GAE vs. Knee Replacement: Understanding Your Options for Knee Osteoarthritis

Written by Pavan Khurana, MD

Knee osteoarthritis can progress from occasional discomfort to pain that significantly limits walking, exercise, work, and everyday activities. You have options when it comes to knee osteoarthritis with GAE vs. knee replacement.

Total knee replacement is an established treatment for advanced knee arthritis, but some patients aren’t ready for major surgery—or aren’t good surgical candidates.

Genicular Artery Embolization (GAE) is a newer minimally invasive option for appropriately selected patients.

What is GAE?

GAE is performed by an interventional radiologist through a tiny catheter placed into an artery.

Knee osteoarthritis can be associated with abnormal inflammation and increased blood flow within tissues surrounding the joint. During GAE, the physician identifies these abnormal areas and delivers microscopic particles into selected genicular artery branches.

The goal is to reduce this abnormal blood flow and inflammation and thereby reduce pain, while preserving the normal healthy blood flow to the knee joint.

GAE does not replace cartilage or structurally rebuild the knee. GAE can slow down the cartilage loss associated with the inflammatory response from arthritis.

How is knee replacement different?

Total knee arthroplasty is major orthopedic surgery.

Damaged portions of the knee joint are removed and replaced with artificial components. For appropriately selected patients with severe arthritis, knee replacement can provide substantial and durable improvement in pain and function.

However, it also involves anesthesia, surgery, rehabilitation, post procedure pain, and a significant period of time for recovery.

Why might someone consider GAE vs. knee replacement?

GAE may be considered in patients with symptomatic osteoarthritis who have persistent pain despite conservative treatments and who want to explore a minimally invasive option.

Potential advantages include:

• No joint replacement
• No large surgical incision
• Usually outpatient treatment
• Quick recovery times (walk in, walk out type of outpatient procedure)
• Preservation of future treatment options

Does GAE replace the need for knee replacement?

Not necessarily.

These procedures accomplish different things. GAE targets pain and inflammation; knee replacement addresses the damaged joint mechanically.

For some patients, GAE may provide meaningful symptom relief and potentially delay the need for surgery. Other patients with severe structural disease and significant disability may ultimately be better served by joint replacement.

The decision depends on the severity of arthritis, symptoms, previous treatments, overall health, and the patient’s goals.

A consultation can help determine whether GAE is a reasonable option before proceeding to—or while trying to postpone—knee replacement.

UR Vascular offers evaluation and minimally invasive embolization treatment for patients with knee osteoarthritis. Schedule a consultation to review your imaging and discuss whether treatment is appropriate for you.