Dr. Öğr. Üyesi Görkem Kıyak
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Sports Medicine & Arthroscopy
Transarterial micro-embolisation (tame)
What transarterial micro-embolisation (TAME) is, how it blocks the tiny abnormal blood vessels that feed painful inflamed joint tissue, what the evidence says for knee osteoarthritis and tendon pain, how it compares with injections and knee replacement, approximate costs in Turkey against the UK, US and Germany, recovery and risks.
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Transarterial micro-embolisation (TAME) in Turkey: what it is
Transarterial micro-embolisation (TAME) is a minimally invasive procedure for long-lasting joint and tendon pain, most often knee osteoarthritis. Chronic inflammation in a painful joint lining or tendon is accompanied by tiny, abnormal new blood vessels (neovessels) and nerve fibres that feed the inflammation and carry pain signals. An interventional radiologist passes a thin catheter through a small puncture in the wrist or groin, guides it to the small arteries supplying the painful area and releases microscopic particles that block those fragile vessels. When the procedure is aimed at the knee it is often called genicular artery embolisation. Interventional radiology units in Turkey now offer it for knees and, less often, shoulders, elbows and heels.
This guide explains how TAME works, what the research does and does not show, who it suits, what it costs compared with the UK, US and Germany, and what to ask a clinic. It is an option for people who want something between injections and joint surgery; see our orthopedics treatments in Turkey for the full range.
How does transarterial micro-embolisation (TAME) work?
The idea comes from Japanese interventional radiology and rests on a simple observation: in a chronically painful knee or tendon the lining is over-supplied by abnormal vessels. Blocking a small number of these reduces the blood flow that sustains low-grade inflammation, and with it pain. The particles used vary between centres. Some use imipenem/cilastatin, an antibiotic mix that forms temporary crystals and dissolves after a few hours; others use permanent calibrated microspheres. The temporary approach is thought to close only the very smallest vessels, which is why it is called micro-embolisation. Which agent is used, and its evidence base, should be explained to you before you agree.
TAME does not rebuild cartilage and does not change the shape of an arthritic joint. Its aim is to turn pain down, so that you can walk, exercise and take part in physiotherapy.
Does TAME work? What the evidence says
Small clinical trials, case series and early randomised studies of knee embolisation report reduced pain and better function for many people for months, with some reporting benefit at one to two years. The research is still limited: studies are small, follow-up is often short, many lack a proper control group, and different particles and technique make results hard to compare. Interventional radiology societies describe the technique as promising but emerging, and in several countries it is offered in research or specialist settings. TAME for the shoulder, elbow or tendons rests on even less evidence than for the knee.
So an honest summary is this: TAME is a reasonable option for some people with moderate knee osteoarthritis whose pain has not improved with standard care and who do not want, or are not yet ready for, replacement surgery. It is not proven to delay or avoid surgery, and no clinic should promise that.
Who is a good candidate for TAME, and who is not?
People who tend to be suitable have persistent knee pain for months despite exercise, weight management, simple painkillers and injections, with imaging showing mild to moderate osteoarthritis. The doctor will usually ask for an X-ray or MRI first, to confirm the pain really comes from the joint. TAME is generally not suitable when:
- the joint is badly worn and bone-on-bone, where a replacement is usually the better option;
- there is an active infection in or near the joint, or a skin infection at the puncture site;
- you have severe kidney problems, an allergy to contrast dye or to the planned embolic agent;
- you have significant narrowing of leg arteries, or are pregnant;
- the pain comes from the spine, hip or a mechanical problem such as a torn meniscus that needs a different treatment.
For mechanical injuries such as a torn meniscus, see arthroscopic meniscus repair.
Step by step: how is the TAME procedure done?
You are awake, with local anaesthetic at the puncture site and sometimes light sedation. A thin catheter is advanced under X-ray guidance, and contrast dye is injected to map the arteries around the painful area. The radiologist identifies the vessels that show abnormal blush, then delivers the particles through a micro-catheter, checking with further images that those branches have closed and that normal supply to skin and muscle is preserved. The catheter is removed and the puncture is closed with pressure or a small closure device. The whole procedure usually takes between 45 and 90 minutes, longer if several joints are treated. Most people go home the same day or after one night.
Transarterial micro-embolisation (TAME) cost in Turkey compared with the UK, US and Germany
The figures below are approximate ranges for one knee, not hospital quotes. They depend on the embolic agent, how many joints are treated, the imaging done before and after and whether you stay overnight. Each hospital confirms its own price in a written quote.
| Country | Approximate cost range (one joint) |
|---|---|
| Turkey | €1,500 – €4,500 |
| United Kingdom | €3,500 – €9,000 |
| United States | €6,000 – €16,000 |
| Germany | €3,500 – €8,500 |
What changes the price: permanent microspheres cost more than temporary agents, MRI or ultrasound before the procedure, treating two knees, and day-case against overnight stay. A package normally includes the consultation, imaging review, the procedure, the radiology team, medication and airport transfers; ask for the list in writing and whether a repeat session is included or charged separately.
TAME, injections or knee replacement: how do they compare?
