Arthrosamid® Safety, Complications & Context
An open and balanced discussion regarding the long-term clinical profile of polyacrylamide hydrogel treatments.
Arthrosamid® (a registered trademark of Contura A/S.).
All medical treatments carry potential risks. This includes Arthrosamid®, a form of polyacrylamide hydrogel.
While Arthrosamid® shows favourable short-to-medium term safety for knee osteoarthritis, patients deserve full awareness of complications observed in other medical contexts.
Reviewed byProf Paul Lee MBBch, FRCS (Tr & Orth), PhDLast reviewed 1 May 2026What Has Been Reported in the Medical Literature
There are published papers describing complications related to polyacrylamide hydrogels, most notably under the brand name Aquamid (a chemically similar product from the same manufacturer group, marketed under a different label).
These reports primarily relate to:
- Cosmetic and soft-tissue injections
- Large injection volumes
- Non-joint tissues (breast, fat)
- Long-term follow-up (many years)
Reported complications include:
- Chronic inflammation
- Infection (delayed presentations)
- Nodules or firmness
- Migration of material
- Need for surgical removal
For transparency, patients who wish to explore this literature in detail are encouraged to read the published review article on Aquamid complications.
Why Context Matters
It is important to understand that clinical outcomes are heavily influenced by the environment and method of application:
The knee joint is a very different biological environment from soft tissue.
Arthrosamid® for knee osteoarthritis is delivered:
- In much smaller volumes
- Inside the joint, not under the skin
- Using image-guided techniques
Most published complication data relate to historic cosmetic use, not modern intra-articular knee treatment.
"That said, differences in indication do not eliminate risk, and this literature reinforces why careful patient selection, technique, and follow-up are essential."
What We See in Knee
Osteoarthritis Practice
In our own independent clinical study and routine practice:
Complications following intra-articular hydrogel injection have generally been uncommon and usually mild.
The most frequently observed issues are:
Serious joint infection has been rare, but remains a recognised risk with any injection.
Because Arthrosamid® is non-biodegradable, any complication — should it occur — may be more complex to manage than with short-acting injections.
This is discussed openly during consultation to ensure patients can make a fully informed decision about their care pathway.
Why We Include This Warning
Integrity in patient care requires full disclosure. We believe patients should:
- Be aware that not all published hydrogel safety data relates to knee osteoarthritis
- Understand that long-term data continues to evolve
- Have access to both supportive and critical literature
- Make decisions based on balanced information, not marketing
"For this reason, Arthrosamid® is not offered routinely, and we do not recommend it where the risk–benefit balance is unfavourable."
What This Means for You
If you are considering Arthrosamid®, our clinical team will guide you through a comprehensive consultation covering:
Potential benefits
Known and theoretical risks
Alternative treatments
Whether this option fits your goals and your knee condition
If you would like to read the published paper discussing Aquamid complications in more detail, please let us know.
Informed decisions require full information — including uncomfortable parts.
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?
Older age associated with higher odds of benefit in your cohort.
Please select an option before moving to the next question.
Vetting Your Arthrosamid® Clinic
Questions to ask any clinic before Arthrosamid®
Side effects and complications are minimised by the clinic process around the injection, not by the injection itself. These questions help you compare clinics on the decisions that actually affect safety outcomes.
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.
Side Effects, Risks & Suitability
Frequently asked questions
For infection-specific questions see the Arthrosamid® infection risk and prevention page.
Is Arthrosamid® safe?
Arthrosamid® has a favourable safety profile when delivered under ultrasound guidance with sterile technique and appropriate patient selection. Reported side effects are mostly short-lived. The most serious risk is joint infection, which is rare. Safety depends on suitability — Arthrosamid® is not right for every osteoarthritis patient, and clinical assessment before treatment is essential.
What are the most common Arthrosamid® side effects?
The most commonly reported side effects are short-term injection-site pain, mild swelling, warmth and joint stiffness in the first few days. These usually settle without treatment. Less commonly, patients report a longer flare lasting a week or two. We review every patient at six weeks and earlier if symptoms warrant.
What are the more serious risks of Arthrosamid®?
The most serious risk is joint infection, which is rare but warrants a conservative prevention protocol. Other less common reported complications include persistent synovitis and reactions at the injection site. Read the dedicated Arthrosamid infection risk page for a full explanation of how London Cartilage Clinic minimises infection risk.
Is Arthrosamid® reversible?
No. Arthrosamid® is a non-resorbable hydrogel and integrates into the synovial membrane of the joint. That is the mechanism that gives it long-acting symptom control, but it also means the product cannot be removed. Patient selection is therefore especially important — we will not offer treatment where suitability is unclear or expectations are unrealistic.
Can Arthrosamid® damage cartilage?
Arthrosamid® is a cushioning hydrogel, not a regenerative product, and it does not regenerate cartilage. Current evidence does not show that it accelerates cartilage loss, but it also does not protect against it. In late-stage bone-on-bone arthritis, the underlying disease may progress regardless of whether Arthrosamid® has been used.
Who should not have Arthrosamid®?
Arthrosamid® is generally not recommended for patients with active joint infection, poorly controlled systemic infection elsewhere, end-stage bone-on-bone arthritis where replacement is the better answer, or unrealistic expectations. We assess suitability for every patient before offering treatment — see the Arthrosamid® suitability self-assessment.
Book an Arthrosamid® Assessment – London
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.
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.