Genicular Artery Embolization (GAE) for Osteoarthritic Knee Pain

Inclusion Criteria:

1. Provide informed consent

2. Age ≥ 40 years

3. Moderate to severe knee pain (VAS >40 mm)

4. Pain refractory to 3 months of conservative treatments, including at least one ofthe following:

• a. Anti-inflammatory medications

• b. Physical therapy

• c. Intra-articular injections

5. Kellgren-Lawrence radiographic grade 1, 2, or 3 disease

6. MRI features of active synovitis (synovial thickening and/or enhancement on MRI).

7. Ineligibility or refusal of surgical management.

8. Local knee tenderness

Exclusion Criteria:

1. Rheumatoid or infectious arthritis

2. Advanced lower extremity atherosclerosis that would limit selective angiography

3. Local knee infection

4. Prior knee surgery (excluding arthroscopic/meniscal interventions)

5. Uncorrectable coagulopathy (INR>1.8, platelets<50,000/µL)

6. Iodine allergy resulting in anaphylaxis

7. Chronic renal insufficiency (serum creatinine >2 mg/dL)

8. Life expectancy less than 6 months