Concierge interventional radiology · London
Genicular artery embolisation in London, by a consultant interventional radiologist.
A NICE IPG766-endorsed, minimally invasive day-case treatment for painful knee osteoarthritis — as an alternative to third-line conservative care, or as a bridge to a knee replacement.
Why patients choose us
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A consultant interventional radiologist, in a proper IR suite
Not a musculoskeletal clinic offering a sideline. A named IR who does geniculate work, in a fluoroscopy suite set up for it.
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Discussed with a knee surgeon first
GAE is a bridge or an alternative — not a replacement for the conversation with an orthopaedic surgeon. We arrange both.
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Independent, and free
We are paid by no clinic, so whether we recommend GAE, an injection, or a knee replacement is impartial and costs you nothing.
Indicative pricing
What genicular artery embolisation costs privately in the UK.
Indicative ranges across our partner IR services. Send the details and we quote firm figures across two or three options.
In short
GAE in our network: £3,500–£6,000 per knee, home the same day.
| Procedure | Indicative range | Typical duration | Recovery |
|---|---|---|---|
| Genicular artery embolisation — one knee | £3,500–£6,000 | 60–90 min | Same visit |
| Genicular artery embolisation — both knees | £6,500–£10,000 | Staged | Same visit |
| Pre-procedure MRI knee | £350–£600 | 30 min | 24–48 h |
| Weight-bearing knee X-ray | £100–£180 | 10 min | Same visit |
| Interventional radiology consultation | £250–£450 | 30 min | Same visit |
| Orthopaedic (knee) consultation | £250–£450 | 30 min | Same visit |
Prices vary by centre, by the interventional radiologist doing the case, by the embolic material chosen, and by whether a bilateral procedure is staged. NHS provision is limited to a small number of specialist IR centres — Guy’s & St Thomas’, UCLH, RNOH, Sheffield, Cambridge and Manchester among them.
The problem
The right conversation before the right procedure.
GAE is quietly one of the most misunderstood procedures in UK musculoskeletal care — over-sold as a knee-replacement replacement, under-offered by orthopaedic clinics that do not do it. We frame it honestly, in front of both an IR and a knee surgeon.
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Not sure a knee replacement is the answer?
For some patients — younger, comorbid, prosthesis-averse — GAE is a legitimate way to defer, sometimes for years.
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Worried about the evidence?
NICE IPG766 endorses GAE with special-arrangements consent. We show you exactly what that means, and what the response rate really is.
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Want it done properly?
A named consultant interventional radiologist, a proper fluoroscopy suite, and a knee surgeon in the MDT before the day.
The journey
From enquiry to review — what happens, in order.
One clinician from first message to review — including the imaging and the MDT before the day.
Phase 1 · Before your procedure
Concierge, off-stage for you
Phase 2 · On the day
A few hours at the clinic
Phase 3 · After
Concierge, back on
- 01
Before
You tell us what is going on
A short, confidential form. Pain, function, what you have already tried, whether a surgeon has discussed a knee replacement.
- 02
Before
We come back with a recommendation
Within one working day: whether GAE is a sensible next step, which IR to see, whether an orthopaedic opinion should come first, and an indicative price.
- 03
Before
Imaging and MDT review
Weight-bearing knee X-ray plus MRI to confirm the pattern of arthritis and exclude other pathology. The case is discussed by the IR and a knee surgeon before the day.
- 04
On the day
Arrival at the IR suite
Arrival, consent — including the NICE IPG766 special-arrangements discussion — and a chat with the interventional radiologist and the anaesthetist about light sedation.
- 05
On the day
The procedure itself
60 to 90 minutes on the fluoroscopy table. Femoral (or radial) access, geniculate angiography, and embolisation of three to six abnormal branches.
- 06
On the day
Home the same day
The cannula stays for around 30 minutes. Immediate weight-bearing is fine. Home a few hours later, with written aftercare.
- 07
After
Recovery, response and review
Pain relief typically begins at one to two months and peaks around six months. A pain diary is kept, and a review is arranged at three months.
Typical end-to-end: 2–3 weeks from enquiry to procedure. Peak pain relief: around 6 months.
When it helps
When genicular artery embolisation is the right step.
The situations we see most, plus the one red flag that means an emergency rather than an appointment.
