Arthrosamid Injections for Severe Knee Osteoarthritis: A Case Series from Pain Spa
Case Study Series
Pain Medicine — Knee Osteoarthritis
Avoiding knee replacement with Arthrosamid injections
A Pain Spa case series showing how ultrasound-guided Arthrosamid injections can provide long-lasting pain relief and improved mobility for selected patients with moderate to severe knee osteoarthritis.
5
Injections performed
4
Patients treated
~70%
Meaningful response rate
Up to 3 yrs
Potential benefit
Case Series Overview
Moderate to severe knee osteoarthritis • Failed conservative treatment • Surgery delayed or avoided
Ultrasound-guidedNon-surgical treatmentLong-lasting hydrogelNative knee joints only
The Challenge
Severe knee osteoarthritis can profoundly affect independence and quality of life
Knee osteoarthritis is one of the most common causes of chronic pain and disability in older adults. As the condition progresses, patients may experience persistent pain, stiffness, swelling, disturbed sleep, and increasing difficulty with walking, climbing stairs, and everyday activities.
While knee replacement surgery can be highly effective, many patients wish to avoid surgery, are not medically suitable, or prefer to explore less invasive options that may provide meaningful and sustained pain relief.
Understanding Arthrosamid — four key points
Hydrogel implant
Arthrosamid is a non-biodegradable polyacrylamide hydrogel injected into the knee joint.
Synovial integration
It integrates with the synovial lining, helping improve joint cushioning and reduce stiffness.
Not a steroid
It is different from steroid injections and hyaluronic acid injections, which often provide shorter or less predictable relief.
Long-lasting option
In selected patients, benefit may last up to three years, making it a useful surgery-sparing option.
Patient Selection
Carefully selected patients with advanced osteoarthritis
This case series included five Arthrosamid injections performed in four patients with moderate to severe knee osteoarthritis. One patient underwent treatment in both knees on separate occasions, while the remaining patients received unilateral treatment.
Symptoms
Persistent knee pain, stiffness, swelling, poor walking tolerance, and disturbed sleep.
Imaging
Moderate to severe degenerative changes, including advanced compartmental disease.
Previous treatments
Physiotherapy, analgesics, steroid injections, and other conservative measures with limited benefit.
Treatment goals
Reduce pain, improve walking, increase activity, and delay or avoid knee replacement surgery.
Why selection matters
Arthrosamid can be very helpful in the right patient, but it is not a cure for osteoarthritis and does not work for everyone. Careful assessment, imaging review, and expectation-setting are essential.
The Procedure
Precision ultrasound-guided injection
All procedures were performed by Dr Murli Krishna under real-time ultrasound guidance. Ultrasound allows direct visualisation of the joint, confirmation of accurate needle placement, and avoidance of surrounding structures.
Arthrosamid was injected into the knee joint using a standardised intra-articular technique to ensure accurate and consistent delivery of the hydrogel.
The Treatment Journey
A structured pathway to long-lasting knee pain relief
Dr Krishna’s approach was based on careful assessment, transparent discussion of options, precise ultrasound-guided injection technique, and realistic follow-up expectations.
Step 1 — Specialist Consultation
Comprehensive assessment and imaging review
Each patient underwent a full clinical assessment, including review of symptoms, imaging findings, previous treatment response, walking tolerance, and individual goals.
Step 2 — Shared Decision-Making
Realistic discussion of benefits and limitations
Patients were advised that Arthrosamid may provide long-lasting pain relief, but not everyone responds. Improvement is often gradual rather than immediate.
Step 3 — Ultrasound-Guided Arthrosamid Injection
Accurate intra-articular placement
The injection was performed under live ultrasound guidance, allowing accurate placement into the knee joint and careful avoidance of surrounding structures.
Step 4 — Gradual Functional Improvement
Pain relief, better walking, and improved activity
Over the following weeks, patients reported improvements in knee pain, stiffness, walking tolerance, and daily activity levels.
