Get rid of your Knee joint Pain by Genicular Artery Embolization (GAE)

Most Advance & Non-Surgical method to treat mild to moderate osteoarthritic Knee Pain.

Dr. Virender K Sheorain
Senior Consultant & Vascular Specilaist

In India, age & obesity (overweight) related Osteoarthritis (OA) of the knee affects millions of people, resulting in pain and disability that can severely limit quality of life.

In our country, the treatment of knee pain usually starts with home remedies, Ayurveda and homeopathic medications. Initial treatment usually involves conservative measures such as physical therapy, use of knee braces, and medical analgesic/anti-inflammatory therapy.

As the symptoms become more severe and, patient usually consults orthopedician and intra-articular injections are then considered, including platelet-rich plasma (PRP) corticosteroids and hyaluronic acid compounds. Finally, if patients are still limited by pain despite these measures, surgical treatment including Knee replacement surgery is advised.

I am writing this blog for all those patients who have mild to moderate OA knee pain and is not yet severe enough to warrant joint replacement, and is resistant to nonsurgical options.

Let’s understand the pathogenesis of pain in the setting of OA of the knee. The latest research suggests that the pain is less mechanical and more often a result of chronic inflammation. The degradation of articular cartilage triggers an inflammatory cascade. Inflammatory factors result in the growth of new blood vessels and nerves within the synovium. Irritation of these “new” nerves is ultimately the stimulus that causes the deep joint pain in knee OA. As sensory nerves grow along new blood vessels in osteoarthritic joints, they eventually penetrate non-calcified articular cartilage, osteophytes, and the inner regions of the menisci. It is hypothesized that angiogenesis contributes to structural damage and pain in OA, and thus may therefore provide a potential embolization target.

Who invented GAE & What is done in procedure ?

This technique of embolization of knee joint to reduce pain secondary to knee OA, was first proven by Dr. Okuno in Japan in 2014. He found that the majority of the patients who were routinely taking pain killer medications prior to GAE stopped taking them after the procedure. In GAE, vascular specialist like Dr. Virender Sheorain, who are certified and trained in embolization; very carefully looks for the abnormal supply to the affected area of the knee ( as seen on MRI, X-ray or site of severe pain). This is called as selective angiography and is done simply by injection of special contrast material on angiography machine. Once the abnormal blood supply is found, the expert will selectively inject a special calibrated time particles / medication in that abnormal artery to decrease the inflammation. It is actually a day care procedure and very rarely patient needs to stay overnight. Patient can do all his routine activities from the very next day. There are No cuts, No need of any surgery, No blood loss and No need for anesthesia. No reported significant complications.

Who should opt for GAE & will benefit from procedure?

• Anyone of age 40 years or older.
• Mild to moderate knee OA,
• Knee pain present for at least 6 months, resistant to conservative treatment (physiotherapy/analgesia/exercise/weight loss/intra-articular injections).

Who will NOT benefit from GAE procedure?

• Patients with rheumatoid or infectious arthritis & 
• Severe  grade of knee OA

What test needs to be done before GAE procedure?

Prior to GAE, patients may be advised to undergo contrast-enhanced MRI of the knee to allow non-invasive assessment of synovial hypervascularity and localise the pathology.

Dr. Sheorain’s Advice to the patients suffering from Knee Joint Pain not responding to medications & Physiotherapy: If you have no relief in your knee joint pain in-spite of taking too many medications (including ayurvedic & homeopathic) and even after many physiotherapy sessions then please consult Dr. Sheorain ( vascular & endovascular expert). He will examine you and will explain you about need for GAE procedure. He will discuss in detail about safety and efficacy of GAE in mild to moderate knee OA. In his personal experience he has found that GAE has the potential to improve pain, function, and quality of life in patients with knee OA.

Dr. Sheorain’s feel that, GAE could be an alternative to intra-articular injections in patients who have failed medical therapy but are not yet ready to undergo surgery.

“Avoid Unnecessary Knee Replacement Surgery & Go for Embolization “GAE”

Dr Virender Sheorain is fellowship trained expert in embolization and he is among very few authorities in the country. He can guide you what is the best option for your OA knee pain & will let you know if you are right candidate for GAE procedure or not.

www.vasculardoctorindia.com
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