Millions of people live with knee pain every day, and for many, available treatments eventually stop working.
Osteoarthritis is the most common type of arthritis and a leading cause of pain and disability around the world. It develops when the protective cartilage that cushions the ends of bones gradually wears away.
As the cartilage becomes thinner, joints become painful, stiff, swollen, and harder to move. Knee osteoarthritis is especially common because the knees support much of the body’s weight. According to the World Health Organization, more than 365 million adults worldwide are affected by knee osteoarthritis.
Many people manage their symptoms with exercise, weight control, pain-relieving medicines, anti-inflammatory drugs, physical therapy, or injections into the knee joint. Unfortunately, these treatments do not work well for everyone. Some patients continue to experience severe pain but are not ready for, or cannot undergo, knee replacement surgery.
A new study published in Radiology suggests there may be another option. Researchers from Charité–Universitätsmedizin Berlin found that a minimally invasive procedure called genicular artery embolization, or GAE, provided lasting pain relief and better knee function for many people with knee osteoarthritis.
Unlike surgery, GAE does not replace the damaged joint. Instead, it targets the abnormal blood vessels that develop around an arthritic knee. Scientists believe these extra blood vessels help maintain inflammation and pain.
During the procedure, an interventional radiologist guides a very thin tube through the blood vessels to the knee using X-ray imaging. Tiny gelatin-based microspheres are then injected to temporarily block the abnormal vessels. These particles dissolve naturally within hours after completing their job.
The study included 194 adults whose knee pain had not improved after at least three months of standard treatment. Participants had already tried treatments such as physiotherapy, anti-inflammatory medicines, and joint injections. Their average age was 69 years.
Between July and November 2024, the researchers performed 239 GAE procedures because some participants received treatment in both knees. Every procedure was completed successfully. Importantly, there were no moderate or severe treatment-related complications. Only a small number of participants experienced mild side effects, and these resolved on their own.
The researchers followed participants for one year. Pain improved quickly. Median pain scores fell from 7 out of 10 before treatment to 4 after six weeks and continued improving to 3 at both six months and one year. Measures of daily activities, sports participation, symptoms, knee function, and quality of life also improved throughout the study.
Overall, about 80% of participants achieved improvements that doctors consider clinically meaningful after one year. This means the changes were large enough to make a real difference in everyday life rather than being only small statistical changes.
Lead researcher Dr. Florian Nima Fleckenstein explained that GAE targets the abnormal blood vessels responsible for ongoing inflammation instead of simply masking pain. By reducing inflammation, the treatment may also improve the unhealthy nerve environment surrounding the joint.
This study provides encouraging evidence that GAE with rapidly dissolving gelatin microspheres could become an important treatment between injections and knee replacement surgery. Its strengths include nearly 200 participants, real-world patients, a high follow-up rate, and one year of outcome data.
However, the study was conducted at a single medical center and did not include a comparison group receiving placebo treatment or standard care alone. Larger randomized clinical trials will be needed to confirm how well the procedure works compared with existing treatments and whether benefits continue beyond one year.
Even so, the findings suggest this minimally invasive technique could offer meaningful relief for many patients whose knee osteoarthritis remains painful despite conventional treatment.
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Source: Charité–Universitätsmedizin Berlin.
