Although Dr May is experienced with genicular nerve ablation (GNA) and offers this service in the public hospital system, in private he is currently focused on GAE as his primary procedure. As OA pain is typically multifactorial by nature (ie. multiple issues contributing to your pain), GAE may not always be appropriate or may only provide partial relief. During your initial consultation, Dr May will perform a full examination and work-up of your knee. If Dr May feels that GAE is not in your best interest and you are more appropriate for GNA, he works with other highly trained specialists experienced with GNA and is happy to refer you on. At this point you will not be lost to Dr May, he will continue to collaborate with your GP and orthopaedic surgeon, and always be available to you should GAE become a treatment option for you in future.

GAE is a relatively new procedure and it is not unusual that you may not have heard of it, in fact most doctors are unaware of its existence. That however doesn't mean that it isn't evidence based. GAE has been around for decades in the treatment of intra-articular bleeding in the knee (known as haemarthrosis), however the first research paper for GAE in the treatment of osteoarthritis was in 2014. Since that time multiple studies have been released, examining the safety and effectiveness of GAE. Several meta-analyses (review papers that collect and analyse the existing literature) have concluded that the available research is sufficient to establish the safety and efficacy of GAE. Dr May is currently working in collaboration with other interventional radiologists in multiple pubic and private hospitals, and has helped establish a multicentre GAE registry. A registry is a repository of unidentified data regarding the outcomes of GAEs performed in those hospitals, which provides a database for research and a foundation from which to establish best practice. Dr May has also been recently awarded a large research grant to study the effects GAE on the biochemical markers of osteoarthritis and the socioeconomic effects of GAE on its participants. He will be partnering with QUT, Ramsay Health and I-MED in this world-first ground-breaking research project. You may be asked if you would be willing to participate in the registry and research project.

As a 'Known Gap' provider, Dr May's fee for GAE is $500 for patients with appropriate private insurance. No gap billing may be considered in certain circumstances. The MBS item numbers can be provided to you to ensure all items are covered by your specific insurance policy. Although Dr May's fees are set at $500, additional costs include the anaesthetic fees. The attending anaesthetist will discuss these with you prior to the day of the procedure. Both overnight and day cases will incur hospital fees. You will need to check with you insurance provider to see if these expenses are covered.

GAE involves blocking the blood supply to the inflammation in your knee. The ultimate outcome is decreased inflammation and regression of tiny abnormal sensory nerves that grow when the inflammation develops. With time this will contribute to pain relief, however initially the procedure can actual PRODUCE localised inflammation and for a few weeks INCREASE pain. We help you get past the worst of this pain using a steroid nerve block in your knee, called a genicular nerve block. The long acting local anaestetic will help with the immediate post-procedural pain, while the steroid helps dampen-down irritation of the nerves around your knee. We have found that this technique gives up to one week of analgesia. Most people have only mild discomfort after a week, however occasionally discomfort can last up to 4 weeks, which simple anagesia (eg. ibuprofen and paracetamol) is typically sufficient to control. Pain during the procedure will be managed by the attending anaesthetist and the pre-mentioned nerve block (which is done pre-operatively). Even with conscious sedation only, this combination is typically enough to provide a pain free experience.

Interventional radiology is one of the most misunderstood specialties in medicine. People are often surprised when they realise that not all radiologists specialise in reporting medical imaging - some are trained in high-end minimally-invasive image-guided surgical techniques. The benefit of these minimally-invasive procedures is their low risk profile - they can typically be performed without the need for general anaesthesia and may offer an alternative to open surgery. The range of procedures Interventional Radiologists perform is wide. The following is just a snapshot of some of the areas in which an IR may chose to specialise. - Trauma: Ever been in a car accident resulting in internal bleeding? You may have had an IR working on you at 3am to keep you alive. IRs perform endovascular embolisation of acute haemorrhage - aka, blocking bleeding blood vessels, without the need for open surgery. We enter the blood vessels with a tiny tube called a catheter, find the bleeding artery using x-ray guidance and block it with a small metal coil or glue-like substance. - Oncology: Using the same endovascular technology described above, we deliver chemotherapy or radiotherapy impregnated microscopic beads into the heart of tumours. In addition, using ultrasound or CT guidance, we place electrodes into tumours via the skin. We then treat the cancer by cooking or freezing the tumour. - Osteoarthritis: Endovascular embolisation techniques can also be used to treat the inflammation associated with osteoarthritis. Download our brochure about Genicular Artery Embolisation for more details. This is most commonly used for OA in the knee, however the same technique is being utilised in the shoulder and other joints with good clinical success (currently in research hospitals only). We also use microwave probes to burn the nerves around arthritic joints, resulting in pain relief (aka nerve ablation). - Benign prostatic hyperplasia: In addition to the effective procedures offered by our urology colleagues, IR is involved in the treatment of enlarged prostates. Prostatic artery embolisation (PAE) is another endovascular procedure, which decreases the blood supply to an enlarged prostate, causing it to reduce in size. - Uterine fibroids: Like PAE, uterine artery embolisation decrease the blood supply to uterine fibroids, causing them to shrink. - Pulmonary pathology: IRs use endovascular techniques to open blocked blood vessels in the lungs (clot retrieval or balloon angioplasty) or shut down abnormal communications between the pulmonary vessels (pulmonary AVMs). - Strokes: Interventional Neuroradiologists are a subspecialist branch of IR and use the prementioned endovascular techniques to retrieve blood clots from the brain. They are the other endovascular specialists you may meet at 3am. - Vascular Malformations: Embolisation of vascular malformations in the skin, muscle, brain, spine, lungs and other organs. - And much much more.