Hip Embolization Research: What the Studies Show

If you are reading about hip embolization, you deserve a clear picture of the evidence behind it. This article summarizes every published clinical study of embolization for hip pain that we could find as of October 2026, plus the trials now underway. The short version: early results are encouraging, but the research is small, short and without placebo comparisons. For an overview of the procedure, see our hip embolization page.

The bottom line

• Hip embolization is the least studied of the joint embolization procedures.
• We found eight published clinical reports on embolization for hip pain: one single-patient case report and seven small studies ranging from 13 to 49 treated patients.
• No randomized trial and no sham-controlled (placebo) trial of hip embolization has been published.
• Follow-up in most studies is 3 to 12 months.
• Pain scores improved on average in every study, and serious complications were not reported, but these designs cannot separate the effect of the procedure from the placebo effect or natural improvement.

Studies in hip osteoarthritis

Study	Design and size	Main findings
Fleckenstein et al., Berlin, 2026	Retrospective, single center, 41 patients, up to 12 months	Median pain 7 to 4 out of 10 at 12 months; 64% reached a meaningful pain improvement; 2 patients (4.9%) had hip replacement; no major or moderate complications
HipE study, Portugal, 2026	Prospective, single arm, 49 treated (31 arthritis and 6 outer hip pain among the 37 who reached 12 months)	Average pain 7.8 to 4.0 out of 10 at 12 months; 73% met the study's success definition; 2 minor groin hematomas
Feier et al., Romania, 2025	Prospective pilot, 18 older adults unable to have surgery, 12 weeks	Average pain 7.8 to 4.3 out of 10; hip function score 45.5 to 62.1; no adverse events
Feier, Bloj et al., 2026	Prospective, non-randomized comparison, 26 embolization vs 36 conservative care, 6 months	More improvement with embolization in pain, function, walking test and pain medicine use; see below
FIRE-NEM, Italy, 2026	Retrospective, 42 patients, 50 procedures, 24 of them in the hip, 6 months	Results reported for all joints combined; 71% reached a meaningful pain improvement at 6 months

The Berlin authors were direct about the limits of their own work: without a control group, they wrote, it is not possible to tell true treatment effect from placebo response.

Studies in outer hip pain (greater trochanteric pain syndrome)

Pain on the outside of the hip usually comes from irritated gluteal tendons and the bursa near them. Embolization research here comes mainly from one group in Brazil:

• 2020 case report: one 77-year-old woman with long-standing hip pain improved over four months after embolization of a branch of the lateral femoral circumflex artery.
• 2022 cohort: 13 patients, 10 with outer hip pain and 3 with hip arthritis, all without an indication for surgery. Reported pain scores fell from 10 to 2 out of 10 at six months, and an arthritis symptom score (WOMAC) fell from 77 to 27. Two patients had temporary thigh numbness.
• 2025 registry update: 31 patients (38 hips) with outer hip pain. At last follow-up, 21 hips had low pain scores (0 to 3), 7 had moderate scores (4 to 6), and 9 had no improvement (7 to 10).

The HipE study also included six people with outer hip pain alone and found no significant difference in results between them and the arthritis group, though six people is far too few to draw conclusions.

This article is part of our Embolization Guide.

The only comparison study so far

The 2026 study by Feier, Bloj and colleagues is the only hip study with a comparison group. It enrolled people aged 60 or older with moderate hip arthritis who were judged too high-risk for hip replacement. Patients were not randomly assigned. Twenty-six had embolization and 36 had structured conservative care.

At six months, 71% of the embolization group had a clinically meaningful drop in pain, compared with 34% of the conservative care group. Function, walking speed and pain medicine use also improved more with embolization. However, after adjusting for differences between the groups, the average pain difference was about 9 points on a 100-point scale, which did not reach the 15-point threshold the authors had set in advance as clinically important. The embolization group also started with higher pain scores, which can make improvement look larger.

Why placebo-controlled trials matter

Chronic pain responds strongly to expectation, attention and time. That is why the knee, the most studied joint, has been tested against sham procedures, where patients do not know whether they received the real treatment. Even there, results are mixed. A 2026 insurer guideline notes that of three sham-controlled knee trials, two found no benefit over sham. You can read more about the knee evidence in our GAE evidence and safety article. No hip study has yet passed this test.

What independent reviewers say

• A 2026 review in CVIR Endovascular grouped hip embolization with other joints outside the knee as "hypothesis-generating," with very limited early reports, durability unknown, and joint-specific safety not fully defined.
• A 2026 German review found the strongest evidence for the knee and only emerging data for the hip, and said the benefit over placebo still needs confirmation.
• A 2026 review of lower-limb embolization called it a promising option for selected patients that warrants further prospective study.
• The 2026 American College of Rheumatology osteoarthritis guideline summary does not include embolization among its recommendations for hip arthritis.