TAME sits in the middle of the ladder of treatments. Injections are quick and cheap but their effect is often short; a replacement is a major operation with long-term results for advanced disease. See our guides to knee arthroscopy and total knee replacement for the surgical options.
| Option | Best suited to | Typical limits |
|---|---|---|
| Injections (steroid, hyaluronic acid, PRP) | Mild to moderate knee osteoarthritis, short-term relief | Benefit often fades within months; evidence varies by type |
| TAME / genicular artery embolisation | Moderate osteoarthritis with persistent pain, not ready for surgery | Limited long-term data; does not repair cartilage; not for severe disease |
| Knee replacement | Advanced osteoarthritis with severe pain and loss of function | Major surgery and rehabilitation; long recovery |
Which joints can be treated with TAME?
The knee is where most experience lies. Other sites reported in smaller series include shoulders with persistent stiffness and pain, elbows (tennis elbow), the base of the thumb, the heel and the Achilles or patellar tendon. Each site has different anatomy and fewer published results, so ask how many patients with your condition the team has treated and whether treatment in that joint is considered standard or experimental in their hospital.
What results can I expect from TAME?
Pain relief, when it comes, usually builds over several weeks rather than immediately; some people notice a change within days, others need up to a month or two. Reported improvements vary from small to large, and some people feel no benefit. TAME does not change X-ray or MRI appearance of the joint, so the pictures will look the same. Success is measured by pain scores, walking distance and how well you cope with stairs and exercise. If your knee improves, the aim is to use the window to strengthen the muscles around it. If it does not, you have still kept the choice of surgery.
Your trip to Turkey and recovery after TAME
Most patients stay four to six days: one or two days for assessment and imaging, the procedure, and a check-up the next day or two. The puncture site is checked for bruising and bleeding and you are asked to rest the leg or arm for the first day. Walking is normally allowed immediately, but avoid heavy exertion for about a week. A mild ache, small bruise at the puncture site or a warm, tender patch on the skin over the joint is common. Gentle physiotherapy usually starts within days and a normal exercise routine resumes over two to four weeks. Many centres use a short course of anti-inflammatory medication, within the limits of your health, and review you by video after you are home. Flying home is generally permitted once the team has checked the puncture site.
Risks and complications of TAME
TAME avoids a surgical cut, but it is still an arterial procedure. Common effects are bruising or a small lump at the puncture site, temporary skin discolouration or numbness near the joint and short-lived soreness. Less common risks include bleeding, infection, injury to the artery, an allergic reaction to contrast dye, kidney strain from the dye and, rarely, damage to skin or other tissue if particles reach unintended vessels. Radiation exposure is small but real. Professional radiology societies, including the Cardiovascular and Interventional Radiological Society of Europe, advise that new techniques be discussed with a qualified interventional radiologist, with clear consent about the level of evidence. Ask what the team does if symptoms do not improve.
How do I choose a hospital for TAME, and what are the red flags?
Look for a qualified interventional radiologist (not only an orthopaedic or pain clinic), a hospital with a full angiography suite and anaesthetic support, and a written explanation of the agent used and its evidence. Red flags include promises of a cure or of avoiding knee replacement, no imaging review before the procedure, no named radiologist and pressure to book several joints at once. Read how our process works and ask for a plan through our free quote page: the hospital reviews your scans and sends a written plan and price.
What should I ask the clinic about TAME?
- Which embolic agent will be used, and is it temporary or permanent?
- How many TAME procedures has the radiologist performed on my joint?
- What did my scans show, and is TAME recommended or experimental in my case?
- What happens if the pain does not improve, and is a repeat session charged?
- What after-care and video follow-up are included?
Hospitals with Orthopedics in Turkey
Frequently asked questions
TAME is a minimally invasive procedure in which a radiologist uses a thin catheter to block tiny abnormal blood vessels that feed painful inflamed joint or tendon tissue. It is most often used for knee osteoarthritis pain.
Small studies show reduced pain for many people for months, and some for one to two years, but the evidence is limited and results vary. It is not proven to delay knee replacement, and some people feel no benefit.
Approximate ranges are €1,500 to €4,500 per joint in Turkey, against about €3,500 to €9,000 in the UK. The price depends on the embolic agent, imaging, number of joints and stay; the hospital confirms its price in a written quote.
Genicular artery embolisation is TAME aimed at the knee, using the genicular arteries around the joint. The term TAME is broader and also covers shoulders, elbows and tendons.
The puncture site is numbed and you may have light sedation, so the procedure itself is not usually painful. Afterwards a mild ache and a small bruise are common, and some people feel a warm tender patch over the joint.
Relief usually builds over several weeks. Some people notice a change within days, others take one to two months, and some experience no improvement.
It is generally well tolerated, but it is an arterial procedure with risks such as bleeding, bruising, infection, contrast reaction and, rarely, skin or tissue damage. A qualified interventional radiologist should discuss these before consent.
It is not a substitute for a replacement in advanced disease. It may help some people with moderate osteoarthritis manage pain for a time; it does not rebuild cartilage.
Plan four to six days: assessment and imaging, the procedure, and a check of the puncture site and your knee before you fly home.
Sometimes, but many teams treat one knee first to see how you respond. Your radiologist will advise based on your scans, kidney function and the contrast dose needed.
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