Interventional Centre
Genicular artery embolisation: a micro-catheter delivering embolic particles into the arteries supplying an inflamed, arthritic knee joint

Knee Osteoarthritis · Vascular & Interventional Radiology

Genicular Artery Embolisation (GAE)

Genicular artery embolisation treats knee osteoarthritis pain by blocking the abnormal blood vessels that drive inflammation in the joint lining. It's a minimally invasive, image-guided procedure, done through a pinhole under light sedation and usually as a day procedure. It's an option for knee pain that no longer responds to physiotherapy or injections.

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Dr Mihir Desai
Dr Suhrid Lodh
Your specialists

Dr Mihir Desai & Dr Suhrid Lodh

Vascular & Interventional Radiologists · FRANZCR EBIR

Genicular artery embolisation is performed at St George and Macquarie University Hospitals. More about the team →

What causes knee osteoarthritis pain?

Knee osteoarthritis pain is not simply worn cartilage. Much of it comes from inflammation in the joint lining, called synovitis. When the joint is damaged, the body grows abnormal new blood vessels into the inflamed area, bringing extra inflammatory cells and pain-sensing nerves with them.

Anti-inflammatories and injections calm that inflammation for a while, but they don't remove its source. GAE targets those abnormal vessels directly, leaving the normal blood supply to the knee intact.

How does GAE work?

An image-guided day procedure, performed through a small puncture at the groin under local anaesthetic and light sedation.

1

Pinhole access

A small puncture at the groin under local anaesthetic and light sedation, with no surgical incision.

2

Block the abnormal vessels

Using advanced imaging, a micro-catheter about 0.5 mm across is guided to the arteries feeding the inflamed tissue. Microscopic particles, some as small as 100 microns, then block the abnormal vessels while the normal blood supply to the knee stays intact.

3

Home the same day

The procedure takes one to two hours. You rest for a few hours and go home the same afternoon; pain reduction typically begins within one to two weeks.

Read the full procedure, step by step →

Does GAE work? What the clinical trials show

50%
Pain scores halved at 12 months in the largest published cohort of 333 patients treated at Charité University Hospital Berlin, with gains in daily activity and quality of life.
Fleckenstein et al., Radiology, 2025
2 yrs
Benefits held at two years, with MRI showing a significant reduction in joint inflammation after the procedure.
Little et al. (GENESIS), CVIR, 2024
444
Procedures in the published safety cohort, with no severe complications reported.
Fleckenstein et al., Radiology, 2025

The option between injections and surgery

For knee osteoarthritis, most people are offered two things: injections and tablets to manage the pain now, or, further down the track, a knee replacement. There is another option in between, and because it is newer, many people simply haven't heard of it.

Usually first Injections & tablets Manage the pain for a while
In between Genicular Artery Embolisation Targets the inflammation at its source
For advanced arthritis Knee replacement Replaces the worn joint
See how GAE compares with each →

Your journey with us

From first contact to recovery

Here's what to expect, from your first phone call through to recovery.

  1. 1
    Get in touchAsk your GP for a referral, or contact our rooms directly. You don't need a referral just to ask a question.
  2. 2
    Your consultationDr Desai reviews your symptoms and imaging, and explains whether GAE is likely to help.
  3. 3
    The procedureIf GAE suits you, it's scheduled as a minimally invasive day procedure, through a pinhole under light sedation.
  4. 4
    RecoveryYou rest for a few hours, then head home. Most patients notice pain easing within one to two weeks.

Cost & Medicare: GAE is covered by Medicare, and we see patients privately or in the public hospital system. More on cost →

Request a consultation

GP or specialist? Refer a patient →

So, could GAE be an option for you?

Which one suits you comes down to the stage your knee is at, and that is what a consultation is for. Not sure where yours sits? These five quick questions are a good place to start, to see whether GAE is worth raising with us. This is general information, not a diagnosis.

To find out whether GAE is likely to suit your knee, the clearest step is a consultation, where we review your imaging and symptoms. Request a consultation →

Would rather just talk it through? Request a consultation →

Frequently asked questions

Common questions about GAE. If you're still unsure whether it's right for you, ask us directly.

What is Genicular Artery Embolisation?
GAE blocks the abnormal blood vessels driving inflammation in the knee joint lining. It is a day procedure performed through a small skin puncture under light sedation, with no surgical incision and no hospital admission.
How is GAE different from a knee replacement?
They are not competing treatments; they suit different stages of osteoarthritis. In the earlier stages, a lot of the pain comes from inflammation, and GAE calms that by blocking the abnormal blood vessels, through a small puncture and with same-day discharge. The joint itself is not cut or replaced. When the arthritis is severe and the joint has worn out, a knee replacement rebuilds it under a general anaesthetic, with a longer recovery. GAE works to improve the pain; a knee replacement rebuilds the joint itself.
Will GAE stop me having a knee replacement later?
No. In a study by Albrecht et al. (2025), patients who had GAE and later required a knee replacement experienced no additional surgical complications. GAE does not close off the surgical option.
When will I feel results?
Most patients notice pain reduction within two weeks. The full effect typically develops over six to twelve weeks.
What side effects should I expect?
Temporary skin discolouration near the knee is the most common side effect, resolving without treatment within one to three weeks. Access-site bruising is minor and self-limiting. No severe complications were reported across 444 procedures in the Fleckenstein 2025 cohort. Every patient and every procedure is different, and this should be discussed with Dr Desai.
Is GAE covered by Medicare or my private health insurance?
GAE is covered by Medicare, and a GP or specialist referral is needed for the rebate to apply. We consult and treat in both the private and the public hospital, whatever cover you hold. We are a known gap provider, so where there is an out-of-pocket amount for the procedure it is set out in a written estimate before anything is booked, and if that gap is what stands in your way we are happy to consider waiving it.
Can I have GAE if I've already had a cortisone or steroid injection?
Yes. Prior injections do not exclude you from GAE. Many patients who have had multiple injections with diminishing effect are good candidates.
How is GAE different from a cortisone injection?
A cortisone injection reduces inflammation temporarily by delivering a steroid into the affected area, and its effect typically lasts weeks to months. GAE reduces inflammation by reducing the blood supply of the abnormal vessels sustaining it, aiming for a more durable reduction in the inflammatory driver.
Do I need a referral?
A GP or specialist referral is required. GPs can refer via HealthLink (EDI: mihdesai), by email, or by phone on (02) 9812 3838. You don't need a referral just to ask a question.

Written and reviewed by Dr Mihir Desai · Last reviewed August 2026

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