Arthrosamid Injection in London: A Complete Guide
Osteoarthritis is the most common form of arthritis in the knee. It increasingly affects younger people. Treatment options include exercise, weight loss, medication, injections, and knee replacement. Arthrosamid — a non-degradable hydrogel — now offers longer-lasting pain relief than other injections for many patients.
Dr Masci performs Arthrosamid injections at his London clinics for £2,500, all-inclusive. This price is significantly below that of most other UK centres. He has over 15 years of experience in ultrasound-guided injections and teaches these techniques to doctors across the UK and Europe. This guide explains what Arthrosamid is, the evidence behind it, the procedure, and the cost.
What causes knee osteoarthritis pain?
Osteoarthritis wears away the knee’s shock-absorbing cartilage. This leads to bone-on-bone contact, inflammation, stiffness, and pain. Importantly, the pain comes mostly from joint inflammation rather than the cartilage wear itself. Arthrosamid targets this inflammation directly.
Treatment options for knee osteoarthritis
Exercise therapy and weight loss remain the most effective treatments. Medications such as ibuprofen also help. For more severe cases, we use injections into the knee joint. Common options include cortisone, hyaluronic acid, and PRP. Arthrosamid now offers a longer-lasting alternative to these established injections.
What is Arthrosamid?
Arthrosamid is a hydrogel. It consists of 97.5% water bound to a 2.5% polyacrylamide backbone. The gel is non-degradable, which means the body cannot break it down. This property gives Arthrosamid its long-lasting effect.
Doctors have used this hydrogel for over 20 years as a bulking agent in conditions such as stress incontinence. Vets have used it extensively in horses with arthritis since 2009, and doctors first used it in human joints in 2010. Biological studies show Arthrosamid is inert. It does not react with muscle, bone, or joint tissue. Clinicians have performed more than 26,000 Arthrosamid injections in Europe and the UK since its approval in 2020.
How does Arthrosamid gel work?
The synovium is a thin membrane lining the joint. Its cells produce the fluid that lubricates the knee. When we inject Arthrosamid gel into the joint, synovial cells take it up and form a new joint lining. This new lining reduces inflammation, which in turn reduces pain. The process takes up to four weeks.
What does the evidence show?

The evidence base for Arthrosamid continues to grow. Early studies from 15 years ago showed excellent results from 4 weeks through 26 weeks. Follow-up studies showed the effect persisted for years.
A randomised controlled trial compared Arthrosamid with hyaluronic acid in knee arthritis. Both improved symptoms at one year. However, Arthrosamid performed better in younger, slimmer patients and in those with a large effusion. The overall positive response rate reached 73%, and age strongly influenced the result:
- Under 60 years: 94% response rate
- Under 70 years: 80% response rate
- Over 70 years: 63% response rate
Pain relief typically begins at 4 weeks and peaks at around 12 weeks. A recent study from Turkey suggests the maximum effect can take up to six months. On average, patients improve by 20–25% in pain and function. Crucially, long-term RCT data show the benefit lasts at least five years. Hyaluronic acid and PRP, by comparison, last around a year.
A further RCT compared Arthrosamid with Synvisc-1 (a hyaluronic acid). Patients with knee swelling responded better to Arthrosamid at 6 months. In our experience, patients with an inflamed, swollen knee do particularly well with Arthrosamid gel.
How does Dr Masci perform an Arthrosamid injection?
Accuracy decides the outcome. Without imaging, knee injections reach the joint only 50–80% of the time. That means up to one in three blind injections misses the target — a costly miss with a £2,500 product. Dr Masci performs every Arthrosamid injection under ultrasound guidance, which delivers close to 100% accuracy.
The procedure follows clear steps. Dr Masci numbs the skin with a local anaesthetic. If the knee carries significant swelling, he drains it first. He then guides the needle into the joint under ultrasound and injects the gel using a sterile technique. The video below shows Dr Masci performing the injection.
[VIDEO: keep existing video embed — Dr Masci performing ultrasound-guided knee injection]
Dr Masci has performed thousands of ultrasound-guided procedures. He teaches advanced injection techniques to doctors and physiotherapists across the UK and Europe, and publishes research on injection therapy. You can read more about his injection expertise here.
What should you expect after the procedure?
We observe you for 15 minutes after the injection. You may feel tightness or mild pain once the anaesthetic wears off. Continue your regular medications and painkillers. Arthrosamid feels denser than other injectables, so the sensation may differ from injections you have had before.
Side effects of Arthrosamid injections
Patients tolerate this implant well. The most common side effect is pain at the injection site. The knee may also feel full or distended, and a Baker’s cyst can swell. This flare affects around 20% of patients, stays mild, and settles within 2–4 weeks. We manage it with relative rest, ice, and anti-inflammatories such as ibuprofen.
Serious side effects are rare. Reported rates of suspected infection sit at around 0.02% — a handful of cases across tens of thousands of injections. As a precaution, we give prophylactic antibiotics at the time of injection. Because the gel is non-degradable, a high antibiotic concentration at injection further reduces the risk of infection.
How much does an Arthrosamid injection cost in London?
