Background: Treatment options for osteoarthritis of the knee include non-pharmacologic and pharmacologic therapies and knee joint replacement surgery, depending on the severity and degree of pain. However, a large number of patients are resistant to conventional nonsurgical therapies or are ineligible / unwilling for surgery. As OA is known to cause neo-angiogenesis, which adds to the pain and the slow progressive joint damage, it offers a potential target of therapy by endovascular embolization of the genicular arteries by devascularizing the hypertrophied and hypervascular synovium of the involved knee.

Novelty: Genicular artery embolization (GAE) is a newly described technique, and no randomized controlled studies exist till date from India to prove its efficacy.

Objectives: To evaluate improvement in pain and functional outcomes, measured by the Visual Analog Scale (VAS) and the Knee Injury and Osteoarthritis Outcome Score (KOOS) in knee osteoarthritis after GAE

Methods: Knee OA patients reporting to the orthopaedics outpatient clinic and not responding to conventional management for 6 weeks, will be enrolled in the study and randomized in two arms, the control arm shall undergo further standard conventional management and the interventional arm shall undergo a single session of GAE under local anesthesia as a daycare procedure, along with standard care. The baseline scores of VAS and KOOS will be compared with those at one day, one week, one month, three months and six months of the intervention.

Expected outcome: GAE will provide superior outcomes of both pain control and functional outcomes, measured by the VAS and KOOS, as compared to conventional management.