The Pain Spa Approach
Four pillars of Arthrosamid treatment at Pain Spa
Excellent outcomes depend on accurate diagnosis, careful patient selection, precise injection technique, and a clear focus on restoring mobility and quality of life.
1. Careful patient selection
Identifying patients most likely to benefit from Arthrosamid, based on symptoms, imaging, function, and treatment goals.
2. Ultrasound precision
Real-time ultrasound guidance helps ensure accurate intra-articular placement and safer needle control.
3. Realistic expectations
Patients are advised that improvement is usually gradual and that not every patient will respond.
4. Functional recovery
The focus is not only pain relief, but better walking, sleep, independence, and daily activity.
Arthrosamid can be a very valuable non-surgical option for selected patients with knee osteoarthritis, but accurate diagnosis, patient selection and precise ultrasound-guided technique are essential.
Dr Murli Krishna — Consultant in Pain Medicine, Pain Spa
Clinical Outcomes
Significant improvements in pain, mobility, and quality of life
Key improvements observed
● Reduction in knee pain intensity
● Improved walking tolerance and mobility
● Reduced stiffness
● Better sleep quality
● Reduced reliance on pain medication
● Increased participation in daily activities
Across the case series, improvements typically developed gradually over several weeks, with ongoing benefit noted at follow-up.
Why Arthrosamid Is Different
Longer-lasting than many traditional injections
Steroid injections may provide relief for a few weeks to months, while hyaluronic acid injections can offer variable and sometimes modest benefit, particularly in advanced osteoarthritis.
Arthrosamid differs because it integrates into the synovial lining and remains in place, giving it the potential to provide longer-lasting symptom improvement in selected patients.
Avoiding Surgery
A valuable option for patients wishing to delay or avoid knee replacement
Arthrosamid is particularly attractive for patients who are not ready for surgery, who wish to postpone joint replacement, or who are unsuitable surgical candidates.
It is only suitable for native knee joints and is not used after knee replacement surgery.
Options when knee replacement has already been performed
AlternativeFor persistent pain after knee replacement, Pain Spa may consider genicular nerve blocks and cooled radiofrequency treatment of the genicular nerves.
ImportantArthrosamid is designed for native knee joints and is not injected into a replaced knee.
Expert Care at Pain Spa
Why specialist technique matters
All Arthrosamid injections at Pain Spa are performed by Dr Murli Krishna, Consultant in Pain Medicine, who has extensive experience in ultrasound-guided joint injections and advanced interventional pain procedures.
Accurate placement under real-time imaging helps maximise procedural precision and minimise risk. This is particularly important in patients with advanced osteoarthritis, complex anatomy, or previous failed injection treatments.
Important Considerations
Arthrosamid does not help every patient. Current evidence suggests that approximately 70% of patients experience meaningful benefit, while others may experience limited or no improvement. Individual results vary, and treatment is most effective when combined with appropriate rehabilitation, weight management where relevant, and ongoing strengthening work.
Summary
A promising non-surgical option for severe knee osteoarthritis
This Pain Spa case series demonstrates that Arthrosamid injection can provide substantial and long-lasting pain relief, improved mobility, and reduced need for surgery in carefully selected patients with knee osteoarthritis.
For patients who wish to avoid or delay knee replacement, Arthrosamid offers a valuable treatment option when delivered by an experienced specialist under ultrasound guidance.
Your Specialist
About Dr Murli Krishna
Dr Murli Krishna
Consultant in Pain Medicine — Pain Spa
MBBS • FRCA • FFPMRCA
Dr Krishna specialises in advanced ultrasound-guided and fluoroscopy-guided pain procedures. He has extensive experience treating patients with severe osteoarthritis who wish to avoid or delay surgery.
To explore whether Arthrosamid may be suitable for your knee pain, contact Pain Spa to arrange a consultation.
Please note: This case series is published for educational and informational purposes. Patient-identifying details have been changed to protect confidentiality, while the clinical treatment described remains representative of real Pain Spa practice. Individual results vary; Arthrosamid does not guarantee improvement. This does not constitute medical advice. For queries write to clinic@painspa.co.uk.
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