Knee osteoarthritis is a common condition that causes joint pain and stiffness, making everyday activities difficult. Fortunately, a growing range of minimally invasive treatments now offer relief without the need for surgery. Among these, Arthrosamid has gained attention as an innovative injectable hydrogel therapy. Alongside Arthrosamid, patients often consider other treatments such as corticosteroid injections, hyaluronic acid, autologous conditioned serum (ACS), Botox, prolotherapy, and non-injection options like physical therapy. This article offers a balanced and straightforward comparison of these treatments, focusing on their effectiveness, how long they last, safety, cost, and practical considerations. Our goal is to help patients and carers make well-informed decisions.

Understanding Arthrosamid: What Makes It Different?

Arthrosamid contains polyacrylamide hydrogel (PAAG), a synthetic material injected directly into the knee joint. It works by attaching to the synovial membrane — the lining of the joint — and forming a supportive scaffold that may improve joint lubrication and overall tissue health. It is mainly intended for those with mild to moderate knee osteoarthritis, but eligibility is best assessed by a healthcare professional.

The treatment is a single outpatient injection, usually guided by imaging to make sure it’s placed correctly. Before the procedure, patients are carefully assessed, and expectations are discussed. Some patients may experience mild swelling or discomfort afterwards, but this usually settles quickly. Research has shown that Arthrosamid provides significant pain relief for at least one year, with evidence supporting effectiveness for up to two years. Encouragingly, studies report that “injection of PAAG hydrogel intraarticularly into the knee has been shown to be safe with no long-lasting adverse events reported.”

Arthrosamid is part of a wider wave of advances in hydrogel technology. Over the past 30 years, improvements in polymer chemistry and how hydrogels are made have led to many new injectable and non-injectable hydrogel products entering clinical use. This ongoing progress underpins Arthrosamid’s promising safety and effectiveness profile.

Injection Treatments Compared

Hydrocortisone injections
Hydrocortisone is a corticosteroid that quickly reduces inflammation when injected into the knee. It is often used when osteoarthritis flares up, causing acute pain and swelling. While relief is often rapid, it tends to be short-lived, lasting a few weeks to months. Repeated use is limited due to risks such as cartilage damage and infection. This treatment suits patients with significant inflammatory symptoms.

Hyaluronic acid injections
These injections aim to restore the natural lubrication of the knee by topping up the depleted joint fluid. Benefits tend to build up gradually and usually last between six months and a year. Many patients tolerate them well, though some experience minor swelling or discomfort soon after the injection. Hyaluronic acid remains a well-established choice for mild to moderate osteoarthritis. Recent research comparing Arthrosamid and hyaluronic acid found that “Arthrosamid was non-inferior at 26 weeks and approached superiority at 52 weeks.” The study also showed Arthrosamid performs particularly well in patients under 70 years old, those with a normal body mass index, and those with moderate osteoarthritis.

Autologous Conditioned Serum (ACS) therapy
ACS is a biological treatment made from the patient’s own blood, processed to boost natural anti-inflammatory substances before being injected into the knee. The goal is to change the joint environment to reduce pain. Evidence is mixed but suggests some patients do experience relief. Its autologous nature means it is generally safe, though the treatment requires multiple steps.

Botox injections
Botox injections are an experimental approach aiming to reduce pain by blocking nerve signalling in the joint. Research is still limited, and patient selection is not well defined. So far, side effects appear minimal, but more studies are needed to confirm long-term safety.

Prolotherapy
Prolotherapy involves injecting a sugar-based irritant solution into the ligaments and tendons around the knee, which may stimulate the body’s healing response. Some patients report pain relief and improved stability, but the scientific support is inconsistent. It is generally safe, with typical side effects including mild soreness and swelling.

Non-Injection Alternatives: The Role of Physical Therapy

Physical therapy remains a cornerstone of knee osteoarthritis management. Tailored exercise programmes designed by a physiotherapist can help reduce pain, strengthen muscles, improve joint stability, and enhance mobility. This approach can be used alone or alongside injections.

