Chronic knee pain is not something we can run away from, literally and figuratively. As the joint’s wear and tear from osteoarthritis progresses, so does the joint pain and inflammation. While there is no cure for osteoarthritis, patients are encouraged to manage symptoms with lifestyle changes, physical therapy, medication and, in some cases, joint replacement surgery. But what happens when a patient is at the point of needing joint replacement but is not a good candidate for surgery?

At Coastal Vascular & Vein Center, Kristian Hochberg, M.D., is offering those patients an innovative technique called geniculate artery embolization, or GAE. “This is a new technique that has come onto the medical scene within the past three to five years,” Dr. Hochberg explained. “Universities across the country have been practicing it, and we are the first to specialize in GAE in this region.”

GAE is a minor procedure that yields major results in pain reduction. Performed in-office at Coastal Vascular & Vein Center, it only takes about half an hour to complete. While the patient is under light sedation – sleepy but not under general anesthesia – a small needle puncture is used to access arteries in the knee with a microcatheter, which is guided to the blood vessels in the inflamed area.

Through this pathway, microscopic beads are injected into the affected capillaries using advanced imaging guidance and essentially micro-embolizes them. The beads stop the flow of blood at a microscopic level and are instrumental in alleviating pain from inflammation.

The benefits of GAE are compelling: The procedure relieves knee pain without requiring regular medications and injections, takes less than an hour, leaves no surgical incision, has little-to-no recovery time and is minimally invasive.

Though the treatment is innovative, its interventional techniques are well-established, trusted and safe. “It is an incredibly safe procedure. The biggest risk is irritation, a slight burning feeling on the skin. We alleviate that sensation with ice packs, which bring the feeling close to zero,” Dr. Hochberg said.

Patients are generally able to walk out immediately following the procedure and can return to their regular activities within a day or two. The ideal candidate is someone who suffers from knee pain due to osteoarthritis but who is deemed non-operative and cannot undergo a major surgery and recovery that a total joint replacement would require.

GAE is ideal for patients who are considered non-operative due to comorbidities such as diabetes mellitus, obesity, coronary artery disease, malnutrition, renal disease, cirrhosis or immunosuppression. These health conditions heighten the risks for complications from major surgery.

Age is also a factor to consider; total knee replacements for young patients often result in complications such as aseptic loosening, and older patients are at a heightened risk for periprosthetic fracture after a joint replacement. GAE provides alleviation of pain without invasive treatment and risky recovery.

Others who have not had success with conservative treatments may undergo a GAE procedure in order to delay surgery because the patient is not currently able to dedicate the time and effort that a total joint replacement and recovery require.

Typically, an orthopedic surgeon or primary care doctor will be the one to identify a patient as non-operative and refer the patient for GAE treatment. “It’s important to understand that GAE does not replace the need for a joint replacement, but it does temporize it. It is a minimally invasive procedure designed to take away the pain of osteoarthritis for those who are non-operative,” Dr. Hochberg explained. “It also does not prevent the patient from having a knee replacement in the future if they are later deemed medically fit to do so.”

The GAE procedure is not a recommended method for those with mild knee pain, patients with superficial femoral artery occlusive disease secondary to peripheral artery disease or those with a prior knee arthroplasty. Patients who do undergo a GAE procedure typically notice improvement within one to three weeks. “We try to manage expectations with patients as pain difference varies afterwards, but the data suggests that GAE has very good pain reduction scores,” Dr. Hochberg explained.

The doctors at Coastal Vascular & Vein Center consistently stay at the forefront of vascular technology and techniques in order to provide the best treatment options for each of their patients. Their primary objective is to help patients maintain their independence. Severe knee pain from osteoarthritis can be debilitating and prevent people from engaging in activities that they enjoy. Innovative GAE procedures offer another solution for patients suffering from knee pain so they can comfortably return to their daily lives. “Joint replacement surgery is a great solution to knee pain from osteoarthritis, but, when surgery and the lengthy recovery are not an ideal option, GAE opens another door for those patients,” Dr. Hochberg said. “We are proud to be the first in the region to provide this novel therapy to patients, allowing them a safe, easy and proven alternative to medication, injections and other avenues that may not last as long or be as effective.”

If you are a non-operative patient who suffers from knee pain caused by osteoarthritis, speak with your primary care physician or orthopedic surgeon to determine if GAE is the right treatment for you. Taking the first step toward better health may lead to pain-free steps in your future.

At CVVC, our vascular specialists are free to listen more, collaborate more and take on new technologies that others do not have the time or access to provide. We turn to minimally-invasive vascular procedures first. If needed, our experts can also navigate complex surgeries to ensure that you can live your best life.