Is my knee pain coming from arthritis, or could something else be causing it?

Knee pain does not always come from arthritis in the joint. Ask what your exam and images show, and whether anything else could explain your pain.

What do my X-rays show, and how severe is my arthritis?

GAE studies have included mild to severe arthritis on X-rays, but pain tended to improve more in mild to moderate arthritis than in severe arthritis.

Do I need an MRI or other scans before GAE?

Before GAE, teams usually look at a recent standing knee X-ray and a recent knee MRI. Ask what the scans are checking for.

Have I tried enough of the usual first treatments?

An arthritis guideline strongly recommends exercise, weight loss for people who are overweight, and self-management programs, among other first steps. GAE has mostly been studied in people whose pain lasted despite 3 to 6 months of other treatment.

Does my situation match the people GAE has been studied in?

Most studies included adults over 40 whose pain lasted despite other treatment. SIR describes GAE for people whose pain has not improved with other care and who cannot have, do not want, or want to put off a knee replacement.

Is there anything about my health that makes GAE riskier for me?

Ask about kidney problems, allergies to X-ray dye, blood thinners, and problems with the arteries in your legs or arms.

How much might my pain improve, and when?

If relief comes, it may start within hours to weeks. In one early single-center, uncontrolled study, about 80% of patients still had meaningful relief 3 years after GAE. Ask how you and your doctor will measure the change.

How does GAE compare with a sham procedure in trials?

Sham-controlled trials are mixed. One small trial found less pain after GAE at 1 month, and two larger trials found no clear difference. Read what studies show so far.

Which particles will you use, and why?

Some doctors use particles that dissolve over time, and others use permanent ones. Skin color change is seen more often with permanent particles, and there is no agreed best choice yet.

What side effects are common?

In one review, skin color change over the knee happened in about 16 in 100 people, and short-term knee pain in about 10 in 100. Skin changes usually fade within a month. Read about GAE side effects and recovery.

What is non-target embolization, and how do you lower the risk?

It means particles reach a small artery that was not meant to be treated, most often one that feeds the skin over the knee. Rarely, it causes a skin sore, in about 3 in 1,000 people. Ask how the team checks the arteries before placing particles.

If GAE does not help, what comes next, and could I still have a knee replacement?

GAE does not rule out surgery later. In one study, 9 of 46 people later had a knee replacement, and their surgeons reported no added difficulty. A repeat GAE may be considered after about 12 months.

Will my insurance or Medicare cover GAE?

Medicare has no coverage policy written specifically for GAE, so ask your doctor's office and your plan before you schedule. Some commercial insurers call GAE investigational. Ask which codes will be billed. Read about GAE insurance and Medicare coverage.

How many GAE procedures have you done, and how do you track results?

NICE, which reviews treatments in the UK, says GAE should only be done by interventional radiologists with specific training in it. Ask about your doctor's experience and how they follow up with patients.

Who will coordinate my care with my orthopedic surgeon and primary care doctor?

Ask how the interventional radiologist will share results with your other doctors, and who to call with questions after GAE.

Questions to ask before GAE

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Get urgent care for a knee that is suddenly hot, red, or very swollen, a fever, not being able to put weight on your leg, or calf swelling or shortness of breath.

Is my knee pain coming from arthritis, or could something else be causing it?

Knee pain does not always come from arthritis in the joint. Ask what your exam and images show, and whether anything else could explain your pain.
What do my X-rays show, and how severe is my arthritis?

GAE studies have included mild to severe arthritis on X-rays, but pain tended to improve more in mild to moderate arthritis than in severe arthritis².
Do I need an MRI or other scans before GAE?

Before GAE, teams usually look at a recent standing knee X-ray and a recent knee MRI². Ask what the scans are checking for.
Have I tried enough of the usual first treatments?

An arthritis guideline strongly recommends exercise, weight loss for people who are overweight, and self-management programs, among other first steps³. GAE has mostly been studied in people whose pain lasted despite 3 to 6 months of other treatment².
Does my situation match the people GAE has been studied in?

Most studies included adults over 40 whose pain lasted despite other treatment². SIR describes GAE for people whose pain has not improved with other care and who cannot have, do not want, or want to put off a knee replacement⁴.
Is there anything about my health that makes GAE riskier for me?

Ask about kidney problems, allergies to X-ray dye, blood thinners, and problems with the arteries in your legs or arms.
How much might my pain improve, and when?

If relief comes, it may start within hours to weeks². In one early single-center, uncontrolled study, about 80% of patients still had meaningful relief 3 years after GAE⁵. Ask how you and your doctor will measure the change.
How does GAE compare with a sham procedure in trials?

Sham-controlled trials are mixed. One small trial found less pain after GAE at 1 month, and two larger trials found no clear difference^6,7,8. Read what studies show so far.
Which particles will you use, and why?

Some doctors use particles that dissolve over time, and others use permanent ones. Skin color change is seen more often with permanent particles, and there is no agreed best choice yet⁴.
What side effects are common?

In one review, skin color change over the knee happened in about 16 in 100 people, and short-term knee pain in about 10 in 100⁹. Skin changes usually fade within a month⁴. Read about GAE side effects and recovery.
What is non-target embolization, and how do you lower the risk?

It means particles reach a small artery that was not meant to be treated, most often one that feeds the skin over the knee². Rarely, it causes a skin sore, in about 3 in 1,000 people⁴. Ask how the team checks the arteries before placing particles.
If GAE does not help, what comes next, and could I still have a knee replacement?

GAE does not rule out surgery later². In one study, 9 of 46 people later had a knee replacement, and their surgeons reported no added difficulty¹⁰. A repeat GAE may be considered after about 12 months².
Will my insurance or Medicare cover GAE?

Medicare has no coverage policy written specifically for GAE, so ask your doctor's office and your plan before you schedule¹¹. Some commercial insurers call GAE investigational^12,13. Ask which codes will be billed. Read about GAE insurance and Medicare coverage.
How many GAE procedures have you done, and how do you track results?

NICE, which reviews treatments in the UK, says GAE should only be done by interventional radiologists with specific training in it¹⁴. Ask about your doctor's experience and how they follow up with patients.
Who will coordinate my care with my orthopedic surgeon and primary care doctor?

Ask how the interventional radiologist will share results with your other doctors, and who to call with questions after GAE.

Talk with your doctor before you decide. This information does not replace personal medical advice. Read the medical disclaimer.