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Kellgren–Lawrence 2–3 knee OA
Moderate-to-severe symptomatic osteoarthritis on weight-bearing X-ray, with pain out of proportion to the imaging on some days.
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Failed 3+ months of conservative care
NSAIDs, physiotherapy, weight loss where relevant, and intra-articular steroid or hyaluronic acid — none of them holding.
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Wanting to defer a knee replacement
Under 65, joint-preservation-minded, still recreationally active — and not ready to commit to a total knee.
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Not a candidate for major surgery
Comorbidity, anticoagulation, or personal preference means a knee replacement is off the table, but the pain is still limiting.
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Recurrent haemarthrosis
A knee that keeps bleeding — after a TKA, in haemophilia, or on anticoagulation — where the bleeding vessel can be embolised.
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PVNS (pigmented villonodular synovitis)
A rare synovial condition where embolisation of the abnormal vascular synovium is used as part of the treatment plan.
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A bridge to eventual TKA
Buying one to three years of pain relief for a patient who will need a knee replacement — just not yet.
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Red flag: acutely hot, painful knee
Fever, a red hot swollen knee or sudden severe pain is not an OA flare — it needs same-day assessment for infection or crystal arthropathy.
Procedure options
The technical choices, in plain English.
What each option on the table actually involves — access route, embolic material, and how bilateral disease is handled.
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GAE with temporary embolic (Imipenem/cilastatin)
The Okuno protocol — 40–100µm particles that dissolve within hours, embolising the abnormal synovial blush.
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GAE with permanent microspheres
Embozene or Embosphere microspheres for a durable, permanent occlusion of the target geniculate branches.
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GAE with PVA particles
Polyvinyl alcohol particles — another permanent option, chosen based on the anatomy on the angiogram.
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Femoral access
The traditional route — a small puncture in the groin, easy to catheterise the geniculates, cannula out at 30 minutes.
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Radial access (emerging)
A wrist puncture in selected patients — early mobilisation and no groin site to worry about.
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Bilateral / staged
For patients with painful arthritis in both knees — typically staged four to six weeks apart rather than done in one sitting.
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GAE for haemarthrosis
Targeted embolisation of the bleeding vessel after a total knee replacement, in haemophilia, or on anticoagulation.
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Consultation only
An honest discussion of whether GAE, an injection, or a referral to a knee surgeon is the right next step — no obligation.
Our vetted UK network
A small panel of interventional radiologists, we picked them.
Consultant IRs across London and a handful of specialist centres — Guy’s & St Thomas’, UCLH, RNOH, Sheffield, Cambridge, Manchester. Not listed publicly — introductions are made privately, once we understand your case.
Selection criteria
How we choose every interventional radiologist in our network.
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Consultant interventional radiologists who do geniculate work regularly
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A knee surgeon in the room, or in the MDT, before the day
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A proper fluoroscopy suite with modern flat-panel angiography
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Written NICE IPG766 special-arrangements consent, not a form thrust across a desk
Safety and recovery
What to expect afterwards — honestly.
GAE is a minimally invasive, day-case procedure with a reassuring safety profile — the things worth planning are the pain flare in the first fortnight, the pain diary, and knowing what is normal after.
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Positioned by NICE as an alternative or bridge
NICE IPG766 (2023) endorses GAE with special-arrangements consent — as an alternative to third-line conservative care, or as a bridge to a knee replacement.
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Skin colour change from non-target embolisation
Temporary skin discolouration around the knee is reported in around 10–20% of early studies — cosmetic, transient, and reducing with technique refinement.
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Transient pain flare in the first one to two weeks
A pain flare after embolisation is common. Pre-medication with a short course of steroid reduces it, and it settles.
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Post-embolisation syndrome
Nausea, malaise and low-grade temperature for one to three days is normal after any embolisation and does not mean something has gone wrong.
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Access-site complications
Bruising is common. Femoral haematoma or pseudoaneurysm are uncommon but recognised — and the reason the cannula stays for 30 minutes.
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Superficial skin ulcer or necrosis is rare
Reported in under 1% of cases with modern particle sizes and careful angiographic technique — but real, and part of the consent.
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Contrast reaction and radiation
Iodinated contrast is used and there is a moderate radiation dose. Both are discussed with the IR, and prior contrast reactions are pre-medicated.
