrong source of pain is unlikely to provide the desired result.
GAE may be considered for people with symptomatic knee osteoarthritis whose pain has continued despite conservative treatments such as:
- Physical therapy and activity modification
- Anti-inflammatory or other pain medications
- Corticosteroid or hyaluronic acid injections
- Other non-surgical treatments
Some patients are interested in GAE because they want to delay or avoid knee replacement surgery. Others may not be good surgical candidates or simply want to understand whether a less invasive option is appropriate before considering major surgery.
The decision should be based on your symptoms, imaging, previous treatments, medical history, and individual goals.
JVI’s Experience With Genicular Artery Embolization
At Joint & Vascular Institute in Libertyville, IL, we provide GAE for patients with osteoarthritis-related knee pain throughout the greater Chicago area. GAE isn’t simply a procedure we’ve added as new research has emerged. Our physicians have helped develop and advance the field.
JVI co-founder Dr. Osman Ahmed is a nationally and internationally recognized leader in musculoskeletal embolization and was among the first physicians to perform GAE. His work includes peer-reviewed GAE research, ongoing clinical studies evaluating the procedure, and serving as first author of the Society of Interventional Radiology’s 2026 position statement on GAE for symptomatic knee osteoarthritis.
That academic involvement is an important part of how we approach patient care.
GAE requires more than the ability to guide a catheter into an artery. Understanding which patients are likely to benefit, identifying the appropriate vessels to treat, performing precise embolization, and selecting the right embolic approach all require experience and clinical judgment.
JVI’s physicians specialize in minimally invasive, image-guided procedures, including embolization treatments for chronic joint pain and other medical conditions. Our goal is to bring the same level of expertise and evidence-based care found at major academic medical centers into a more personal outpatient setting.
What Does This Research Mean for People With Chronic Knee Pain?
For someone who has been living with osteoarthritis knee pain despite months or years of conservative treatment, the traditional choices can sometimes feel limited: continue managing the symptoms or consider surgery.
GAE offers another option.
The new Radiology study provides further evidence that targeting the abnormal blood vessels associated with knee osteoarthritis may lead to meaningful improvements in pain and function. In this group of patients, those improvements were still present one year after treatment.
Research into GAE continues to evolve, including studies examining patient selection, procedural techniques, and different embolic materials. For patients, the important question isn’t simply whether GAE works. It’s whether GAE is appropriate for the specific cause of their knee pain.
At Joint & Vascular Institute, that starts with a careful evaluation.
If knee osteoarthritis continues to interfere with walking, exercise, work, or the activities you enjoy, request a consultation to learn whether genicular artery embolization may be an option for you.
Frequently Asked Questions About GAE
How does GAE help osteoarthritis knee pain?
GAE targets abnormal blood vessels associated with inflammation in an osteoarthritic knee. By selectively reducing blood flow through these vessels, the procedure is intended to decrease inflammatory activity and the pain associated with it.
Does GAE repair damaged cartilage?
No. GAE does not regrow cartilage or reverse the structural changes caused by osteoarthritis. Its purpose is to address the abnormal vascular and inflammatory processes that contribute to pain.
Can GAE help me avoid knee replacement?
GAE may provide a minimally invasive option for some people who want to delay or avoid knee replacement, but it is not a replacement for surgery in every situation. The severity and source of your symptoms, your overall health, previous treatments, and your goals all need to be considered.
Is GAE an outpatient procedure?
Yes. GAE is generally performed as an outpatient procedure through a small vascular access point, without a large surgical incision or removal of the knee joint.
How do I know if my knee pain is appropriate for GAE?
The first step is determining what is actually causing your pain. When you schedule an appointment at Joint & Vascular Institute, an interventional radiologist will review your symptoms, imaging, previous treatments, and medical history to determine whether osteoarthritis-related inflammation may be contributing to your pain and whether GAE may be appropriate.
Source: Fleckenstein FN, et al. Genicular Artery Embolization Using Rapidly Resorbable Gelatin-based Microspheres for Osteoarthritis-related Knee Pain. Radiology. 2026;319(3).