Physical therapy is very safe and non-invasive, but it usually takes longer to show benefits compared with injections. Success depends on staying committed to the prescribed exercises. Limitations can include patient motivation and access to regular physiotherapy sessions.

Side-by-Side Comparison: Efficacy, Duration, Safety & Practical Considerations

Let’s compare key treatments across important factors:

• Effectiveness: Both Arthrosamid and hyaluronic acid injections provide good pain relief, with Arthrosamid potentially lasting longer. Studies show Arthrosamid can give “positive results for at least 2 years” and is statistically superior in some patient groups, particularly younger patients with normal weight and moderate osteoarthritis. Hydrocortisone injections provide faster relief but are more suited to short-term flare management. ACS and prolotherapy offer mixed results, while Botox is still experimental. Physiotherapy improves function and pain but more gradually.
• Duration: Arthrosamid may provide relief for up to two years, whereas hyaluronic acid typically lasts up to a year. Hydrocortisone relief is shorter, commonly a few weeks to months. ACS and prolotherapy effects tend to be short to medium term, and physical therapy benefits require ongoing effort.
• Safety: Arthrosamid and hyaluronic acid are generally safe, with minimal serious side effects. Arthrosamid studies note no long-lasting adverse reactions. Corticosteroids risk damage if overused. ACS is safe given its use of the patient’s own blood. Botox safety is still being established. Prolotherapy is well tolerated but can cause mild soreness. Physiotherapy is extremely safe.
• Cost and Availability: Arthrosamid tends to be pricier and mainly offered privately. Hydrocortisone injections are lower cost and commonly available on the NHS. Hyaluronic acid and ACS may be available via both NHS and private routes. Botox and prolotherapy are mostly private. Physiotherapy access varies but is largely NHS funded.
• Practicalities: Arthrosamid and hyaluronic acid involve outpatient injections with little downtime, though Arthrosamid requires careful placement. Hydrocortisone injections may be repeated but less frequently due to risks. ACS needs blood processing. Botox and prolotherapy usually require multiple treatments. Physical therapy requires patient commitment over time.

Making the Choice: Discussing Options With Your Healthcare Provider

Deciding which knee osteoarthritis treatment is right for you should be done in partnership with your healthcare provider. It’s important to discuss your pain levels, lifestyle, previous treatments, and expectations. You might ask how Arthrosamid compares with other injections, what side effects to watch for, how long each treatment lasts, and how physical therapy might fit in your care plan.

Preparing questions ahead of time can help you make the most of your consultation. Remember, a shared decision-making approach ensures your treatment plan fits your individual needs and circumstances.

Conclusion
Knowing your treatment options for knee osteoarthritis gives you greater control over your care. Arthrosamid offers a promising, longer-lasting injectable treatment with a strong safety record, alongside well-established alternatives and physical therapy. With ongoing research and clinical advances, more effective treatments are becoming available, broadening choices for managing knee pain and improving quality of life.

References

• Cole, A., Maulana, R. K., Whitehead, J. P., & Lee, P. Y. F. (2022). A systematic review of the novel compound Arthrosamid polyacrylamide (PAAG) hydrogel for treatment of knee osteoarthritis. Medical Research Archives, 10(8). https://doi.org/10.18103/mra.v10i8.2950
• Clegg, J. R., Adebowale, K., Zhao, Z., & Mitragotri, S. (2024). Hydrogels in the clinic: An update. Bioengineering & Translational Medicine, 9(6). https://doi.org/10.1002/btm2.10680
• Bliddal, H., Beier, J., Hartkopp, A., Conaghan, P. G., & Henriksen, M. (2023). Polyacrylamide hydrogel versus hyaluronic acid in knee osteoarthritis: A subgroup analysis of a randomised study. Orthopaedic Proceedings, 105-B(SUPP_13), 81. https://doi.org/10.1302/1358-992x.2023.13.081