Infection Is a Serious Consideration With PAAG
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 PAAG 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.
Our 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 PAAG, 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 PAAG uses
- 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®
PAAG 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 600+ Arthrosamid® injections
Safety is not an afterthought — it is built into the treatment.
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Long-lasting relief starts with the right decision — not just an injection.
Learn More about Arthrosamid
Deep dive into our clinical resources and patient guides.
Clinical Evidence
Evidence from Real Clinical Practice
Infection Safety
Infection Is a Serious Consideration With PAAG
Safety & Context
Arthrosamid Safety, Complications & Important Context
Full FAQ
Arthrosamid® (PAAG) Injection – Full Patient FAQ
Funding & Insurance
Funding, Insurance & NHS Coverage – Important Information
Patient Assessment
PAAG-8+ Questionnaire
Arthrosamid® (PAAG) 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.