Overview
Millions of adults live with the debilitating effects of chronic hip pain, most often caused by osteoarthritis. As the cartilage in the hip joint wears down, the lining of the joint, the synovium, can enter a state of chronic inflammation. That inflammation signals the body to grow abnormal, microscopic new blood vessels in the hip capsule, and those vessels are accompanied by highly sensitive nerve fibres, creating a constant cycle of joint pain.
Transcatheter arterial micro-embolization (TAME) of the hip is a cutting-edge, minimally invasive procedure that safely reduces these abnormal blood vessels and stops the pain at its source.
It is a breakthrough alternative for patients who have plateaued with conservative therapy and want to delay or avoid a total hip replacement.
Hip embolization stops the cycle of chronic joint inflammation, significantly reducing pain and improving daily mobility without joint-altering surgery or a gruelling rehabilitation.
Who it’s for
Most patients considering hip embolization come to the clinic with mild to moderate hip osteoarthritis. They have typically exhausted conservative treatment such as physical therapy, anti-inflammatory medication, weight management, and cortisone or gel injections without lasting relief. The pain is actively interfering with their quality of life, making it difficult to walk, climb stairs, or sleep comfortably.
Recent X-rays or an MRI are used to assess how much joint wear is present and to confirm the inflammatory changes that make you a good candidate for the procedure.
Who is not a candidate
If your hip pain is caused by severe, end-stage bone-on-bone arthritis with significant joint deformity, by an acute fracture, or by an active joint infection, embolization may not be the appropriate treatment. In those cases we will direct you to the right orthopedic surgeon for your care.
How the procedure works
1. Accessing the artery
An interventional radiologist cleans and numbs a small area, usually at the top of the thigh or at the wrist. A tiny tube called a catheter is inserted through a small needle puncture access into the artery.
2. Navigation and imaging
Using real-time X-ray guidance (fluoroscopy), the catheter is navigated directly to the tiny articular arteries supplying the inflamed capsule of the hip joint. You will not feel this happening inside your body.
3. Embolization: blocking the vessels
Once the catheter is precisely positioned near the abnormal vessels, either crystallised antibiotic particles or tiny gel particles are delivered into them. These wedge safely into the inflammatory vessels and block their abnormal blood flow, while preserving the healthy surrounding bone and tissue.
4. Relief and restoration
Deprived of their abnormal blood supply, the inflamed synovial tissue shrinks and the extra nerve endings recede. That breaks the cycle of chronic pain and allows the joint environment to calm down. The catheter is removed and a simple bandage is applied.
What to expect on the day
When you arrive, our team will get you comfortable and start an IV. You will be given “twilight” sedation, so you will be relaxed and sleepy but breathing on your own, without a breathing tube or general anesthesia.
The procedure itself typically takes 45 minutes to an hour. Afterward you will rest in our recovery room for about an hour while the sedation wears off. Because there are no surgical incisions and the joint itself is never opened, you go home the same day.
Recovery
Recovery is highly manageable compared with traditional joint surgery. On day one, plan to rest at home. You may have mild soreness at the access site, and your hip may feel slightly achy or stiff. This is completely normal and is easily managed with over-the-counter pain relievers such as ibuprofen or acetaminophen.
By the end of the first week most patients feel completely back to their baseline. You can typically return to a desk job or normal daily activities within one to two days. We ask that you avoid heavy lifting, strenuous leg exercise, and high-impact activity for about a week so the access site heals properly. As the underlying joint pain subsides over the following weeks, walking and light physical therapy become much easier.
What is normal, and when to call
Mild bruising at the entry site is completely normal. Call our office if you experience severe or worsening hip pain, a fever above 101°F, active bleeding at the access site, or any sign of infection.
Risks and considerations
Transcatheter arterial micro-embolization is highly safe, but as with any procedure there are potential risks, and we would rather set them out plainly.
Common, minor side effects include bruising at the access site and temporary skin discolouration over the upper thigh or hip. This looks like a mild rash and resolves completely on its own within a few days.
Rare but more serious risks include infection, injury to the blood vessel, and non-target embolization, where the particles block blood flow to healthy tissue. Because the procedure is performed by a highly trained interventional radiologist using advanced, real-time imaging, the risk of major complications is extremely low.
Results and evidence
The clinical evidence supporting arterial embolization for osteoarthritis is very promising and continues to expand rapidly. Studies show a technical success rate of nearly 100%, meaning the target arteries feeding the hip can almost always be reached and treated successfully.
For symptom relief, 70% to 80% of patients experience a significant decrease in pain both at rest and when bearing weight. Because the pain is relieved, patients are able to regain their mobility and return to low-impact activity.
Early clinical data show that these results are durable over time, allowing patients to bridge the gap between failed conservative therapy and the point at which a joint replacement becomes necessary.
Common questions
- Is it painful?
- The procedure is well tolerated. We numb the entry site with local anesthesia and provide IV sedation to keep you relaxed, and you will not feel the catheter inside your body. Afterward your hip may ache mildly for a few days, which is easily managed with over-the-counter pain medicine.
- Will insurance cover it?
- Coverage can vary, because TAME for joint osteoarthritis is a newer and highly specialised application of embolization. Some major carriers cover it once standard treatments such as steroid injections and physical therapy have failed, while others currently consider it investigational. Our office will work closely with your insurance provider to verify your exact benefits and out-of-pocket costs before you proceed.
- How soon will I notice a difference?
- Many patients notice a significant reduction in hip pain within the first two to four weeks. As the joint inflammation settles you will find it much easier to walk and climb stairs, with continued improvement in function over the next one to three months.
- What happens if it doesn’t work?
- If you do not have adequate relief after a few months, we will re-evaluate your hip. And if embolization ultimately does not relieve your symptoms, it burns no bridges: you remain a full candidate for traditional orthopedic treatment, including a total hip replacement if that becomes necessary.