Dr Masci performs Arthrosamid injections for £2,500, all-inclusive. This covers the ultrasound-guided procedure with one of the UK’s most experienced injection specialists. Most other London and UK centres charge considerably more for the same product — often without ultrasound guidance as standard.
UK private insurance does not currently cover Arthrosamid, so all patients self-fund. Dr Masci also treats patients travelling from overseas, including the USA and Canada, where Arthrosamid is not yet available. Our clinic locations are here, and you can contact the team here to book.
Who responds best to Arthrosamid?
From our experience, the best candidates include:
- Patients with patellofemoral osteoarthritis who want to avoid surgery
- Those who tried other injections without lasting relief
- Patients too young for a knee replacement — under-70s show an 80%+ response rate
- People who want to stay active
- Patients with knee swelling or pain after activity
Not everyone improves. Around 5–20% of patients see no benefit or feel worse, a rate similar to other injectables. We discuss this honestly at your consultation before you commit.
Frequently asked questions about Arthrosamid
How long does Arthrosamid take to work?
Pain relief usually starts at four weeks. The maximal effect generally arrives at 3 months, though a recent study suggests it can take up to six months. Some patients notice improvement within two weeks.
How long does Arthrosamid last?
A 2025 study shows the benefit lasts at least 5 years. Patients under 70 respond better than those over 70. This compares favourably with hyaluronic acid and PRP, which last around a year.
Is Arthrosamid gel a type of hyaluronic acid?
No. The body rapidly degrades hyaluronic acid. Arthrosamid hydrogel is non-degradable, so it remains in the knee joint and lasts longer.
When can you return to sport after an Arthrosamid gel injection?
Rest the knee from exercise for around 10 days. Short-term rest reduces the chance of a flare. A typical return to running looks like this:
- Day 1: complete rest, ice, and ibuprofen for pain
- Day 2: upper body weights and swimming without kicking
- Days 3–7: add light kicking and light cycling
- Days 7–10: start lower body weights at 50% intensity
- Day 14: return to running, guided by pain
Are there any contraindications?
We do not inject Arthrosamid if you have: active skin or joint infection; a recent cortisone, hyaluronic acid, or PRP injection that has not yet degraded; a knee replacement (metal in the joint); knee arthroscopy within six months; infection in another joint; or inflammatory arthritis such as psoriatic arthritis. We also do not treat minors or pregnant women.
I’ve just had a Durolane injection. Do I have to wait?
Yes. Wait 3 months for the Durolane to fully degrade before having Arthrosamid.
Can Arthrosamid be injected without imaging?
Yes, but we strongly advise against it. Blind knee injections reach the joint only 60–80% of the time. Ultrasound guidance delivers close to 100% accuracy. With a £2,500 product, accuracy matters. Always confirm that your doctor uses an ultrasound.
Can I have both knees treated?
Yes. We space the injections at least 1 week apart rather than treating both knees in one visit.
Can I have a top-up injection?
Yes, if you had a partial response. Wait around 6 months first, as Arthrosamid can take that long to reach full effect. Top-ups use 3 mL rather than the initial 6 mL.
Can you have a knee replacement after Arthrosamid?
Yes. Safety data extend roughly 15 years, including 90 knees that went on to replacement with no reported problems during or after surgery. About 10% of Arthrosamid patients later undergo knee replacement.
Do diabetes or obesity change the response?
Diabetes reduces effectiveness by roughly 10%, but it is not a contraindication. Obese patients respond similarly to non-obese patients, and weight loss further helps with pain.
Can people with active cancer have Arthrosamid gel?
Yes. Unlike PRP, active cancer does not contraindicate Arthrosamid.
Is Arthrosamid available on the NHS?
No. Several NHS trusts are running studies so that you can contact your local trust for details.
When will Arthrosamid be available in the USA?
Contura has applied for FDA approval, as well as approval in Canada and Australia. The timeline remains uncertain. In the meantime, Dr Masci treats patients who travel to London from the USA and Canada.
Final word from Sport Doctor London about Arthrosamid
Could Arthrosamid be a game changer for stubborn knee arthritis? Potentially, yes. Consider it if exercise, weight loss, and other injections such as Durolane or PRP have not worked. Understand that not every patient improves — we select candidates carefully and advise you honestly.
Dr Masci offers ultrasound-guided Arthrosamid injections in London for £2,500 — significantly less than most other UK centres. He also welcomes patients from the USA and Canada. Contact his dedicated team here or call +44 (0) 203 488 0350.
Could you please provide information of where the treatment is based. I am looking for options that are an alternative to knee replacement for my 75 year old mother.
I would also like more information about treatment for psyoratic arthritis for my daughter (in her feet) who is 26
Hi Rebecca, Arthrosamid is available in most EU countries and UK. I don’t think it’s licensed in US yet. You should see a rheumatologist to discuss treatment options for psoriatic arthritis.
LM
I had this procedure at a (different) clinic and cannot recommend it highly enough. To be able to walk without a stick and without pain after 8 years gave me my life back.
