Knee osteoarthritis pain

Who it may help

GAE may suit you if you:

• have had moderate to severe knee pain from osteoarthritis for more than 3 months
• have not had relief from medication, physiotherapy or injections
• want to avoid or delay knee replacement surgery
• would prefer a non-surgical, day-stay option for pain relief

It may be considered for mild to moderate osteoarthritis, particularly in younger people who are not yet suitable for a knee replacement, and for people who cannot have a knee replacement because of other medical conditions or a higher surgical risk. In carefully selected cases, it may suit persistent pain after a knee replacement, or chronic knee pain where inflammation is the main cause.

Suitability depends on your age, symptoms, imaging findings and overall health.

Conditions treated

• Knee osteoarthritis
• Persistent knee pain after arthroscopy or joint injury
• Jumper’s knee (patellar tendinitis)
• Chronic inflammatory knee pain that has not responded to other treatments

Jumper's knee · 1 of 2

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Understanding knee osteoarthritis pain

Knee osteoarthritis pain can slowly change the way you move. It might begin as stiffness after sitting for a while or a dull ache after walking longer than usual. Some people feel it around the front of the joint; others notice pain on the inside of the knee, especially when climbing stairs, bending the knee or putting weight through the leg.

Osteoarthritis develops when the smooth cartilage inside the knee joint starts to wear down. As the surface becomes rougher, the joint may become irritated, leading to swelling, stiffness and pain that make everyday movement harder. It is one possible cause of knee pain, particularly when symptoms come on gradually. It is often linked to a combination of joint wear, inflammation and repeated stress on the knee over time.

Factors that can increase pressure on the knee joint include:

• age-related cartilage changes
• previous knee injuries
• excess load through the joint
• long-term standing, kneeling or heavy activity
• changes in leg alignment or joint mechanics

As osteoarthritis progresses, the knee may not move as smoothly as it once did. Some people feel stiffness after rest, while others notice swelling after activity. Pain can also vary from day to day, which is why symptoms may feel unpredictable.

Because knee pain can come from several structures, assessment is important. Imaging and clinical review can help confirm whether the pain is related to osteoarthritis or another knee condition.

Non-surgical treatment options

Many people with knee osteoarthritis can manage symptoms without surgery, especially when treatment is guided by the cause and severity of the problem.

Medication may be used to reduce pain or inflammation. It can help some people stay active and manage flare-ups, but medication choice should be discussed with a health professional, especially if you have other medical conditions or take other medicines.

Image-guided injections may also be considered in selected cases. They may give short-term pain relief by reducing inflammation, but the benefit is not usually long-lasting, and injections do not reverse the underlying joint changes.

A knee support or brace may help when the knee feels unstable or strained during activity. It does not reverse joint changes, but it may reduce discomfort during walking, standing or exercise.

Non-surgical care is planned around your age, symptoms, scan findings, overall health and personal goals.

What is genicular artery embolisation?

Over time, abnormal small blood vessels may form around the knee joint and add to ongoing pain and inflammation.

GAE is a minimally invasive, image-guided procedure for chronic knee pain caused by osteoarthritis or ongoing inflammation. It reduces blood flow to the inflamed areas of the knee, which can help relieve pain and improve movement. The interventional radiologist inserts a small catheter (a thin, hollow tube) into the artery at the top of your thigh and, using X-rays, guides it to the arteries supplying the lining of the knee. Tiny particles are then injected through the catheter to reduce the blood supply, which reduces the inflammation and can ease the pain.

How the procedure is performed

1. The procedure is performed by an interventional radiologist.
2. It is done under local anaesthetic with light sedation for comfort.
3. A small catheter is inserted into an artery, usually at the top of the thigh.
4. Using X-ray guidance, the catheter is passed to the small arteries supplying the inflamed areas of the knee.
5. Tiny particles are injected to block the abnormal vessels while keeping normal blood flow.
6. The procedure usually takes about 1–2 hours, and you go home the same day.

Access through the artery at the top of the thigh · 1 of 3

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Benefits

• No surgical incision
• Local anaesthetic rather than a general anaesthetic
• A day procedure, with no overnight hospital stay
• Pain often improves within weeks
• Better movement and function for many people
• May delay or reduce the need for knee replacement surgery

After the procedure

• Most people go home the same day.
• Light activities can usually resume within 24–48 hours.
• Pain relief typically begins within 2–4 weeks and continues to improve over several months. Some people feel better straight away; for others it is gradual.
• GAE may reduce the need for regular pain medication and help you return to activities you had stopped.
• Physiotherapy may help maintain movement and knee strength.
• Your interventional radiologist arranges follow-up.