Infection Is a Serious Consideration With Arthrosamid®
Infection is a recognised risk with any joint injection. However, with Arthrosamid® — a permanent, non-biodegradable hydrogel — prevention is our absolute mandate.
Arthrosamid® (a registered trademark of Contura A/S.).
Difficult to Eradicate
Because the Arthrosamid® hydrogel is permanent and not absorbed by the body.
Prolonged Treatment
Should infection occur, it may require extended clinical intervention.
Surgical Intervention
Occasional surgical needs to ensure patient safety and hydrogel integrity.
Reviewed byProf Paul Lee MBBch, FRCS (Tr & Orth), PhDLast reviewed 1 May 2026Our Approach:
Infection Prevention From the Start
From the very beginning of Arthrosamid® use in the UK, Professor Paul Y.F. Lee adopted a more cautious infection-prevention protocol than is commonly used for routine joint injections.
As the first clinician to perform Arthrosamid® knee injections in the UK, Professor Lee has pioneered safety standards that define our practice today.
Extensive experience in clinical practice ensures the highest level of procedural precision.
Antibiotic Protocol
All Arthrosamid® injections at our clinics are performed with intravenous (IV) antibiotics as a standard safety measure.
Why We Use IV Antibiotics (Not Oral)
Our clinic does not recommend oral antibiotics for Arthrosamid® injections.
This is because:
- Oral antibiotics have variable absorption
- Blood and joint concentrations can be unpredictable
- Timing relative to injection is less reliable
- Effectiveness against potential biofilm-forming bacteria may be reduced
In contrast, intravenous antibiotics provide:
- Immediate and reliable blood levels
- Better tissue and joint penetration
- More consistent protection at the time of injection
Given the permanent nature of Arthrosamid®, we believe IV antibiotics offer a safer and more controlled approach.
A Deliberately Conservative Protocol
Our antibiotic protocol was developed independently, based on:
- The known behaviour of polyacrylamide hydrogels
- Published reports of delayed and biofilm-related infections in other hydrogel applications
- The principle that prevention is far preferable to treatment
This approach is more cautious than standard steroid or hyaluronic acid injections, but we believe that difference is justified.
What Patients
Should Understand
- Infection after Arthrosamid® injection is uncommon, but potentially serious
- Prevention matters more with non-biodegradable materials
- Our clinic takes a deliberately conservative stance
- This is one reason Arthrosamid® is not offered routinely and only after proper assessment
If a patient is uncomfortable with IV antibiotics, Arthrosamid® may not be the right option for them.
Transparency Matters
Some clinics may use different protocols, including oral antibiotics or none at all. We believe patients should be aware that practice varies, and that there is no single universally accepted protocol.
Our approach reflects our experience, caution, and priority for patient safety —not manufacturer instruction.
In Summary
Infection is a major consideration with Arthrosamid®
Arthrosamid® infections may be more complex to manage
IV antibiotics are standard practice at our clinic
Oral antibiotics are not recommended due to concerns over reliability and effectiveness
This protocol has been used consistently across 1,000+ Arthrosamid® injections
Safety is not an afterthought — it is built into the treatment.
Am I Suitable?
Take the Arthrosamid® Suitability Assessment
Eight quick questions to support a shared decision-making conversation about Arthrosamid®. Your answers stay with you across visits, so you can pick up where you left off.
Will Arthrosamid work for me?
Arthrosamid® suitability questionnaire
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How old are you?
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Vetting Your Arthrosamid® Clinic
Questions to ask any clinic before Arthrosamid®
Infection is the most serious complication of Arthrosamid®. These questions help you pressure-test a clinic on the things that actually move the risk needle, regardless of which provider you choose.
Is the injection delivered under real-time ultrasound guidance?
Ultrasound guidance is fundamental to accurate intra-articular placement. Landmark-based injections are faster and cheaper but less reliable for Arthrosamid® specifically.Who performs the injection?
A consultant-led pathway where the clinician you consult is the clinician who injects gives you a single point of accountability. A consultation/inject hand-off is cheaper to staff but is not the same service.What infection-prevention protocol is used?
Joint infection after Arthrosamid® is rare but serious. Ask the clinic to walk you through their sterile-field standards, antibiotic policy, and how a post-injection flare is managed.Are IV antibiotics used as part of the protocol?
Routine IV antibiotic cover is a deliberately conservative choice; not every UK clinic uses it. Ask whether IV is standard, oral-only is offered, or no antibiotic cover is used at all — and whether the choice is yours.What happens if symptoms flare after treatment?
A short-lived post-injection flare is common; a persistent flare warrants prompt review. Ask about out-of-hours support, escalation pathway and whether further appointments are included.What clinical follow-up is included as standard?
A six-week clinical review is the minimum we would recommend. Some packages skip follow-up entirely or quote it separately later.How many Arthrosamid® injections has the clinician performed?
