Knee Osteoarthritis Treatment Decision
Who Is Suitable
for Arthrosamid®?
Arthrosamid® is not right for every osteoarthritis patient. Use this page as a guide before booking; the final decision is made at consultation with Professor Paul Lee after imaging and clinical assessment.
Reviewed byProf Paul Lee MBBch, FRCS (Tr & Orth), PhDLast reviewed 1 May 2026Quick Answer
Arthrosamid® may be suitable for adults with diagnosed knee osteoarthritis who have mild-to-moderate cartilage wear, ongoing symptoms despite conservative treatment, and want to delay more invasive options. It is less suitable for advanced bone-on-bone arthritis, active infection, or where realistic expectations cannot be set. A clinical assessment with imaging review is essential before any decision.
Strong Indicators
Good candidates may include
Diagnosed knee osteoarthritis
A clinical diagnosis supported by recent imaging (X-ray or MRI). The diagnosis matters because Arthrosamid® is licensed and evidence-based specifically for osteoarthritis, not general knee pain.
Mild-to-moderate cartilage wear
Cartilage damage that is sub-total. Patients with mild-to-moderate disease tend to respond best to Arthrosamid®; outcomes drop as cartilage loss approaches bone-on-bone.
Symptoms despite conservative treatment
You have tried activity modification, physiotherapy and simple pain relief, and symptoms continue to limit daily activity. Arthrosamid® is generally not a first-line option.
Wants to delay more invasive treatment
A genuine preference to delay or avoid knee replacement where the joint is still salvageable. Arthrosamid® can be appropriate where surgery has been suggested but you want to explore alternatives first.
Realistic expectations
Understanding that Arthrosamid® is a long-acting cushion, not a cure. It does not regenerate cartilage. Average symptom relief is two to three years from a single injection; results vary.
Willing to accept the safety protocol
Comfortable with our conservative protocol including ultrasound-guidance, IV antibiotic cover and the six-week follow-up. Skipping safety steps to save cost is not an option we offer.
Where Caution Is Needed
Patients who may need caution
These are not absolute contraindications, but they warrant a careful conversation before treatment. In many of these situations we recommend an alternative pathway.
Advanced bone-on-bone arthritis
End-stage osteoarthritis where the joint surface has been substantially lost. Arthrosamid® may give some relief but the underlying disease may progress to needing knee replacement.
Active infection
Any active infection, in the joint or systemically, is a reason to defer Arthrosamid®. We treat the infection first.
Poorly controlled diabetes
Raised HbA1c increases infection risk for any joint injection. We may ask you to optimise control before scheduling.
Immunosuppression or high infection risk
Patients on immunosuppressive therapy or with conditions that raise systemic infection risk warrant a tailored discussion.
Unrealistic expectations
Patients who expect Arthrosamid® to cure their arthritis, regenerate cartilage or guarantee permanent relief are not good candidates — the treatment cannot deliver any of those things.
Unwillingness to accept the protocol
A clinic-specific safety protocol that includes IV antibiotics, sterile technique and six-week follow-up is non-negotiable at London Cartilage Clinic. Patients who decline these steps should consider a different provider.
Pre-Treatment Assessment
What we check before recommending Arthrosamid®
Imaging review
Recent X-ray and (where available) MRI of the affected joint. We are looking at the stage of disease, the pattern of wear and any features that change the recommendation.
Conservative-treatment history
What you have tried, what worked, what did not. Arthrosamid® is not a first-line treatment; it sits after physiotherapy, activity modification and simple analgesia.
Comorbidity and medication review
Diabetes control, immunosuppression, anticoagulation, recent infection. Any of these can change the safety profile.
Symptom pattern
What hurts, when, and what limits you. Some patterns of pain respond well to Arthrosamid®; others suggest a different treatment is the better answer.
Your goals and expectations
What you want from treatment, what would count as a good outcome, and over what timeframe. We will not offer Arthrosamid® where expectations cannot be matched to what the treatment can do.
Advanced Disease
Bone-on-bone arthritis and advanced osteoarthritis
Arthrosamid® is unlikely to help in end-stage, bone-on-bone disease. Where the joint surface has been substantially lost, a cushioning hydrogel cannot restore what is no longer there. Some patients still get partial relief, but the durability is shorter and the underlying disease may progress regardless.
In these cases, the better answer is often a knee replacement conversation. We will say so honestly. Read more on the forthcoming Arthrosamid® vs knee replacement comparison.
Where the disease is moderate but advancing, Arthrosamid® may still be appropriate as a way to delay surgery. Imaging at consultation is what tells us which side of the line your case sits on.
Eight Questions, Three Minutes
Take the Arthrosamid® suitability self-assessment
A benefit-weighted scoring system developed from outcomes of over 600 patients treated at London Cartilage Clinic. Use it before booking a discovery call so we start from a shared understanding.
Suitability for Arthrosamid®
Frequently asked questions
Who is the ideal candidate for Arthrosamid®?
The ideal candidate is an adult with a clinical and imaging diagnosis of knee osteoarthritis, mild-to-moderate cartilage wear, ongoing symptoms despite conservative treatment (activity modification, physiotherapy, simple analgesia), realistic expectations, and a desire to delay or avoid more invasive treatment. The patient should be willing to accept the conservative safety protocol used at London Cartilage Clinic.
Can I have Arthrosamid® if I have bone-on-bone arthritis?
Advanced bone-on-bone osteoarthritis is one of the situations where Arthrosamid® is less likely to deliver meaningful or lasting benefit. In many of these cases, knee replacement is the more appropriate answer. We will review imaging and tell you honestly which is right for your stage.
Can I have Arthrosamid® if I have diabetes?
Well-controlled diabetes is not a contraindication, but poorly controlled diabetes raises the infection risk for any joint injection. We will review HbA1c and recent control as part of the assessment, and may ask you to optimise control before scheduling treatment.
Can I have Arthrosamid® if I am on blood thinners?
Many patients on anticoagulation or antiplatelet therapy can safely have Arthrosamid®, but the decision depends on the agent, the indication and your overall bleeding risk. We will review this at consultation; in some cases we ask the prescribing clinician to advise on peri-procedure management.
What if my suitability self-assessment score is borderline?
A borderline score on the Arthrosamid® suitability self-assessment is one of the reasons we offer a free discovery call before committing to a consultation. The questionnaire is a decision-support tool, not a final answer; the consultation is where the clinical decision is made.
Will you tell me honestly if I am not a good candidate?
Yes. We routinely decline Arthrosamid® cases where the chance of meaningful benefit is low, or where another treatment is the better answer. A clinic willing to say no is a clinic selecting for outcomes — see the Arthrosamid® safety page for the broader picture.
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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
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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.
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vs Knee Replacement
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Arthrosamid® Injection
Comprehensive Overview
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