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Incomplete relief, and eventual TKA
Around 60–70% of patients respond, with durable relief at 12–24 months. Roughly 30–40% still need a knee replacement within two years.
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Red flags after the procedure
Fever, a hot swollen knee, spreading redness at the access site, or a cold or pulseless foot are not normal — call the clinic or A&E the same day.
Reading your procedure report
Your GAE report in four parts. Read the last one first.
Whichever embolic was used, the report the interventional radiologist sends you keeps to the same shape.
A quiet reminder
Interventional language is precise and can read coldly — we translate it for you.
If you would like us to talk you through the report before your three-month review, just ask.
- 01 Header
Indication and consent recorded
Why GAE was done — moderate-to-severe OA, haemarthrosis, PVNS — and confirmation that NICE IPG766 special-arrangements consent was taken.
- 02 Technique
Access, catheters, embolic used
Femoral or radial access, the geniculate branches catheterised, and which embolic (temporary Imipenem/cilastatin, permanent microspheres, or PVA) at what particle size.
- 03 Findings
Angiographic blush and branches treated
The pattern of abnormal synovial blush seen on angiography, and how many geniculate branches (typically three to six) were successfully embolised.
- 04 Impression
Recovery, pain diary, review timing
Read this first: expected pain flare, when to expect relief, whether steroid pre-medication was given, and when the three-month review is booked.
Recognised by major UK insurers
Cover for GAE varies by insurer and by policy — because NICE positions it with special-arrangements consent, most insurers assess it case-by-case. We confirm cover before booking.
Frequently asked
Everything we get asked about GAE.
Quick answers on response rates, cost, risks, and how GAE compares to a knee replacement.
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What is genicular artery embolisation, and who is it for?
GAE is a minimally invasive procedure done by an interventional radiologist. Tiny particles are used to block abnormal small arteries feeding an inflamed knee joint lining, which reduces pain from knee osteoarthritis. It is designed for patients with moderate-to-severe symptomatic OA (Kellgren–Lawrence 2 or 3) who have failed at least three months of conservative care and who want to defer, or cannot have, a knee replacement.
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Is GAE approved in the UK?
Yes. NICE published IPG766 in 2023, endorsing GAE for knee OA with "special arrangements" consent — meaning the IR must explain that the evidence base is developing, discuss it with a knee surgeon, and audit outcomes. It is offered at a small number of NHS interventional radiology centres and by a growing number of private IR services.
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How well does GAE work?
In published series, around 60–70% of patients get meaningful pain relief. Relief typically begins at one to two months, peaks at around six months, and is durable at 12–24 months in responders. Roughly 30–40% still go on to a knee replacement within two years — so GAE is best framed as a bridge or an alternative for the right patient, not a cure.
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What does GAE cost privately in the UK?
Typically £3,500–£6,000 per knee, with bilateral procedures usually staged rather than done at the same sitting. That is inclusive of the day-case bed, the interventional radiologist, the consumables and the same-day review — but not the pre-procedure MRI, which is £350–£600.
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Is GAE painful?
The procedure itself is done under local anaesthetic with light sedation, so it is not painful at the time. A "pain flare" in the treated knee for one to two weeks afterwards is common — this is a good sign that the embolisation worked, and short-course steroid pre-medication reduces it.
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What are the main risks?
Temporary skin colour change around the knee (10–20% in early studies, less now), a transient pain flare, mild post-embolisation nausea and malaise for a few days, femoral access bruising, and — rarely — a superficial skin ulcer or a groin pseudoaneurysm. Iodinated contrast is used and there is a moderate radiation dose.
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How does GAE compare to a knee replacement?
A total knee replacement is major surgery with excellent long-term results but a significant recovery, and it commits you to a prosthesis. GAE is a day-case procedure with almost no downtime — but relief is partial in some patients and not permanent in most. For a symptomatic under-65 patient who wants to keep their own joint for another few years, GAE is often a sensible bridge.
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Can GAE be repeated, or done on both knees?
Yes to both. A partial response can be topped up with a repeat embolisation, and patients with bilateral disease are usually treated one knee at a time, typically four to six weeks apart. We agree the plan with the interventional radiologist before the first procedure.
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