ProcedurePath

Compare knee arthritis treatment options.

Knee osteoarthritis treatments range from exercise, weight management, and medicines to injections, nerve ablation, genicular artery embolization (GAE), and knee replacement. This page compares 10 options side by side, with how each works and what guidelines say about it. GAE is newer and still being studied. It is education, not a recommendation for you.

A neutral overview of knee arthritis treatments people commonly discuss with clinicians, including genicular artery embolization (GAE). Not medical advice, and not a statement about what is right for you.

This comparison is educational. Talk with your doctor about these options.

Knee arthritis treatment options at a glance. Every option is listed, in the same order as the cards below. No option is ranked.

Knee arthritis treatment options at a glance
OptionHow it worksAnesthesia and settingTypical recoveryOwn knee joint keptEvidence note
Exercise and physical therapyStrengthening, stretching, and walking or water exercise.None; no procedureNo procedure; it works only while you keep it upYesStrongly recommended by an arthritis guideline and an orthopedic guideline.
Weight managementLosing weight, for people who are overweight, to lower the load on the knees.None; no procedureNo procedureYesRecommended for people with knee arthritis who are overweight.
MedicinesPain relievers and NSAIDs, taken by mouth or rubbed on the skin.None; no procedureNo procedureYesNSAIDs are strongly recommended when they are safe for you.
Braces and canesA cane, or a knee brace fitted for the part of the knee with arthritis.None; no procedureNo procedureYesAn arthritis guideline strongly recommends them; an orthopedic guideline says both could be used.
Corticosteroid injectionA steroid medicine injected into the knee joint to calm inflammation.Office procedure; ask about anesthesiaAn office procedureYesRelief is short term.
Hyaluronic acid injectionA gel-like fluid injected into the knee joint.Office procedure; ask about anesthesiaAn office procedureYesGuidelines disagree about it.
PRP and "biologic" injectionsPlatelet-rich plasma made from your own blood, injected into the knee.Office procedure; ask about anesthesiaAn office procedureYesEvidence rated as limited because study results are inconsistent.
Genicular nerve radiofrequency ablation (RFA)Thin needles heat the small nerves that carry pain from the knee.Outpatient; ask about anesthesiaPeople went home after the procedure in a trialYesRecommended conditionally by an arthritis guideline; limited evidence.
Genicular artery embolization (GAE)Tiny particles placed in small arteries around the knee calm an inflamed joint lining.Outpatient; ask about anesthesiaMost people go home within a few hoursYesStill being studied; sham-controlled trials are mixed.
Partial or total knee replacementSurgery removes damaged cartilage and bone and puts in metal and plastic parts.Surgery; home the same day or after 1 to 2 days; ask about anesthesiaFull recovery takes 4 months to a yearNo; a partial replacement replaces only one partRelieves pain for most people; over 90 percent of artificial knees last over 15 years.

Knee arthritis options people commonly discuss with clinicians

Every option is listed. There is no ranking, and no option is marked as right for you.

First treatments

No procedure
First treatment

Exercise and physical therapy

Strengthening, stretching, and walking or water exercise, often planned with a physical therapist.

What guidelines say: Strongly recommended by an arthritis guideline and an orthopedic guideline1,2. OARSI lists exercise as a core treatment3.

Recovery: No procedure. It works only while you keep it up.

Trade-offs to discuss
  • Takes regular effort over weeks and months.
  • Pain can flare at first; a therapist can adjust the plan.

Ask: Which exercises fit my knee, and should I see a physical therapist?

First treatment

Weight management

Losing weight, for people who are overweight, to lower the load on the knees.

What guidelines say: Recommended for people with knee arthritis who are overweight1,2.

Recovery: No procedure.

Trade-offs to discuss
  • Can be hard to reach and keep; support programs can help.

Ask: How much weight loss would matter for my knees, and what support is available?

First treatment

Medicines

Pain relievers and anti-inflammatory medicines (NSAIDs), taken by mouth or rubbed on the skin.

What guidelines say: NSAIDs on the skin or by mouth are strongly recommended when they are safe for you1,2. An orthopedic guideline also recommends acetaminophen, and says opioid pain medicines, including tramadol, raise side effects without improving pain or function2.

