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Arthrosamid "hydrogel" Injections for Knee Osteoarthritis

PH570400 — Mon, 28 Aug 2023 15:20:01 GMT

A permanent injectable that lubricates, cushions and reduces inflammation

How will a Hydrogel (Arthrosamid™) Injection help me?

Injectable non-degradable hydrogels, act as permanent lubrication and a cushion that sits in the joint without being resorbed. They have been shown to significantly reduce pain and improve function for at least 56 weeks , with recent evidence suggesting these results last well beyond three years .

What does the procedure involve?

During this treatment you will be asked to take an oral dose of antibiotics containing PENICILLIN one hour prior to the injection to reduce the risk of infection during the procedure.

The surgical team will then clean around the injection side and inject local anaesthetic into the skin and joint. Once the area is numb 6ml of hydrogel will be injected into the joint using ultrasound to ensure the injection goes into the correct place.

If you feel well, you can leave 15 minutes later.

Will the procedure hurt?

The doctor or nurse will normally inject a small amount of local anaesthetic under the skin to stop the injection from hurting. You will feel a gentle pressure as the hydrogel is injected. Very few patient require any form of painkiller after the injection

Can everyone have this treatment?

PLEASE TELL THE DOCTOR IF YOU HAVE ANY ALLERGIES OR HAVE EVER HAD A REACTION TO A MEDICATION.

You should not have the treatment if

· You have a temperature or ongoing infection anywhere

· You have had an operation or injection into the knee in the last 6 months

· You have an uncontrolled bleeding disorder

· You have a rash or broken skin over the joint to be treated

If you have any of these contra-indications please tell your doctor

Does the injection work for everyone? How effective is the treatment?

Like most medical treatment every patient responds slightly differently. Younger patients with less severe arthritis seem to respond better to the injection. Over all 73% of patients felt that a single injection of Arthrosamid significantly improved their symptoms. This number is slightly higher in the under 70s (80%) and slightly lower in the over 70s (63%).

Is it safe? What are the complications?

Hydrogel injections have been shown to be safe and effective and have been used across multiple areas of surgery since 2001. It must however, be done by a suitable trained doctor.

Complications are very rare but can include

· Infection requiring antibiotics or an operation to washout the joint

· Pain

· Failure to improve symptoms or rarely making symptoms worse

· Damage to local structures like ligament, tendons, nerves or blood vessels

Please feel free to discuss these with your treating doctor

What happens after the injection?

There are no specific restrictions after the procedure but it is recommended you rest on the day of the procedure. You can return home a 15 minutes after the procedure and begin your usual activities the following day

Most patient start to notice a gradual improvement in symptoms after about 10 days . Pain levels and function should continue to improve after each injection for up to 12 weeks and should last multiple years.

How much does the treatment cost? Is it covered by my insurer?

Unfortunately, insurers do not cover this treatment at present.

St Joseph’s Hospital, Newport

Arthrosamid Injection into One knee - £2595

Arthrosamid Injection into Both Knees - £4495

Pro Sports Medicine Cardiff

Arthrosamid Injection into One knee - £2295

Arthrosamid Injection into Both Knees - £3995

Cellular Matrix Injections for Osteoarthritis

Sun, 05 Mar 2023 16:58:21 GMT

Platelet Rich Plasma (PRP) and Hyaluronic acid (HA) in one injection

Cellular Matrix is a combined injection of hyaluronic acid and Platelet Rich Plasma that improves pain and function in patients with early knee osteoarthritis.

There is increasing evidence that for patients with early osteoarthritis recurrent steroid injections are not only detrimental as it is associated with rapid progression of arthritis , subchondral insufficiency fractures and increased infections (Guermazi et al 2020) but also ineffective (Donovan et al 2022).

Platelet Rich Plasma (PRP) and Hyaluronic acid (HA) injections has been shown to be superior to intra articular steroid injections with pain relief and improved function lasting up to 24 months (Donovan et al 2022).

The combination of Platelet Rich Plasma (PRP) and Hyaluronic Acid (HA) in one injection has demonstrated synergistic improvements in pain and function far superior to the individual injections (Aw et al 2021).

How will a Platelet Rich Plasma (PRP) Injection help me?

Your own blood contains anti-inflammatory molecules and growth factors that are able to relieve pain and help certain cells (Chondrocytes) to repair damaged cartilage. If you have early arthritis a course of PRP injections has been proven to reduce pain, improve the function of the joint and improve the quality of the cartilage. These natural anti-inflammatories “relieve symptoms and potentially delay the need for joint replacement surgery” (National Institute of Clinical Excellence 2019)

What is Hyaluronic Acid (Hyaluronan) and how will it help my joints?

Hyaluronic Acid is a naturally occurring protein that functions as a lubricant (visco-supplement), reduces inflammation (anti-inflammatory) and provides pain relief (analgesic) to damaged joints. Dual treatment with Hyaluronic acid and platelet rich plasma (Cellular Matrix) can significantly improve pain and function when compared to a single treatment of PRP.

What does the procedure involve?

A sample of blood is taken from your arm and centrifuged to concentrate the platelets, growth factors and anti-inflammatories in the liquid plasma. Red and White cells are removed. The platelet-rich plasma is combined with Hyaluronic Acid and injected into the joint space in the knee, usually under ultrasound guidance. The whole process takes around 5-10 minutes and can be done while you wait.

