Arthrosamid
What Is Arthrosamid?
Arthrosamid® is a non-absorbable, non-biodegradable, injectable, gel consisting of non-biodegradable cross linked polyacrylamide (2.5%) and attached non-pyrogenic water (97.5%).Â
It is also known as an intra-articular polyacrylamide hydrogel (iPAAG)Â
It is a non toxic similar to Hyaluronic acid in overall structure and tissue compatibility but with a longer lasting ‘viscous’ effect.
It is a novel treatment for Knee OsteoarthritisÂ
When injected into the knee. it offers sustained pain relief compared to other injections in the market.
How does Arthrosamid achieve this effect?Â
It embeds into the Knee Synovium and helps reduce the pain and inflammation in Knee Arthritis
It is non degradable product which helps it to lubricate and cushion the joint for longer without breaking down. It becomes an integrated part of the soft synovial tissue in the joint capsule and is therefore classed as a knee implant.
It works by reducing stiffness, and offers relief from pain associated with Knee Osteoarthritis.Â
It slows down the degeneration of the knee with a single injection and as a result, can lead to better functioning of the knee.
It has been used in the UK for 2 years and in Denmark for over 10 years. Dr Andreas Hartkopp and Professor Paul Lee are the pioneers of Arthrosamid in Denmark and the UK respectively.
In many patients it has delayed or prevented the need for Knee Replacement Surgery.
My MSK Clinic were the early adopters of Arthrosamid and started injecting this product in late 2022.Â
We have also found the product to delay the need for Osteoarthritis and provide pain relief in our patients.
We are therefore delighted to be able to offer this exciting revolutionary treatment in the battle against Osteoarthritis.
Dr Akhtar’s view on Arthrosamid:Â
‘There is no question to the quality of the product. We have been using the product in our clinic for 2 years and found it to delay knee replacement surgery in many of our patients.
Results are dependant on factors such as Body weight, Stage of Osteoarthritis and Age.
Unfortunately the product does not work for every case but we have had good results in many patients and therefore are happy to recommend it to patients’
History of Arthrosamid
Arthrosamid was formulated by Contura in Denmark approximately 20 years ago.
Initially it was used in aesthetics as a skin filling agent and also used in plastic surgery for patients with skin burns undergoing skin repair procedures. As Contura developed the product further, its application evolve to include women with stress urinary incontinence where it is known as Bulkamid
In 2000, the Contura team and its chief Scientific officer, Dr Ankorina Stark, aware of the unique properties of this hydrogel, decided to trial the product in joints.
in 2006 the Contura team investigated the application of the hydrogel on rabbits and found it integrated into the synovial membrane of the joints without side effects.
In 2008. Dr Stark and her colleagues led by Dr Aziz Tnibar carried out research on goats. It was found the hydrogel slowed down the progress of Osteoarthritis and improve Joint capsule elasticity. MRI’s were performed prior to and at 3, 4, 5 and 7 months post injection. MRI follow up showed reduction followed by stabilisation of the OA lesions after PAG treatment in Goats.
In 2009, Arthrosamid was injected into a horse suffering severe lameness in 2 joints and on the verge of being put down. One of the Vets Linus Camitz, injected the joints with the hydrogel and within a few weeks finished a race in fourth position. According to Contrura, this opened the ‘floodgates’ to the use of the hydrogel becoming more widespread amongst Vets
Following this, a 2y study involving 43 horses was carried out which showed after one single injection of 2ml of hydrogel into the affected joint, 82.5% of horses were lame free.
In 2010, the first human received hydrogel via Dr Andreas Hartkopp and experienced an immediate improvement. Dr Hartkopp began to treat a number of patients compassionately off label, with encouraging results.
After discussions with his colleagues in Denmark including Dr Hartkopp, Dr Akhtar now also treats patients in the UK for both Knee Osteoarthritis and Osteoarthritis in the Shoulder, Hip or Ankle with Arthrosamid.
How Does Arthrosamid Work?
The Arthrosamid Injection interacts with the synovial membrane and reduces degeneration in the knee joint. This leads to enhanced lubrication and better cushioning in the knee
The outcome of a single injection can help greatly reduce pain.
It is injected into the inner joint cavity and improves the viscosity of the synovial fluid that’s located at your knee joint.
How Is Arthrosamid Injection Administered?