Trials now underway

• HIPE randomized trial (NCT07396246), Portugal: compares embolization with a platelet-rich plasma injection for outer hip pain in about 30 patients, with pain measured up to 12 months. It began recruiting in January 2026 and is expected to finish at the end of 2027. It is the first randomized hip embolization trial, though it compares against another treatment rather than a sham.
• VA Palo Alto study (NCT05700682): uses a special MRI to look for abnormal blood flow around painful shoulders, hips and knees in veterans, then offers embolization to some. It plans about 40 participants per joint.

What we still do not know

• How much of the benefit is due to the procedure rather than placebo.
• How long relief lasts beyond about a year, and whether repeat treatment works.
• Which patients are most likely to benefit, and whether arthritis severity matters. Our candidacy guide explains who was included in the studies so far.
• Whether embolization delays hip replacement or affects its later results.
• Whether it helps pain after a hip replacement. We found no published studies on this.

If you are weighing your options, our comparison of hip embolization, hip replacement and injections puts this evidence side by side with established treatments. You can also explore the wider field in our embolization guide.

Frequently Asked Questions

Is hip embolization proven to work?

Not yet. Small studies show average pain improvement, but none compared the procedure with a sham treatment, so the size of the true effect is unknown.

How many people have been studied?

The published hip studies we found include roughly 220 patients in total, with the largest single study treating 49 people. That is far fewer than the knee, which has been studied much more.

Are there clinical trials of hip embolization?

Yes. A randomized trial in Portugal (NCT07396246) is comparing embolization with platelet-rich plasma injection for outer hip pain, and a VA study in Palo Alto (NCT05700682) includes the hip. Neither has reported results yet.

Does the American College of Rheumatology recommend hip embolization?

The 2026 ACR osteoarthritis guideline summary does not include embolization. It strongly recommends exercise, weight loss when needed, oral anti-inflammatory medicines and steroid injections for hip arthritis.

Keep Reading

• Hip Embolization in Manhattan
• Hip Embolization Risks and Side Effects: What Studies Report
• Hip Embolization vs. Hip Replacement and Injections: An Honest Comparison
• What Is Causing Your Hip Pain? Arthritis, Bursitis and Tendinopathy Explained
• Is Hip Embolization Covered by Insurance?
• Is Hip Embolization Painful? What to Expect Before, During and After
• Embolization Guide: knee, heel, shoulder, elbow and hip

Sources

1. Fleckenstein et al., Cardiovasc Intervent Radiol, 2026 — Transarterial embolization for symptomatic hip osteoarthritis (41 patients)
2. Cavalheiro, Marinho Lopes et al., Cardiovasc Intervent Radiol, 2026 — HipE study: hip embolization for hip OA and GTPS, 12-month follow-up
3. Feier et al., Cureus, 2025 — Periarticular embolization via brachial access in older adults with hip OA: pilot study (18 patients)
4. Feier, Bloj et al., J Clin Med, 2026 — Periarticular embolization vs conservative care in surgery-ineligible hip OA (prospective comparative study)
5. Discalzi et al., Radiol Med, 2026 — FIRE-NEM: microembolization for refractory hip, knee and shoulder pain (42 patients)
6. Correa et al., CVIR Endovascular, 2020 — Short-term follow-up of embolization of hip synovitis (case report)
7. Correa et al., Cardiovasc Intervent Radiol, 2022 — 6-month follow-up of lateral femoral circumflex artery embolization for hip OA and GTPS (13 patients)
8. Giordani et al., Cardiovasc Intervent Radiol, 2025 — Latino-Hip registry: midterm follow-up of embolization for GTPS (31 patients)
9. Pelage et al., CVIR Endovascular, 2026 — Transarterial embolization in musculoskeletal care: indication-stratified narrative review
10. Can et al., Radiologie, 2026 — Transarterial periarticular embolization for chronic joint pain (review, German)
11. Hur and Choi, Semin Intervent Radiol, 2026 — Transarterial embolization for lower-extremity musculoskeletal pain (GTPS, Achilles, plantar fasciitis)
12. Carelon Medical Benefits Management (Anthem/Elevance) — Vascular Embolization and Occlusion Procedures, effective Nov 2026
13. American College of Rheumatology, 2026 — Update of recommendations for management of osteoarthritis of the knee, hip, and hand (summary)
14. ClinicalTrials.gov NCT07396246 — HIPE RCT: embolization vs PRP injection for greater trochanteric pain syndrome
15. ClinicalTrials.gov NCT05700682 — Perfusion MRI-targeted joint embolization for shoulder, hip and knee pain (VA Palo Alto)

Medically reviewed by David Fox, MD, FACS, RPVI. This article is general information, not a substitute for a medical evaluation.

Living with joint or tendon pain that hasn’t improved? Schedule a consultation with Dr. David Fox at Fox Vein & Vascular in Manhattan to find out whether embolization is right for you. Call (212) 362-3470 or request an appointment online.