Recovery: No procedure.

Trade-offs to discuss
  • Not every medicine is safe for every person, so ask which fit your other health conditions.

Ask: Which pain medicine is safest for me, and for how long?

First treatment

Braces and canes

A cane, or a knee brace fitted for the part of the knee with arthritis.

What guidelines say: An arthritis guideline strongly recommends a cane and, for arthritis in the main part of the knee, a brace1. An orthopedic guideline says both could be used2.

Recovery: No procedure.

Trade-offs to discuss
  • A brace has to fit well to help; ask who can fit one.

Ask: Would a cane or brace help my knee, and how should I use it?

Injections

Office procedure
Injection

Corticosteroid injection

A steroid medicine injected into the knee joint to calm inflammation.

What guidelines say: An arthritis guideline strongly recommends steroid injections for knee arthritis1. An orthopedic guideline says they could provide short-term relief2.

Recovery: An office procedure.

Trade-offs to discuss
  • Relief is short term2.

Ask: How many injections can I have, and how far apart?

Injection

Hyaluronic acid injection

A gel-like fluid injected into the knee joint.

What guidelines say: An orthopedic guideline does not recommend it for routine use2. OARSI lists it as an option for some people with knee arthritis, depending on their other health conditions3.

Recovery: An office procedure.

Trade-offs to discuss
  • Guidelines disagree about it.

Ask: Why do you suggest this, given that guidelines differ?

Injection

PRP and "biologic" injections

Platelet-rich plasma (PRP) is made from your own blood and injected into the knee.

What guidelines say: An orthopedic guideline says PRP may reduce pain and improve function, but rates the evidence as limited because study results are inconsistent2.

Recovery: An office procedure.

Trade-offs to discuss
  • How PRP is prepared varies, which makes studies hard to compare2.

Ask: How is your PRP prepared, and does my plan cover it?

Minimally invasive procedures

Needle or catheter
Nerve procedure

Genicular nerve radiofrequency ablation (RFA)

Thin needles heat the small nerves that carry pain from the knee. A test nerve block is often done first4.

What guidelines say: An arthritis guideline recommends it conditionally1, and an orthopedic guideline says nerve treatments may reduce pain, with limited evidence2.

Recovery: Outpatient. People went home after the procedure in a trial4.

Trade-offs to discuss
  • In one open-label trial, 74% had at least 50% less pain at 6 months, compared with 16% after a steroid injection4.

Ask: Would a test nerve block tell us if RFA could help me? Compare GAE and RFA.

Minimally invasive IR

Genicular artery embolization (GAE)

An interventional radiologist places tiny particles in small arteries around the knee to calm an inflamed joint lining5.

What guidelines say: SIR calls it an established treatment option5. NICE in the UK says it should be used only in research6. Some commercial insurers call it investigational7,8.

Recovery: Outpatient. Most people go home within a few hours9.

Trade-offs to discuss
  • It is still being studied, and sham-controlled trials are mixed10.
  • The most common side effect is a temporary skin color change over the knee11.

Ask: Does my knee fit the people GAE has been studied in? Read what GAE is.

Surgery

Surgical
Surgery

Partial or total knee replacement

Surgery that removes damaged cartilage and bone and puts in metal and plastic parts12. A partial replacement replaces only one part of the knee.

When it is considered: When arthritis pain keeps you from sleeping or doing normal activities and has not improved with other treatment12.

Recovery: Home the same day or after 1 to 2 days. Full recovery takes 4 months to a year12.

Trade-offs to discuss
  • Relieves pain for most people, and over 90 percent of artificial knees last over 15 years12.
  • A replacement can be redone, but the results are often not as good as the first time12.

Ask: Am I a candidate for a partial or total replacement? Compare GAE and knee replacement.

This treatment comparison is for education only. It is not medical advice, a diagnosis, or a statement that any option fits you. Discuss these options with your doctor, an orthopedic surgeon, or an interventional radiologist.

More about these options

Knee osteoarthritis wears away the cartilage that cushions the knee and causes ongoing inflammation9. Most people start with exercise, weight management if needed, and self-management, which guidelines rate as core or strongly recommended treatments1,3. Medicines, a cane or brace, and injections are often added. Knee replacement is usually considered when pain limits sleep or daily life and other treatment has not helped12.

