Genicular Artery Embolization vs Nerve Ablation Intervention (GENI) for Knee Osteoarthritis

Inclusion Criteria: * Age \> 40 years * Able to provide informed consent * Knee pain due to osteoarthritis for at least 6 months * Pain refractory to conservative therapies (oral medication, or physical therapy, or activity modification) for at least 3 months with a desire for TKA * Candidate for TKA at Hotel Dieu Hospital Site * Able to comply with all treatments and protocol follow-up visits Exclusion Criteria: * Current local infection * Systemic or joint centered inflammatory disease (ie rheumatoid arthritis, Lupus, multiple sclerosis or other autoimmune diseases) * Current use of systemic immunosuppression therapy * Known lower extremity vascular disease or lower extremity symptoms thought to be secondary to arterial vascular disease (eg claudication, ischemic rest pain) * Irreversible coagulopathy * Renal dysfunction as defined by GFR (eGFR) of \<30 obtained within the past 60 days * Contraindication for MR Imaging (such as claustrophobia, metallic fragment or foreign bones, implants or prosthesis) * IV CT and/or MRI contrast allergy characterized by anaphylaxis or anaphylactoid reactions * Pregnancy or women of childbearing potential not currently on a medically acceptable method of birth control