December 9, 2024
As knee osteoarthritis progresses, with symptoms becoming worse and treatments becoming less effective, most people need to consider some form of surgical intervention.
From a surgical perspective, there are a number of procedures available, including a full knee replacement. There are also less invasive options, such as genicular artery embolisation (GAE).
With the information in this guide, you’ll learn the key differences between GAE vs. knee surgery to help you make an informed decision. As always, this is general information only and should be used to help you have more in-depth discussions with your health care providers.
Surgical Knee Pain Relief Options
There are four types of knee surgery you may be recommended to treat knee osteoarthritis:
- Arthroscopic surgery, involving the use of a fiber-optic camera and tools inserted through a small incision to help repair the knee joint and damaged cartilage.
- Partial knee replacement surgery, where only the most damaged portion of your knee is replaced with metal and/or plastic parts, and is less intensive with reduced recovery than a total knee replacement.
- Total knee replacement surgery, which requires the surgeon to cut away damaged bone and cartilage, replacing it with artificial joints.
- Osteotomy, which can help delay or avoid a total knee replacement by removing bone from the highbone or shinbone to help align the knee to relieve pain.
The surgery you are recommended or may need depends on your individual circumstances. For the purpose of this article, we will be discussing total knee replacement surgery.
Genicular Artery Embolisation vs. Knee Surgery
Process
GAE is a minimally invasive treatment using a small incision in the groin to insert a catheter to be able to inject small particles into the knee. These particles restrict the flow of blood to a layer in the knee, triggering a reduction in inflammation, which can help reduce pain. It takes 1 to 2 hours to perform, and requires a topical anesthetic to numb the incision area.
A full knee replacement requires full sedation to allow the surgeon to cut away damaged bone and cartilage from the kneecap, as well as the highbone and shinbone. This will then be replaced with an artificial knee joint made of metal alloys, plastic and polymers. The whole surgery can take between 1 to 3 hours.
Recommended reading: A Step-by-Step Guide to Genicular Artery Embolisation for Knee Pain
Candidacy
People with osteoarthritis with no significant joint deformity who are not suitable for knee surgery, who are seeking alternative options to surgery, or who have not responded well to other treatments may be a candidate for GAE. However, it does not address cartilage damage.
Someone with severe knee pain, swelling and stiffness who also has cartilage damage, and may not be responding to other treatment is a potential candidate for knee replacement surgery.
Recommended reading: The 4 Stages of Knee Osteoarthritis
Recovery
There is very minimal recovery following genicular artery embolisation. You can usually go home on the same day as your treatment on bed rest, returning to your normal routine within 2 to 3 days. In the days following, you may experience some discomfort, which you can manage with over-the-counter pain medications. You should also keep your incision site clean while it heals.
Recovery following a full knee replacement is quite intensive. You’ll be required to stay in hospital for a few days, and may be unable to walk for up to 3 to 6 weeks. Swelling typically starts to reduce around the 4 to 6 week mark, at which time you can discuss returning to work with your doctor. Around week 6 to 12, you can begin to reintroduce light physical activity and exercise. You won’t start to regain full range of motion in your knees for at least 3 months.
Risks
Studies have shown there is potentially less than a 1% risk from GAE. However, you may experience bruising or hematoma around the incision site, infection, allergic reaction, non-target embolisation, incomplete pain relief, vascular complications or post-embolisation syndrome.
There are complication risks with any procedure or surgery. Some of the potential risks of knee surgery include blood clots or deep vein thrombosis, infection, nerve or tissue damage, problems with the new knee (such as problems bending) and ongoing pain.
Success Rate
GAE has an overall technical success rate of 99.7%.
The success rate of full knee replacement can vary depending on age, but is typically 90% to 95% in younger patients. This can decrease in older recipients.
Effectiveness
Research has revealed GAE can result in a 50% to 60% decrease in pain for up to 12 to 24 months. Effects may be felt in the first 3 to 14 days.
Replacement knees can last up to 15 to 25 years, after which time a revision part may be required, depending on age and condition.
Take the First Step Towards Relief and a Better Quality of Life
If you’re experiencing knee pain or suspect you might have osteoarthritis, early intervention is key to managing symptoms and slowing the progression of the disease. At Northern Beaches Interventional Radiology, our expert team offers advanced, minimally invasive treatments tailored to your needs, including genicular artery embolisation to help reduce osteoarthritis pain.
Book a consultation with us today to discuss your symptoms and explore the best treatment options for you.
