New Minimally Invasive Knee Procedure Offers Alternative to Replacement Surgery

A 74-year-old patient, Cynthia Schraf-Fletcher, found remarkable relief from genicular artery embolization (GAE) on her right knee. She says the improvement is comparable to the total knee replacement she had on her left knee. Now she can garden and ride a stationary bicycle without pain.

GAE is an outpatient procedure that reduces blood flow to inflamed areas in the knee joint. Using X-ray guidance and contrast dye, doctors insert a tiny catheter through the femoral artery to the genicular arteries. They release microscopic beads to block abnormal blood vessels, easing inflammation and pain.

The procedure takes one to two hours under conscious sedation. Patients are monitored for a few hours and can go home the same day. Recovery involves a few days of rest.

Dr. Leigh Casadaban, assistant professor of radiology at the University of Colorado Anschutz School of Medicine, says GAE is best for patients with mild to moderate osteoarthritis. Those with advanced disease may also benefit but with less durable results. He notes that about 70% of patients see their pain scores cut in half or more; some become pain-free.

Originally developed in Japan over a decade ago, GAE has gained global attention. In 2021, the FDA granted breakthrough device status to several related devices. Four-year data from Japan shows relief can last four years, while U.S. two-year data show similar durability for good responders.

Dr. Casadaban is leading two clinical trials at CU Anschutz: one examining changes in knee fluid after GAE, another testing a temporary arterial treatment device called Nexsphere-F. Researchers are also exploring GAE for other conditions like frozen shoulder, tennis elbow, and plantar fasciitis.