Genicular Artery Embolization for Refractory Pain After Total Knee Arthroplasty: Clinical Outcomes From a Pilot Study

Purpose : To evaluate the clinical outcomes and safety of selective transarterial genicular artery embolization (GAE) in patients with refractory pain following knee arthroplasty without evidence of prosthetic loosening, infection, or mechanical failure. Materials and Methods: This single-center retrospective cohort study included consecutive patients who underwent GAE for refractory post-arthroplasty knee pain between January 2022 and December 2025. Pain and functional outcomes were assessed using the Numeric Rating Scale (NRS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Knee Injury and Osteoarthritis Outcome Score (KOOS) and Total Analgesic Consumption Score (TACS) at baseline and at 1, 3, 6, and 12 months. Changes from baseline were analyzed using the paired Wilcoxon signed-rank test. Complications were classified according to Society of Interventional Radiology standards. Results : Fifteen patients (median age, 67 years) underwent GAE. Median baseline NRS was 7.0 (IQR, 6.0–8.0). Significant pain reduction was observed at 1 month (median NRS, 1.0; p < 0.001) and pain reduction was most pronounced during the first 6 months, with partial attenuation at 12 months. WOMAC and KOOS scores demonstrated parallel significant improvements through 12 months (p ≤ 0.041). TACS scores improved significantly through 6 months (p ≤ 0.026). Repeat embolization was performed in 3 patients (20%). No major complications occurred; minor transient adverse events were observed in 2 patients (13%). Conclusion : Genicular artery embolization was associated with significant improvements in pain and function with a favorable safety profile in patients with refractory post-arthroplasty knee pain.