Question 1

How much does Genicular Artery Embolisation cost?

Accepted Answer

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.

Question 2

Does GAE hurt?

Accepted Answer

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.

Question 3

I've never heard of GAE.  Is there research supporting this?

Accepted Answer

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.

Question 4

Do you do Genicular Nerve Ablation?

Accepted Answer

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.

FAQ

Frequently asked questions

How much does Genicular Artery Embolisation cost?

Does GAE hurt?

I've never heard of GAE. Is there research supporting this?

Do you do Genicular Nerve Ablation?