Genicular Embolisation

Chronic knee pain is persistent pain in the knee that lasts for more than 3 months. It can be caused by various conditions, including:

• Osteoarthritis: Wear and tear of the joint cartilage.
• Meniscal injuries: Tears in the menisci (cartilaginous cushions).
• Ligament injuries: Sprains or tears of the ligaments.
• Bursitis: Inflammation of the bursa (small fluid-filled sacs).
• Tendinitis: Inflammation of the tendons.
• Other conditions: Rheumatoid arthritis, gout, etc.

1. Preparation: Before the procedure, you will have a consultation with an interventional radiologist, a doctor who specialises in image-guided procedures. They will review your medical history, the medicines you are taking and the results of your imaging tests (X-rays, MRI scans).
2. Anaesthesia: Geniculate embolisation is usually carried out under local anaesthesia with light sedation to help you relax.
3. Vascular access: The interventional radiologist inserts a thin catheter (tube) into an artery in the groin.
4. Guidance: Using real-time imaging (X-ray), the catheter is guided to the geniculate arteries, which supply the synovial membrane of the knee.
5. Embolisation: Tiny, calibrated particles (known as embolic agents) are injected through the catheter to selectively block the geniculate arteries closest to the inflamed area.
6. Verification: X-rays are taken to check that the target arteries are properly occluded.
7. Catheter removal: Once the embolisation is complete, the catheter is removed and a pressure dressing is applied to the insertion site.

• Minimally invasive: No surgical incision, no scar, minimal pain and immediate recovery, unlike some surgical procedures.
• Pain relief (knee pain): Significantly reduces chronic knee pain, thereby improving quality of life.
• Improved function: Improves knee mobility and function, enabling patients to resume daily activities.
• Alternative to conservative treatments: An option for patients who do not find relief from conservative treatments (medication, physiotherapy, corticosteroid injections).
• Joint preservation: Unlike certain surgical procedures (such as knee replacement or prosthetics), knee embolisation does not alter the structure of the joint.
• Can be repeated: If pain recurs over time, the embolisation can be repeated.

Like any medical procedure, knee embolisation carries certain risks and potential side effects, including:

• Pain: Pain at the catheter insertion site or in the knee (temporary).
• Haematoma: Bruising or swelling at the catheter insertion site (temporary).
• Infection: Rare, or even exceptional
• Nerve damage: Very rare, but possible.
• Skin necrosis: Rare, but possible, due to insufficient blood supply to the skin around the knee.
• Complications related to embolisation agents: Migration of embolisation particles to other parts of the body (very rare).
• Ineffectiveness: In some cases, embolisation does not significantly improve the pain.

Following the embolisation, you will be closely monitored. Most patients are able to go home either on the same day or the following day. Pain relief medication will be prescribed. A follow-up appointment will be arranged to assess the effectiveness of the treatment and monitor any side effects. Rehabilitation (physiotherapy) may be recommended to strengthen the knee muscles and improve mobility.

Knee embolisation is a promising option for people suffering from chronic knee pain that is not relieved by traditional treatments. However, it is essential to discuss your treatment options with your doctor to determine whether knee embolisation is the best option for you, taking into account your general state of health, the cause of your pain and your personal preferences.