Normally patients require a course of 3 injections over 2 months to get the best results.

Will the procedure hurt?

The doctor or nurse will normally inject a small amount of local anaesthetic under the skin to stop the PRP injection from hurting. You will feel a gentle pressure as the PRP is injected. Very few patient require any form of painkiller after the injection

Can everyone have this treatment?

The treatment will not work if you have low platelet count or have taken medicine such as aspirin

You should not have the treatment if

· You have a temperature or ongoing infection anywhere

· You are known to have any form of cancer

· You have a rash or broken skin over the joint to be treated

If you have any of these contra-indications please tell your doctor

Is it safe? What are the complications?

The National Institute of Clinical Excellence (NICE) have approved this treatment and stated it is safe and effective to use. It must however, be done by a suitable trained doctor.

Complications are very rare but can include

· Infection requiring antibiotics or an operation to washout the joint

· Pain

· Failure to improve symptoms

· Damage to local structures like ligament or tendons

Please feel free to discuss these with your treating doctor

What happens after the injection?

You can return home and begin your usual activities about an hour later.

Most patient start to notice a gradual improvement in symptoms after about 10 days. Pain levels and function should continue to improve after each injection for up to 12 weeks and may last for 1-2 years.

Robot Assisted Joint Replacements

Sun, 23 Jan 2022 19:30:00 GMT

Robot Assisted Hip and Knee Replacements

What is a robot assisted joint replacement?

When joints such as the knee or hip become damaged due to arthritis or trauma, the best treatment option to improve pain and function may be to replace the joint. A joint replacement involves removing the surface of a damaged joint and replacing it with material such as titanium or cobalt chromium alloy. Traditionally a surgeon would use an X-ray and cutting guide placed on the bone to help cut the bone at the correct angle and depth.

Robotic technology now makes this process much more accurate, allowing surgeons to create a 3D model of the bone and use the robot to ensure the bone cuts are within a millimetre or half a degree from the pre-operative plan.

What are the surgical benefits?

The robotic system enables the surgeon to practice putting the joint replacement in the perfect position, even before the case has begun. The pre-operative scan allows the joint replacement to be placed in the optimal position for each individual patient and restores the alignment of the limb.

What are the benefits to the patient?

Robot assisted surgery allows:

· Smaller surgical wounds to be used (Minimally invasive surgery)

· Quicker return to function with most patients walking on the day of surgery

· Reduces the chance of damage to surrounding ligament, tendons, nerves and blood vessels

· Can improve long term function and reduce the risk of further surgery in the future

Are there any additional risks to using a robot?

Robotic Procedures take slightly longer than manual procedures but are not associated with any increased risks to the patient. Theoretically, the robot should decrease the chance of a surgical complication and has been shown to reduce the chance of readmission to the hospital after the operation. Recent studies have also suggested a lower 5 year revision rate, particularly for partial knee replacem ents.

Always discuss any concerns you have or questions about potential complications with your surgeon directly.

For videos, patient information or to book an appointment to discuss a robot assisted hip or knee replacement click the below links….

Robotic Assisted Partial Knee Replacement

Robotic Assisted Total Knee Replacement

Platelet Rich Plasma (PRP) Injections Improving knee pain without surgery

PH570400 — Mon, 26 Apr 2021 12:38:52 GMT

Platelet Rich Plasma (PRP) Injections use your bodies own Anti-Inflammatory Molecules and Growth Factors to improve pain, function and prevent the progression of Osteoarthritis

What is Osteoarthritis?

Osteoarthritis of the knee is the result of progressive deterioration of the articular cartilage and menisci of the joint, usually because of trauma, and wear and tear. This leads to exposure of the bone surface. Symptoms include pain, stiffness, swelling and difficulty walking.

What are my treatment options?

Conservative treatments include painkiller and corticosteroid injections to relieve pain and inflammation. In addition to physiotherapy and prescribed exercise to improve function and mobility.

When symptoms are severe, surgery may be indicated. Surgical options include breaking and resetting the bone to realign the leg (Osteotomy) or replacing part (Partial) or all of the Knee (Total knee replacement).

How will a Platelet Rich Plasma (PRP) Injection help me?

What does the procedure involve?

A sample of blood is taken from your arm and centrifuged to concentrate the platelets, growth factors and anti-inflammatories in the liquid plasma. Red and White cells are removed. The platelet-rich plasma is injected into the joint space in the knee, usually under ultrasound guidance. The whole process takes around 5-10 minutes and can be done while you wait. Normally patients require a course of 3 injections over 3-6 weeks to get the best results.

Will the procedure hurt?

Can everyone have this treatment?

The treatment will not work if you have low platelet count or have taken medicine such as aspirin

You should not have the treatment if

· You have a temperature or ongoing infection anywhere

· You are known to have any form of cancer

· You have a rash or broken skin over the joint to be treated

Is it safe? What are the complications?

The National Institute of Clinical Excellence (NICE) have approved this treatment under special arrangement and stated it is safe. It must however, be done by a suitable trained doctor and you must be followed up to see how you get on with the treatment.

Complications are very rare but can include

· Infection requiring antibiotics or an operation to washout the joint

· Pain

· Failure to improve symptoms

· Damage to local structures like ligament or tendons