The Arthrosamid Injection can only be administered by a qualified specialist such as a MSK specialist or an Orthopaedic surgeon. It is injected into the knee joint under image guidance to ensure accuracy.
It is a minimally invasive procedure that can also be done as an outpatient. You won’t need to be admitted to a hospital to receive this treatment.
An antibiotic is given prior to the injection as this is a knee implant. This is to minimise the possibility of an infection.Â
Arthrosamid Injection Process
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Antibiotics are taken in advance of the procedure
A local anaesthetic is administered at the injection site to numb the area to be injected. This is perhaps the only pain that you might feel.
After the injection has been administered, you will be advised to rest and ICE the knee for 48 hrs
The steps involved in the administering of Arthrosamid Injection are as follows:
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First, the knee is thoroughly cleaned and sterilised
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The injecting of Arthrosamid Injection takes place with the assistance of imaging to ensure that it’s administered accurately
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A needle is used for administering the knee injection
- The needle is removed, and the injection site is covered using a plaster.
Once the knee injection is administered, you can go home straight away. You don’t need to stay at the clinic after the treatment.
What Does The Arthrosamid Research Say?
The hydrogel does not degrade over time and thus is capable of providing long-term relief to knee pain. The clinical trials saw patients reporting a major reduction in knee pain after four weeks of the Arthrosamid Injection treatment.
In addition, the level of reduction was maintained during the first 3 years. In approximately 70% of patients, they will see a significant pain reduction with a single knee injection for at least 3 years and possibly longer.
Patient with Grade 2 and 3 Arthritis and patients with a lower body mass index seem to have the best results and in the under 70’s successful outcomes have been reported in up to 80% of patients.
The 3 year post Arthrosamid Injection study (from Denmark) was recently published and shows even at the 3 year mark, Arthrosamid is working providing relief for Knee Joint Pain.
In the 3 year study outlined in the graph below, 49 patients were recruited. The average age was 70 (with a range from 44-86). the average BMI was 27.5. 45 patients completed the first 1yr with a decrease in WOMAC score of -17.5 (The WOMAC questionnaire is administered to patients as a score quantifying pain, stiffness and function within the joint)
The Researchers concluded ‘that a single intra articular injection of 6ml of Arthrosamid was well tolerated and continued to demonstrate clinically relevant and statistically significant effectiveness 3 years after treatment’
Anecdotal cases from Denmark have reported that some patients are still experiencing positive benefits 5-8 years post treatment
Arthrosamid in under 70’s
In a large study comparing the effectiveness of Arthrosamid to Hyaluronic Acid, It was found that in patients under the age of 70, Arthrosamid performed significantly better than Hyaluronic Acid treatment at 12 months. The Link to that study is here. Arthrosamid v Hyaluronic Acid
This is interesting research as Hyaluronic Acid injections are more favourable in the mild to moderate Osteoarthritis group between the ages of 50 and 60. It suggests Arthrosamid may be have a good success rate up to the age of 70
Arthrosamid Case Studies at MyMSK Clinic
Dr Akhtar started injecting Arthrosamid into joints in December 2021.
We here at MyMSK Clinic are always interested in any new treatments for Joint Pain and Arthrosamid represents an exciting project.
In June 2023 Dr Akhtar was invited by Contura to the factory where Arthrosamid is manufactured and had the opportunity to discuss the patient group that Arthrosamid was most likely to be successful in. During this visit Dr Akhtar also met the Doctor who first injected a human with Arthrosamid, Dr Hartkopp.
This has fostered a relationship where Dr Akhtar is able to regularly liaise with colleagues around the globe to ensure patients receive up to date information on the product.
This helps ensure we deliver the product carefully and stay up to date with any new developments from Contura Orthopaedics.
Dr Akhtar has experience with the product and feels he can share a few case studies (anonymised) regarding a product he strongly believes in. If patients wish to discuss Arthrosamid with previous patients, this can be arranged with patient consent.
Arthrosamid Case 1:Â
89y old retired policeman, had Oxford Knee Score (OKS) of 29 (questionnaire indicating moderate to severe knee arthritis), had been offered knee replacements for both knees, had varus deformity on both knees (bowing of knees due to Arthritis), walked 100-200 yards with aid of a stick.
