Knee Embolization

Osteoarthritis in the knee is a common and painful condition that gets worse with age. Pain from arthritis can limit your daily activities, affect your mood, and interfere with your quality of life.  

Knee embolization—also called geniculate artery embolization or genicular artery embolization—is a non-surgical treatment that provides immediate and sustained relief for people with moderate to severe pain due to arthritis. The procedure is performed in an outpatient office, and you will be able to return to normal activity within a couple of days. 

Arthritis Pain Treatment at Columbia Interventional Radiology 

Knee embolization is a minimally invasive, safe, and effective treatment that targets inflammation in the lining of the knee (also called the synovium). This inflammation is one of the major causes of knee pain in people with arthritis. The procedure is performed by an interventional radiologist, who uses tiny tools and imaging to perform procedures that would otherwise require open surgery.  

During the procedure an interventional radiologist uses live X-rays to navigate a catheter (a thin, hollow tube) to the small arteries that supply the knee lining with blood. Tiny round beads—each measuring the size of a grain of sand—are injected through catheter and into the arteries. The particles block the arteries and reduce the blood flow to the lining of the knee, relieving inflammation and painful symptoms associated with arthritis.

The procedure is performed under moderate "twilight" sedation, and our patients go home on the day of their procedure with a Band-aid. Some patients feel pain relief within a few hours and most people feel relief in one to two weeks. 

Am I a candidate for knee embolization? 

A consultation with a Columbia interventional radiologist can help determine if knee embolization is right for you. You may be a candidate if: 

• you have had persistent knee pain for four to six months. 
• you have tried anti-inflammatory medications, steroid injections, anesthetic injections, gel injections, or physical therapy and they haven't worked or no longer help your pain. 
• you are not a good candidate for a knee replacement due to other medical conditions. 
• you do not want a knee replacement (surgery). 

Studies show that between 70 and 85 percent of patients experience significant improvement after knee embolization (at least 50 percent improvement in their overall pain). 

What will happen during the procedure?  

• You should not eat or drink anything after midnight on the evening before your procedure. Your doctor will tell you which medications you may take in the morning.  
• On the day of your procedure, be sure to bring someone with you who can escort you home.  
• When you arrive at our outpatient office, a nurse will escort you to the interventional radiology suite and prepare you for the procedure.  
• We will administer moderate sedation through an intravenous (IV) line. 
• We will administer a local anesthetic to numb your groin area. 
• We will insert a needle into the numbed area. This needle provides access for a catheter, which we guide to the small arteries that supply blood to your knee lining. We use live X-ray imaging—called fluoroscopy—to guide the catheter into position. 
• Once the catheter is in place, we will inject a contrast dye, which enables us to see the blood vessels in the area.  
• We will then slowly inject an embolic (blocking) agent—synthetic particles the size of grains of sand—through the catheter and into one of the blood vessels feeding the inflammed portion of the knee joint. The embolic agent becomes wedged in the blood vessel, blocking the blood flow. 
• When the blood flow is blocked from one blood vessel, we frequently move the catheter to another vessel and repeat the process. 
• The procedure takes between one and two hours. You will then recover in your own private room for up to two hours before going home. 

Are there any risks? 

The procedure is safe when performed by an experienced interventional radiologist. Please discuss all risks and benefits with your interventional radiologist during your consultation. 

After the procedure 

We will watch you for up to two hours in our recovery room before you are discharged home with an escort. Most people feel only minor discomfort in the groin area, where we insert the needle, and we will send prescriptions to your pharmacy for pain medications just in case you need them. You will be asked to avoid heavy lifting and exercise for several days. You can return to work the next day if it does not require strenous activity.

Follow-up

You will be scheduled for a follow-up appointment with your interventional radiologist about two weeks after the procedure.