📖 Our Knee Centre
The Knee Osteoarthritis Centre at Cochin AP-HP offers genicular artery embolization (GAE) — a minimally invasive alternative to knee replacement for chronic osteoarthritic pain. GAE targets the abnormal synovial neovascularisation that drives pain in arthritic knees, selectively blocking pathological micro-vessels while preserving normal circulation.
Performed under local anaesthesia as a day case, GAE achieves 70–80% pain reduction at 3–6 months. Compatible with eventual knee replacement — GAE does not prevent future surgery. No patient fees at Cochin AP-HP.
Cochin AP-HP is among the very few centres in France to offer, within a single coordinated care pathway, genicular artery embolization, genicular nerve radiofrequency ablation, a preliminary diagnostic nerve block and image-guided injections — alongside the expertise of the Physical Medicine and Rehabilitation (PM&R) department led by Prof. François Rannou.
🎯 Suitable candidates
- Moderate-to-severe knee osteoarthritis (grade II–III on X-ray) with persistent pain
- Failure of conservative treatment (physiotherapy, injections, NSAIDs)
- Patient wishing to avoid or delay total knee replacement (TKR)
- High surgical risk precluding TKR
- Synovitis confirmed on MRI or ultrasound
🔧 Our techniques
🩸 Genicular artery embolization
Selective catheterisation of the medial and lateral genicular arteries via femoral access. Injection of 75–150 µm microspheres to occlude pathological synovial neovessels. Validated by randomised controlled trials (LipioJoint-1).
🔥 Genicular nerve radiofrequency ablation
A complementary technique that interrupts pain signal transmission at the genicular nerves, under CT or ultrasound guidance. Performed under local anaesthesia, as a day case.
🎯 Diagnostic genicular nerve block
A test injection of local anaesthetic at the genicular nerves, performed before radiofrequency ablation to confirm the origin of the pain and select the best candidates for treatment.
🩻 Pre-procedural CT and MRI
Morphological assessment to confirm the osteoarthritis grade, evaluate synovitis and plan the embolization. Pre-procedural CT angiography maps the genicular arteries before the intervention.
💉 Image-guided diagnostic and therapeutic injections
Intra-articular injection of corticosteroids, hyaluronic acid or PRP (platelet-rich plasma), under ultrasound or CT guidance. Useful both to relieve pain and to help confirm the diagnosis based on the response to the injection.
📋 Rheumatology follow-up and PM&R coordination
Coordinated care with the Physical Medicine and Rehabilitation department (Prof. François Rannou) and Cochin's orthopaedic surgeons. Follow-up consultation at 3 and 6 months with pain VAS, KOOS questionnaire and follow-up imaging.
🤝 Multidisciplinary management: PM&R at Cochin
Not all musculoskeletal pain requires interventional radiology. The Physical Medicine and Rehabilitation (PM&R) department at Cochin Hospital, led by Prof. François Rannou, manages the medical treatment of musculoskeletal conditions, including osteoarthritis, and coordinates care with Interventional Radiology for patients who may benefit from genicular embolization or radiofrequency ablation.
❓ Frequently asked questions
What is the difference between embolization and genicular nerve radiofrequency ablation for the knee?
Does genicular embolization replace knee replacement surgery?
🔗 Related pages
🇫🇷 French version: centre-gonarthrose.html
✓ Why this page is trustworthy
Written by the Interventional Radiology team at Cochin Hospital AP-HP, Université Paris Cité. Medically reviewed by an interventional radiologist of the department. Last updated: August 2026.