Thanks, Patricia, for the comment. As I mentioned in my blog, I’m still hesitant to recommend Arthrosamid as a first-line injeciton treatment as it’s a relatively new drug. But if I get more feedback like yours, I’ll be more confident moving forward. Indeed, my veterinary friends are raving about how effective Arthrosamid is in racing horses.
Lorenzo
Can you tell me if this is suitable for moderate/severe osteoarthritis of the patella femoral joint please.
Hi Pamela, patellofemoral osteoarthritis is generally less responsive to other injectables such as hyaluronic acid or PRP. So I tend to use Arthrosamid in these cases as a preference.
LM
My 85 year-old father had surgery on his left knee for a torn meniscus in the 1970s. (Just a few years later, when the right knee was worked on, the procedure medical technology had evolved and the procedure was arthroscopic.) He’s reached a point where cortisone injections don’t work. For really the first time, just a couple of days ago, he said he is actively considering a knee replacement. But he also remarked that signing up for a procedure that would involve four or months of painful rehab is a difficult proposition when “I don’t knowhow many months I have left.
I had a vague memory of there being new treatments, but in doing the research, it’s clear the United States is lagging behind the UK. The FDA approved a hydrogel by Contura called Bulkamid (2.5% polyacrylamide; 97.5% water) for urinary incontinence, but whether this is the exact same configuration as Arthrosamid under another name is not clear. In any event, getting updated passports and going on an international trip sounds much more appealing than invasive surgery and months of rehab. Does your clinic offer services to non-UK residents/citizens?
Hi Shawn,
Yes, I believe the hydrogel used for urinary incontinence is the same gel used for knee osteoarthritis.
And yes I see overseas patients at my clinic.
LM
I can vouch for Dr. Lorenzo. I consult him from outside the UK for my treatment plan and he’s given practical and useful advice for my chondromalacia patella. His blog also has easy to digest and up to date information on new developments.
Hi could you please advice.I’m 52 and have had none on bone in my right knee for over 2 years.I’ve had steroid injections but they don’t work anymore.
My Gp has just referred me to see an orthopaedic surgeon but I’m told I’m too young for knee replacement surgery.
I will have to wait 10 years?
I’ve lost a lot of weight hoping this will help with weight bearing on the joints.I’m in agony 24/7.
I have psoriatic arthritis but possibly rheumatoid as I don’t have psoriasis.
Please could you advise if I could have this injection.It’s my tight knee and I can’t even walk anymore without aids.
Thank you.
Hi Mary,
I would avoid further cortisone injections as recent evidence suggests that cortisone injections may accelerate arthritis progression.
You have a few options. I outline options in this blog:
https://sportdoctorlondon.com/no-cartilage-in-knee/
Durolane is my preferred first option for mild to moderate osteoarthritis
https://sportdoctorlondon.com/durolane-injection/
Arthrosamid is an option if your knee pain and swelling is NOT directly related to inflammatory arthritis. if you have acute inflammatory arthritis affecting your knee, you need to consider other options.
Hi, I had Arthrosamid injections in both knees 6 weeks ago, so far I’ve had no relief whatsoever, is there a chance it will improve? If not what should be my next step?
Hi Les, As I mentioned in my blog, onset of pain relief may take up to 12 weeks and sometimes longer. So you need to wait a few more months yet.
LM
Hello, Would insurance cover the injections? Thanks
Hi Cynthia,
Many thanks for your query. Unfortunately, UK private insurance does not cover Arthrosamid. Moreover, I’m not aware of insurance coverage in Europe. Currently, it is not used in the USA or Canada.
Regards
Lorenzo
I am 80 years old had authrosamid injections over a month ago i did not have ultra sound guidance or imflamation procedure and i have no pain relief i am most disappointed
Mr.F.Ralph
f.ralph@sky.com
Thanks for your comment. I’m sorry to hear you didn’t get a response to Arthrosamid. Based on studies, the drug is only effective in 75-85% of individuals, with younger patients doing somewhat better. So that leaves at least 1 in 4 to 1 in 5 who don’t respond at all.
Hi! I am 83 years old. I am a reasonably fit, athletic male suffering from an arthritic knee. This, for the past couple of years. Two weeks ago I had the arthrosamid injection in my left knee. Presently the arthritic pain in the knee is showing signs of alleviating the pain. After reading the comments you have expressed concerning patients queries on your ‘comment page’ you have given me a glimmer of hope to expect great things from my treament. Thanks, Lorenzo!
Good to hear you’re experiencing pain relief at 2 weeks. You should expect your symptoms to continue to improve for at least another 2-3 months with a maximal effect at 3-4 months. LM
Hi there, I am 27 F with background of left knee MPFL reconstruction three years ago then found out I have pain from chondromalaecia patellae in my right knee 1.5 years ago due to a TTTG distance of 21mm which has been causing me pain on any lateral movement thus have not been able to do any sports or intense exercises, even after adherence to intense physiotherapy sessions as suggested by an orthropaedic consultant. Please can I ask if arthrosamid will be beneficial in my case? I will be most grateful.
Hi It could be but I’d recommend you look at other options such as hyaluronic acid or PRP first – cheaper and may work as well for you. See this article for further information regarding your options https://sportdoctorlondon.com/no-cartilage-in-knee/