Genicular artery embolization, or GAE, treats knee arthritis pain from inside the blood vessels. In an arthritic knee, the lining of the joint becomes inflamed and grows a web of small, abnormal blood vessels that feed that inflammation. Through a pinhole in the groin or wrist, an interventional radiologist guides a thin catheter to the arteries around the knee, called the genicular arteries, and releases tiny particles that quiet those abnormal vessels. Nothing is cut, no implant is placed, and the knee joint itself is left intact.
At NYMD Center, GAE is performed by Dr. Yosef Golowa, our fellowship-trained interventional radiologist, as an outpatient procedure: you go home the same day. It is designed for people whose knee osteoarthritis keeps hurting despite exercise, physical therapy, medication or injections, and who are not ready for, not eligible for, or simply want to postpone a knee replacement.
Why patients come to NYMD Center for GAE
- A dedicated interventional radiology program. We built our interventional radiology program in 2021 and now perform embolization for the prostate, fibroids, varicoceles, hemorrhoids and the knee within one group.
- A fellowship-trained specialist. Dr. Yosef Golowa, MD, FSIR, performs the procedure. GAE is technically delicate: the genicular arteries are small, and treating the right branches while protecting the skin and bone around the knee takes experience.
- A whole medical group behind you. NYMD Center has ten physicians plus physician assistants and nurse practitioners. Internal medicine can review the rest of your health, and your care stays coordinated in one place.
- Outpatient, no hospital stay. Most people go home the same day and return to light activity within a day or two.
- All insurance accepted. We accept all insurance, including Medicare and Medicaid, and we check your plan's coverage for GAE before anything is scheduled.
How GAE relieves knee pain
Osteoarthritis is more than worn cartilage. The synovium, the thin lining of the joint, becomes inflamed, and that inflamed tissue grows new blood vessels and sensory nerve fibers alongside them. The extra blood flow sustains the inflammation, and the new nerve fibers carry pain. By reducing the abnormal blood supply to the inflamed lining, GAE aims to calm the inflammation and the pain it produces while leaving normal blood flow to the knee in place.
GAE does not regrow cartilage, straighten a deformed knee or cure arthritis. It treats one of the main drivers of pain. That is why the evaluation focuses first on whether inflammation-related pain is what you are dealing with.
Are you a candidate for GAE?
GAE is worth discussing if you:
- have knee osteoarthritis confirmed on examination and X-ray or MRI;
- have had moderate to severe knee pain for several months that limits walking, stairs or standing;
- have tried physical therapy, weight management, anti-inflammatory medication or joint injections without enough relief;
- are not a candidate for knee replacement, do not want surgery, or want to delay it.
GAE is less likely to help when the knee joint is severely collapsed, when the pain comes from somewhere else (the hip, the back, a torn meniscus that locks the knee), or when there is an active infection. Kidney function and allergies to X-ray contrast are reviewed beforehand.
How GAE compares with other knee treatments
| Exercise and physical therapy | Joint injections | GAE | Knee replacement | |
|---|---|---|---|---|
| What it does | Strengthens the muscles that support the knee | Medication placed into the joint to reduce pain and inflammation | Reduces the abnormal blood supply to the inflamed joint lining | Replaces the damaged joint surfaces with an implant |
| Anesthesia | None | Local | Sedation and local anesthetic | General or spinal anesthesia |
| Hospital stay | None | None | Outpatient, home the same day | Usually a hospital stay |
| Recovery | Ongoing program | A day or so | About a day or two of light activity | Weeks to months of rehabilitation |
| How long relief lasts | As long as the program continues | Often weeks to months | Varies; in some studies relief lasted a year or more | Long-lasting, but it is major surgery |
| Rules out later options? | No | No | No; a knee replacement remains possible later | Final step |
Your GAE day, step by step
- Check-in. You arrive for an outpatient procedure; there is no hospital admission.
- Sedation. You receive light sedation, and the skin at a pinhole access point in the groin or wrist is numbed.
- Mapping. Dr. Golowa guides a thin catheter to the arteries around the knee and uses contrast and X-ray imaging to find the abnormal vessels feeding the painful areas.
- Treatment. Tiny particles are released into those selected branches to reduce their blood flow.
- Finish. The catheter is removed and the access point is closed. The procedure typically takes about an hour.
- Home the same day. After a period of observation you go home with a companion.
Recovery and results
- First few days: mild soreness at the access site and in the knee is common. Most people return to light activity and desk work within a day or two.
- First weeks: many patients notice less pain within the first weeks as the inflammation settles.
- Months after: improvement can continue over several months. We follow your pain, walking and daily function at follow-up visits.
- If pain returns: injections, physical therapy and knee replacement all remain available.
What the evidence says
GAE is a newer procedure, and we discuss its evidence honestly. The Society of Interventional Radiology's 2026 position statement supports considering GAE for appropriately selected patients after conservative treatment, as part of coordinated knee care, and calls for larger randomized trials. Early studies, including a small sham-controlled trial, showed meaningful pain relief; a larger 2024 sham-controlled trial did not show a statistically significant difference at four months. In practice, results depend heavily on choosing the right patient and treating the right vessels, which is why the evaluation comes first.
Risks to know about
GAE is minimally invasive but not risk-free. Possible side effects include bruising or bleeding at the access site, temporary knee soreness, temporary skin discoloration over the knee, small areas of bone or skin irritation from particles reaching unintended tissue, and reactions to contrast. Serious complications are uncommon. We review your individual risks before you decide.
Insurance
We accept all insurance, including Medicare and Medicaid. Coverage for GAE itself varies by plan and may require prior authorization, so our staff verifies your benefits and explains any expected costs before scheduling.
Questions patients ask
Is GAE the same as a knee injection?
No. A knee injection places medication into the joint. GAE works inside the arteries around the knee, reducing the abnormal blood supply that feeds inflammation. They are different treatments, and GAE is often considered when injections no longer give lasting relief.
Does GAE replace knee replacement surgery?
No. GAE does not replace the joint or repair cartilage. It treats pain and can help many people stay active and postpone surgery. Having GAE does not prevent a knee replacement later if you need one.
Is GAE painful?
You are sedated and the access point is a pinhole, so most people find it easier than expected. Afterward, some soreness at the access site and in the knee for a few days is common.
How long does GAE take, and do I stay overnight?
The procedure typically takes about an hour. It is done as an outpatient, and most people go home the same day after a period of observation.
How soon will I feel better, and how long does it last?
Many patients notice improvement within the first weeks, and relief can build over several months. How long it lasts varies from person to person; we track your response at follow-up and discuss next steps if pain returns.
Is GAE covered by insurance?
We accept all insurance, including Medicare and Medicaid. Coverage for GAE varies by plan and may need prior authorization, so we verify your benefits before scheduling.
Make an appointment
Manhattan (212) 991-9991 · Forest Hills (718) 360-9550 · same-week visits, all insurance accepted, including Medicaid and Medicare.