Arthrosamid®
Arthrosamid is a new, injectable treatment for Osteoarthritis of the knee. It is unique in its action, and can provide years of pain relief without resorting to surgery.
What is Arthrosamid®
Arthrosamid is a novel non-surgical treatment for knee osteoarthritis. It is an injectable polyacrylamide hydrogel, which when injected into the knee, over a period of a few weeks becomes absorbed into the lining of the knee where it functions to reduce inflammation and pain.
The Arthrosamid, being a polymer hydrogel cannot be degraded or cleared by the body, and so it remains in the knee, providing ongoing benefit for several years.
Is it suitable for me?
All patients with knee Osteoarthritis are potential candidates for Arthrosamid.
It is currently not recommended for patients who suffer from inflammatory joint disease such as Rheumatoid Arthritis, Psoriatic arthritis, Gout, Pesudogout etc. as there is no clinical information regarding its effect and safety in these patients.
Mr Platt recommends it is a suitable treatment for patients in the following groups who suffer disabling knee Arthritis even in severe 'bone-on-bone' arthritis where Mr Platt still can achieve encouraging results.
Broadly Arthrosamid patients will fall into one of the following groups:
- Too young for joint replacement surgery. Where joint replacement is performed in young patients, due to high patient demands placed on their replaced joint, their joint replacements fail earlier than they should, and thus these patients are committed to further, ever more complex replacement surgeries which normally provide ever diminishing function, and in some cases may not provide adequate symptom relief for the remainder of the patient's life. Prior to Arthrosamid, this left patients with a stark choice - either give up high impact activity, or suffer with ongoing pain in order to delay undergoing surgery.
- Medically unfit for joint replacement. These patients often suffer in pain as they have medical conditions which prevent them being passed fit to undergo surgery, and thus their treatment options are limited to only those which are non-surgical.
- Cannot afford time to recover from surgery. Those patients who are in active employment, particularly those who are self-employed, or those in caring roles for a dependent partner or family member are ideal Arthrosamid recipients. Those who cannot take time off for surgery without significant financial consequence can undergo Arthrosamid treatment without the need to take any time off work afterwards or arrange respite care while they recover.
- Patient preference. Some patients simply prefer to avoid surgery and exhaust all non-surgical options due to preference. Importantly, Arthrosamid treatment does not preclude surgery at a later date if required.
How is it adminstered?
The Arthrosamid procedure is completed in outpatient clinic setting and the procedure is split into two parts:
- Part 1 - Mr Platt completes a consent form with the patient, checks allergies and suitability to proceed with the procedure. Oral antibiotics are administered and the time of antibiotic administration is recorded.
- Part 2 - Between 1-2 hours after the antibiotics are taken the implantation procedure takes place. The procedure is performed in a procedure room under local anaesthetic with full sterile precautions. Mr Platt uses an ultrasound machine to scan the knee whilst performing the procedure to ensure correct placement of the Arthrosamid and uses a nurse assistant during the procedure.
The procedure itself takes around 10-15 minutes per knee and patients can walk out of the treatment room once their treatment is complete.
Will it work?
As the graphic shows, younger patients are more likely to respond to Arthrosamid, though a previous response to steroid or hyaluronic acid may indicate a greater chance of successful response in patients of all ages, even those patients with grade IV 'bone-on-bone' osteoarthritis.
Mr Platt is currently researching the relationship between steroid response and Arthrosamid response and asks all patients undergoing Arthrosamid treatment with him to complete a questionnaire before and after treatment to monitor response to Arthrosamid.
How soon will it work?
The integration of the Arthrosamid into the knee lining commences around a week to two weeks after the procedure, and completes over a period of several weeks thereafter, though it could take up to three months for this to complete. The effect of the Arthrosamid in relieving pain is gradual, therefore. Mr Platt has observed that patients reporting the best response to Arthrosamid have noticed improvement within a week of the procedure.
Patients are advised to avoid high impact activities in the first two weeks after the procedure.
Mr Platt reviews outcomes after Arthrosamid treatment by sending patients questionnaires at 8 weeks post-procedure, 3 months post-procedure 6 months post-procedure, one year post-procedure and annually thereafter.