Where GAE fits

GAE has mostly been studied in people whose pain lasted despite 3 to 6 months of other treatment9. SIR describes it for people who cannot have, do not want, or want to put off a knee replacement5. It is still being studied, and sham-controlled trials are mixed10. GAE does not rebuild cartilage, and some people may still need a knee replacement later.

Why guideline status differs

Groups weigh evidence differently and update on different schedules. The arthritis and orthopedic guidelines on this page date from 2019 to 2021. SIR's 2026 position statement calls GAE an established treatment option5, while NICE in the UK says it should be used only in research6, and some insurers call it investigational7,8. Injections show the same split: one guideline lists hyaluronic acid as an option for some people, and another does not recommend it for routine use2,3.

Every card above stays on the page. There is no ranking, and nothing here says an option is right for you. Talk with your doctor about which options fit your knee, your health, and your goals.

Common questions

What is the first treatment for knee arthritis?

Exercise, weight loss for people who are overweight, and self-management programs are strongly recommended first steps in an arthritis guideline1. OARSI calls education and exercise, with or without weight management, core treatments3.

Is there a new treatment without surgery?

Genicular artery embolization (GAE) and genicular nerve radiofrequency ablation (RFA) are newer options done without surgery13. GAE is still being studied, and sham-controlled trials are mixed10.

Are PRP or hyaluronic acid injections recommended?

An orthopedic guideline does not recommend hyaluronic acid for routine use, and says PRP may reduce pain and improve function, with limited evidence2. OARSI lists hyaluronic acid as an option for some people, depending on their other health conditions3.

When is it time for a knee replacement?

A doctor may recommend it when arthritis pain keeps you from sleeping or doing normal activities and has not improved with other treatment12. Ask an orthopedic surgeon whether and when it fits you.

Where does GAE fit?

GAE has mostly been studied in people whose pain lasted despite other treatment9. SIR describes it for people who cannot have, do not want, or want to put off a knee replacement5.

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 GAE

Sources

  1. Kolasinski et al., 2019 American College of Rheumatology/Arthritis Foundation osteoarthritis guideline, Arthritis Care & Research 2020 (PMID 31908149) ↩︎
  2. American Academy of Orthopaedic Surgeons, management of osteoarthritis of the knee (non-arthroplasty), 3rd edition, 2021 ↩︎
  3. Bannuru et al., OARSI guidelines for knee, hip, and polyarticular osteoarthritis, Osteoarthritis and Cartilage 2019 (PMID 31278997) ↩︎
  4. Davis et al., randomized trial of cooled radiofrequency ablation versus steroid injection for knee osteoarthritis pain, Regional Anesthesia & Pain Medicine 2018 (PMID 29095245) ↩︎
  5. Ahmed et al., Society of Interventional Radiology position statement on genicular artery embolization, Journal of Vascular and Interventional Radiology 2026 (PMID 42118083) ↩︎
  6. NICE (UK), genicular artery embolisation for pain from knee osteoarthritis, HTG595 (formerly IPG708), 2021 ↩︎
  7. Blue Cross and Blue Shield of Texas, medical policy SUR705.048, effective July 15, 2025 ↩︎
  8. Molina Clinical Policy No. 410, genicular artery embolization of the knee for osteoarthritis ↩︎
  9. Brown et al., genicular artery embolization: a technical review, Journal of Clinical Medicine 2025 (PMID 40142914) ↩︎
  10. Milhem et al., systematic review of sham-controlled trials of GAE, Journal of Orthopaedics 2025 (PMID 40766107) ↩︎
  11. Ashraf et al., systematic review of GAE safety and results, 2025 (PMID 40219609) ↩︎
  12. MedlinePlus, U.S. National Library of Medicine, knee joint replacement ↩︎
  13. Kwak et al., cost-effectiveness model comparing GAE, radiofrequency ablation, and steroid injection, American Journal of Roentgenology 2024 (PMID 39320355) ↩︎

What is GAE? All knee arthritis guides

Talk with your doctor. This page is education only. It does not diagnose or recommend a treatment for you. ProcedurePath does not collect your email, health details, or answers. Read the full medical disclaimer.