The goal of this clinical trial is to investigate the effectiveness and safety of intra-articular corticosteroid injection (IACI) in alleviating post-procedural pain and improving early outcomes in patients undergoing geniculate artery embolization (GAE) for knee osteoarthritis (OA). The main questions it aims to answer are:

• Does intra-articular corticosteroid injection reduce pain levels post-procedure compared to GAE alone?
• Does the combination of GAE and IACI improve functional outcomes and patient-reported outcomes compared to GAE alone?

Investigators will compare patients receiving GAE with IACI to those receiving GAE alone to see if the addition of IACI provides superior pain relief and functional improvement.

Participants will:

• Undergo geniculate artery embolization, with or without intra-articular corticosteroid injection.
• Have their pain levels assessed using the Visual Analog Scale (VAS) at 1 week, 2 weeks, and 4 weeks post-procedure.
• Complete functional outcome assessments using the KOOS and WOMAC scores.
• Report any adverse events throughout the study period.

This study is a prospective, randomized, comparative trial designed to evaluate the role of intra-articular corticosteroid injection (IACI) in patients undergoing geniculate artery embolization (GAE) for knee osteoarthritis (OA). The trial will enroll adult participants diagnosed with knee OA who are eligible for GAE.

Participants will be randomized into two groups: Group A (GAE with IACI) and Group B (GAE alone). The primary outcome measure will be the Visual Analog Scale (VAS) pain scores at 1 week, 2 weeks, and 4 weeks post-procedure. Secondary outcome measures will include functional improvement assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the Western Ontario and McMaster Universities Arthritis Index (WOMAC), patient-reported outcomes, and the incidence of adverse events.

The study aims to determine whether the addition of IACI to GAE provides better pain relief and functional outcomes compared to GAE alone. Data will be collected at baseline and specified time points post-procedure, and statistical analysis will be conducted to compare the outcomes between the two groups. This study is conducted in accordance with the principles of the Declaration of Helsinki and has received ethical approval from the institutional review board. Informed consent will be obtained from all participants before enrollment.

Inclusion Criteria:

• Adults aged 18 years and older
• Diagnosed with knee osteoarthritis (OA) based on clinical and radiographic criteria.
• Eligible for geniculate artery embolization (GAE) as determined by the treating physician.
• Able to provide informed consent and comply with the study protocol.

Exclusion Criteria:

• Contraindications to corticosteroid injections or geniculate artery embolization.
• Pregnant or breastfeeding women.
• Active infection or skin condition at the injection site.
• Severe cardiovascular, renal, or hepatic diseases that may affect study participation.
• Previous knee surgery within the last 6 months.
• Participation in another clinical trial within the last 30 days.
• Inability to comply with follow-up visits or complete study assessments.

At this time, there is no plan to share individual participant data (IPD) with other researchers. This decision is based on considerations related to patient confidentiality, data privacy concerns, and the absence of a current infrastructure for secure data sharing. The primary results of the study will be published in peer-reviewed journals and presented at scientific conferences, ensuring that the findings are accessible to the broader research community.

Given the specific nature of the interventions, it may not be possible to blind participants or operators; however, to minimize potential bias, outcome assessors will be blinded to the treatment assignments.