The goal of this observational study (prospective registry) is to collect long-term real-world data on the effectiveness and safety of genicular artery embolization (GAE) for knee osteoarthritis in adults aged 18 years or older with symptomatic KOA that has not responded to medical therapy.

The main questions it aims to answer are:

1. Does GAE lead to sustained improvement in pain (WOMAC, VAS) and quality-of-life scores over 12-36 months?
2. What patient or procedural factors are associated with better outcomes after GAE?

Participants will:

• Undergo GAE as part of their routine clinical care.
• Complete clinical follow-up assessments at 1, 3, 6, 12, 18, 24, and 36 months after treatment, including symptom and quality-of-life questionnaires.
• Have safety outcomes tracked according to Society of Interventional Radiology guidelines.

There is no comparison group; results will be analyzed to identify predictors of success and inform best practices for patient selection and treatment.

Inclusion Criteria:

• Adults (≥18 years) with symptomatic KOA refractory to medical therapy, referred for GAE.

Exclusion Criteria:

• Pregnancy, coagulopathy, severe comorbidities, or inability to consent.

The study population consists of adult patients (18 years and older) presenting to the Joint & Vascular Institute for clinical consultation regarding symptomatic knee osteoarthritis. This population includes individuals who have failed standard medical management and are seeking minimally invasive alternatives to total knee arthroplasty. The registry will include men and women of all races and ethnicities without exclusion, provided they meet the clinical criteria for GAE as determined by the Principal Investigator or Sub-Investigators.