Operator volume matters for any image-guided injection. Ask for a specific number; published outcome data from a clinician’s own series is a stronger signal still.How does the clinic decide who is NOT suitable for Arthrosamid®?
A clinic willing to decline unsuitable cases is selecting for outcomes. A clinic that says yes to everyone is selecting for revenue. The first conversation should include an honest “this may not be right for you” pathway.
Watch Out For
Red flags when choosing an Arthrosamid® provider
No clear discussion of infection risk
Infection is rare but is the most serious complication. A clinic that does not mention it or skips the antibiotic question is leaving a known risk unaddressed.No clear antibiotic protocol
Ask explicitly whether antibiotics are routine, whether IV or oral is used, and the reasoning. Vague answers are a signal.No imaging review before treatment
An MRI or detailed ultrasound review before injection is what tells us whether Arthrosamid® is the right treatment. Skipping imaging review compresses the assessment.Injection offered without a suitability assessment
Arthrosamid® is not right for every osteoarthritis patient. A consultation that ends with “book the injection” without a clinical decision is selling, not treating.No follow-up plan
If the post-treatment plan is “see how you go”, you are paying for an injection, not for a service. Six-week clinical review should be the minimum.Guaranteed or permanent cure claims
Arthrosamid® is a long-acting cushion, not a cure for arthritis. Any clinic claiming permanent results, guaranteed outcomes or cartilage regeneration is overstating what the treatment can do.
Infection Risk & Prevention
Frequently asked questions
See also the broader Arthrosamid® side effects and safety page for non-infection complications.
How common is infection after an Arthrosamid® injection?
Joint infection after Arthrosamid® is rare. Published reporting puts the rate at well under one percent, in line with other intra-articular knee injections delivered under sterile conditions. Rare does not mean impossible, which is why prevention protocol matters more than headline rates when choosing a clinic.
Why does London Cartilage Clinic use IV antibiotics for Arthrosamid®?
Because Arthrosamid® is a permanent hydrogel that integrates into the joint, late infection is harder to manage than for resorbable injections. We use routine IV antibiotic cover as a deliberately conservative measure to minimise risk further. Some UK clinics use oral antibiotics or none at all; ours is the more cautious end of the spectrum.
Can I have oral antibiotics instead of IV?
IV antibiotics achieve tissue levels faster than oral and are easier to dose accurately for a single peri-procedural cover. We recommend IV for Arthrosamid® specifically. If you have a clinical reason to avoid IV, we will discuss the alternative options at consultation.
What happens if I develop infection symptoms after the injection?
Mild post-injection soreness, warmth and swelling can be normal for the first few days. A persistent flare, fever, expanding redness or worsening pain after day three warrants urgent review. You will have a direct line to the clinical team during recovery; out-of- hours patients are advised to attend A&E and contact us in parallel.
Does the infection risk go up with more boxes of Arthrosamid®?
Larger volumes mean a slightly longer injection time and more product in the joint, but the per-procedure infection risk does not scale linearly with box count. The biggest determinants of risk are sterile technique, antibiotic cover and operator experience, not box number.
How long am I followed up after an Arthrosamid® injection?
We follow patients clinically at six weeks as standard, with a direct line for any questions in between. Onward physiotherapy guidance is included where helpful. Patients who travel from outside London are followed up by phone or video where in-person review is impractical.
Book an Arthrosamid® Assessment – London
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Learn More about Arthrosamid
Deep dive into our clinical resources and patient guides.
Cost in the UK
Arthrosamid® cost in the UK from £3,000, what is included and why prices vary.
NHS & Insurance
Is Arthrosamid® available on the NHS or private insurance?
Suitability
Who is suitable for Arthrosamid® — and who may need caution.
Clinical Evidence
Real-world outcome data and what the evidence means for patients.
Side Effects & Safety
Arthrosamid® side effects, risks, complications and clinical context.
Infection Risk
Arthrosamid® infection risk, prevention protocol and IV antibiotic policy.
In London
Private Arthrosamid® treatment at our Harley Street clinic.
Self-Assessment
Eight-question Arthrosamid® suitability self-assessment tool.
Full FAQ
Arthrosamid® patient FAQ across cost, suitability, safety and comparisons.
vs Hyaluronic Acid
Arthrosamid® compared to hyaluronic acid injections.
vs PRP
Arthrosamid® compared to PRP for knee osteoarthritis.
vs Steroid Injection
Arthrosamid® compared to corticosteroid injection.
vs Knee Replacement
Where Arthrosamid® may help delay surgery — and where it cannot.
Arthrosamid® Injection
Comprehensive Overview
Arthrosamid® is a registered trademark of Contura A/S. London Cartilage Clinic is not affiliated with or endorsed by Contura A/S.