Arthrosamid injection in Left knee December 2022, had such a marked improvement in his left knee (6 weeks post injection) that he decided to have the Arthrosamid Injection in his Right knee in January 2023. Oxford Knee Score was 33 in the Right Knee (mild to moderate Arthritis in Right Knee) Update Feb 2024: Right knee is fine. Left knee intermittent severe pain
Arthrosamid Case 2:
74y old retired male, Oxford Knee Score 34, MRI showing advanced Osteoarthritis, advised need total knee replacement, struggling to walk uphill or downhill but getting progressively more difficult, Injected in Right Knee (Dec 2022), within a few weeks able to resume Gym activity and gone back to playing Golf, also starting to walk regularly 5 miles on the beach (patient resides in Europe). Did well for 6-9 months post injection, then could feel symptoms returning, had 3ml ‘top up’ in Nov 23, considering the Left knee also. Update: no issues cited (May 24)
Arthrosamid Case 3:
65y old active male, right knee advanced osteoarthritis, Oxford Knee Score 26, Arthrosamid Dec 2022, 9 weeks post injection feels such an improvement that would like the left knee to be treated also, left Knee OKS score 32, Left Knee Arthrosamid (Feb 23), right knee in pain 7 months following injection, ‘topped up’ with Arthrosamid in August 2023. Update Oct 23: Right knee in pain, left knee is ‘good’. Outcome, Right knee worked for a ‘few months’, left knee ‘still working’
Arthrosamid Case 4:
68y old, advanced OA both knees (OKS 38) Arthrosamid injected both knees under exceptional circumstances (Feb 2023), worked well until 9 months post injection left knee, 3ml top up, Update April 2024 (is doing well both knees, walking regularly, also uses unloading knee brace to help)
Arthrosamid Case 5:
63 yr old male, Advanced OA right knee on recent Xray (also knee cartilage removed at the age of 21-22), wanted to trek to Tanzania with his daughter, (Arthrosamid Injection Dec 2023). 12 week update: in his own words when sharing feedback with us.
‘Apologies for only just replying but just back from my trek in Tanzania.Â
Arthrosamid Case 6:
In our experience, it is one of the best available products on the market and is currently now on trial in NHS trusts in the UK with the hope it may lead to a delay at the age at which a patient may require surgery.
Is Arthrosamid Safe?
The Arthrosamid Injection has approval for symptomatic treatment of knee arthritis.
However, it is not suitable for the following cases:
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If the patient has an infection around the injection site
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If the patient has undergone knee arthroscopy within the last six months ·
- If the patient suffers from haemophilia
In addition, if you have dental work going on, have an autoimmune disease, are under 18, are undergoing pregnancy, have a foreign body in your knee, or breastfeeding, you should contact us beforehand to ensure suitable provisions can be made before it is injected.
In April 2021, after 10 years of rigorous research and 20 years after first injecting the hydrogel into a Joint, Arthrosamid was granted European approval for the symptomatic treatment of patients with Knee Osteoarthritis.
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Arthrosamid Aftercare
- The main side effect of the arthrosamid injection is swelling at the site of the injection. This usually eases off on its own.Â
- Patients who are feeling discomfort may be advised to take NSAIDs for 2 weeks post procedure. Rest and applying ice at the site of the injection, in short intervals, for 48 hours after the procedure is also recommended.
- Intense or strenuous physical activities should be avoided for the first 4 weeks.
- If sudden swelling occurs please let us know as soon as possible.
Arthrosamid Side Effects
The most common side effect is knee swelling for 4 to 6 weeks after the injection which does subside.
It is advised that you continue with your painkillers and regular medication as normal after the procedure.
The Arthrosamid Injection may induce a different sensation in the knee initially since it is a non-degradable hydrogel which embeds itself into the synovium as opposed to other treatments. The Knee may initially feel full but as time goes by this feeling subsides.
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Availability Of The Arthrosamid Injection In The UK
Are you residing in the UK and suffering from Knee Arthritis? Is the quality of your life affected because of the knee pain?
If the answer to these questions is YES, then you could benefit from Arthrosamid.Â
Arthrosamid Injection is readily available at MyMSK Clinic in the UK.
We have two branches operating in the UK,  Burnley and Manchester.Â
Call 0333 772 9655 to book in for a consultation today
Want to know more about Arthrosamid? Click below
Feel free to schedule your appointment today
 Say goodbye to knee arthritis pain!
Book in at MyMSK clinic here or contact us: 0333 772 9655
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