Key facts
- Knee replacement surgery takes about 2 hours. People go home the same day or after 1 to 2 days, and full recovery takes 4 months to a year1.
- GAE is usually an outpatient procedure of about 1 to 2 hours, and most people go home within about 4 hours3.
- Knee replacement relieves pain for most people, and over 90 percent of artificial knee joints last over 15 years1.
- For GAE, sham-controlled trials are mixed4.
- Evidence status as of October 2026: it is not yet known whether GAE can put off a knee replacement.
What each procedure does
| GAE | Knee replacement | |
|---|---|---|
| Goal | Ease pain by calming inflammation in the joint lining2 | Replace damaged joint surfaces with man-made parts1 |
| Anesthesia | Numbing medicine and often light sedation3 | General anesthesia, or spinal or epidural anesthesia with medicine to make you sleepy1 |
| Opening | A needle puncture into an artery, usually at the groin and sometimes at the wrist3 | A cut over the knee, often 8 to 10 inches long1 |
| How long it takes | About 1 to 2 hours3 | About 2 hours1 |
| Going home | Most people go home within about 4 hours3 | The same day, or after 1 to 2 days1 |
| Recovery | Many teams advise no heavy lifting or hard exercise for 1 to 2 days3 | Full recovery takes 4 months to a year1 |
| Evidence | Newer; sham-controlled trials are mixed4 | Relieves pain for most people; over 90 percent of artificial knees last over 15 years1 |
| If it does not help | A repeat GAE may be considered, or other treatments, including knee replacement3 | A replacement can be redone, but the results are often not as good as the first time1 |
Questions to ask
- What would each option mean for my daily life and work in the first few months?
- What results would count as success for me with each option?
- What are the main risks of each for someone with my health?
Can GAE delay a knee replacement?
This is not established. It is not yet known whether GAE can put off a knee replacement. The sham-controlled trials followed people for up to 12 months5,6. In the GENESIS study, 9 of 46 people later had a knee replacement, and their surgeons reported no added difficulty during the operation7.
SIR describes GAE for people who want to put off a knee replacement, among others2. That is a reason people consider GAE, not a proven result.
Who each has been studied in
Knee replacement is most often done in people age 60 and older. A doctor may recommend it when arthritis pain keeps you from sleeping or doing normal activities and has not improved with other treatment1.
GAE studies mostly included adults over 40 whose pain lasted despite 3 to 6 months of other treatment. Pain tended to improve more in mild to moderate arthritis than in severe arthritis3.
Questions to ask
- How severe is the arthritis in my knee on X-rays?
- Am I a candidate for knee replacement now, or later?
- Does my knee fit the people GAE has been studied in?
If you are not ready for surgery, or cannot have it
Some people want to wait, have health problems that make surgery riskier, or are younger. Younger people who have a knee replaced may put extra stress on it and wear it out sooner1. SIR describes GAE for people who cannot have, do not want, or want to put off a knee replacement2.
Other options include exercise, weight loss, medicines, a cane or brace, steroid injections, and nerve treatments such as radiofrequency ablation8. Compare them on the knee arthritis options page.
GAE after a knee replacement
GAE was first used to treat bleeding into the knee joint after a knee replacement3. Some people have pain that continues after a knee replacement. Medicare-approved device studies are testing GAE for that pain9, but there is less research on this use than on GAE for arthritis. Ask your surgeon and an interventional radiologist whether it could fit you.
Common questions
Is GAE an alternative to knee replacement?
GAE is a different kind of treatment. It aims to ease pain and does not rebuild the joint, and some people may still need a knee replacement later3. It is not yet known whether GAE can put off a knee replacement.
Which has a faster recovery?
GAE is usually an outpatient procedure, and most people go home within hours3. Full recovery from knee replacement takes 4 months to a year1. The two treatments have different goals and different amounts of evidence.
Can I have a knee replacement after GAE?
GAE does not rule out surgery later3. In one study, 9 of 46 people later had a knee replacement, and their surgeons reported no added difficulty7.
How long does a knee replacement last?
Over 90 percent of artificial knee joints last over 15 years, and some last as long as 25 years1.
Bring questions to your visit
A printable list of questions about GAE, with background notes from the sources. Talk with your doctor about these questions.
Questions to ask before GAETalk with your doctor before you decide. This information does not replace personal medical advice. Read the medical disclaimer.
Sources
- MedlinePlus, U.S. National Library of Medicine, knee joint replacement ↩︎
- Ahmed et al., Society of Interventional Radiology position statement on genicular artery embolization, Journal of Vascular and Interventional Radiology 2026 (PMID 42118083) ↩︎
- Brown et al., genicular artery embolization: a technical review, Journal of Clinical Medicine 2025 (PMID 40142914) ↩︎
- Milhem et al., systematic review of sham-controlled trials of GAE, Journal of Orthopaedics 2025 (PMID 40766107) ↩︎
- Landers et al., triple-blind sham-controlled trial of GAE, Bone & Joint Open 2023 (PMID 37051829) ↩︎
- van Zadelhoff et al., the same trial at 12 months, European Radiology 2026 (PMID 42009866) ↩︎
- Little et al., GENESIS long-term results, CardioVascular and Interventional Radiology 2024 (PMID 38819473) ↩︎
- Kolasinski et al., 2019 American College of Rheumatology/Arthritis Foundation osteoarthritis guideline, Arthritis Care & Research 2020 (PMID 31908149) ↩︎
- CMS, Medicare-approved investigational device exemption (IDE) studies ↩︎