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Hôpital Cochin – Port-Royal · AP-HP · Université Paris Cité
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RI Home› Centre — Inflammatory Ankle Embolization
🏥 Reference centre · Paris 14th

🦶 Inflammatory Ankle Centre in Paris

Ankle arthritis & synovitis · Synovial neovascularization · Outpatient · Alternative to joint replacement · Paris

Quick answer

The Inflammatory Ankle Centre at Cochin AP-HP treats chronic pain from arthritic or inflammatory ankles with joint embolization, as is done for the knee, by targeting the synovial hypervascularization responsible for the pain, without surgery.

Inflammatory ankle centre at Cochin AP-HP

The Ankle Embolization Centre at Cochin AP-HP offers percutaneous treatment for chronic pain from arthritic or inflammatory ankles using joint embolization. As with the knee, chronic ankle pain is driven by pathological synovial neoangiogenesis — a mechanism targeted by selective embolization of the synovial arteries.

This minimally invasive technique is offered to patients for whom conservative treatments (injections, physiotherapy, orthoses) have failed, as an alternative or complement to surgery (tibiotalar arthrodesis, ankle replacement). 100% covered at Cochin AP-HP.

What are the symptoms of ankle arthritis?
Chronic pain when walking or at rest, swelling (joint effusion), morning stiffness, and sometimes a feeling of instability. This pain often resists standard painkillers and injections when persistent synovial inflammation is the cause.
How do we know if embolization could help me?
A Doppler ultrasound and MRI of the ankle are used to look for synovial hypervascularization (neoangiogenesis) — this is the specific mechanism targeted by embolization. This work-up is essential before any treatment decision.
What is the difference between embolization and injection?
Injections (corticosteroid or PRP) act locally within the joint and their effect is temporary. Embolization directly targets the abnormal vessels responsible for chronic inflammation, aiming for a longer-lasting effect. The two techniques can be complementary.
How long do the results of ankle embolization last?
Currently available data show pain improvement in 65 to 75% of patients. Follow-up data on the exact duration of results is still limited for this more recent indication than for the knee — regular monitoring is offered to assess progress over time.
Can embolization be repeated in case of recurrence or incomplete improvement?
Yes, a further embolization may be considered if the initial response is insufficient or if pain returns, after re-assessment by the team.
Is ankle embolization reimbursed?
Yes. Covered 100% by French national health insurance at Hôpital Cochin AP-HP, a public-sector hospital, with no extra fees.

Indications

  • Chronic painful tibiotalar arthritis that has failed conservative treatment
  • Chronic ankle synovitis (rheumatoid arthritis, post-traumatic)
  • Patients refusing or unable to undergo ankle arthrodesis or replacement
  • Insertional or mid-portion Achilles tendinopathy that is resistant to treatment
  • Resistant chronic plantar fasciitis
  • Peritendinous or synovial neovascularization confirmed on Doppler ultrasound

Techniques

🩸 Embolization of ankle synovial arteries

Selective catheterization of the anterior tibial, posterior tibial arteries and their synovial branches via the right femoral approach. Injection of 75–150 µm microspheres. Reduces inflammatory joint neovascularization.

🦵 Embolization of peroneal arteries (fasciitis, Achilles)

For peritendinous conditions (Achilles tendinopathy, plantar fasciitis 🇫🇷): selective embolization of the nourishing branches of the tendon or plantar fascia.

🔬 Prior Doppler ultrasound and MRI work-up

Confirmation of synovial or peritendinous neovascularization. Ankle MRI for lesion assessment and procedure planning.

💉 Complementary guided injection

Intra-articular injection of corticosteroid or PRP under ultrasound or fluoroscopic guidance, in addition to embolization.

Results

65–75%
Pain improvement
Outpatient
No hospitalization
Conservative
Ankle preserved

Frequently asked questions

Is ankle embolization suitable for any type of arthritis?
It is intended for chronic inflammatory pain that has not responded to standard medical treatment (painkillers, injections), particularly when synovial hypervascularization is identified on imaging.
Is the procedure painful?
It is performed under local anaesthesia with light sedation if needed. Moderate discomfort may persist for a few days, managed with simple painkillers.
When does improvement appear?
The effect on pain is generally progressive, noticeable within weeks of the procedure, with efficacy assessed at 1 and 3 months.

Musculoskeletal pain: the Cochin PRM department

Not every musculoskeletal pain condition falls under interventional radiology. The Physical Medicine and Rehabilitation (PRM) department at Hôpital Cochin, led by Pr François Rannou, manages the medical treatment of musculoskeletal disorders: low back pain, neck pain, disc herniation, arthritis, lumbar spinal stenosis, scoliosis, shoulder conditions, sports trauma, as well as inflammatory rheumatic diseases.

The department has a comprehensive technical platform (balneotherapy, musculoskeletal ultrasound, movement analysis, occupational therapy, podiatry) and offers consultations in physical medicine, sports medicine, manual medicine and rheumatology, as well as spinal injections. Complex cases are discussed at medico-surgical meetings.

PRM secretariat: +33 1 58 41 25 87 · Bâtiment Hardy B, Hôpital Cochin, 27 rue du Faubourg Saint-Jacques, 75014 Paris

Related pages

Scientific references

Genicular artery embolization for knee osteoarthritis: results of the LipioJoint-1 trial

Sapoval M, Querub C, Pereira H, Pellerin O, Boeken T, Di Gaeta A, et al. Diagn Interv Imaging 2024;105(4):144-150.

Society of Interventional Radiology Research Reporting Standards for Genicular Artery Embolization

J Vasc Interv Radiol 2024.

Learn more

Why this page is trustworthy

Written by the Interventional Radiology team at Hôpital Cochin AP-HP, Université Paris Cité. Medically reviewed by an interventional radiologist from the department. Last updated: July 2026.

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