London Cartilage Clinic IconLondon Cartilage Clinic
Professor Paul YF LeeReviewed byProfessor Paul YF LeeCartilage and joint preservation expertise
Last reviewed 4 October 2026Last updated 20 August 2026
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UNDERSTAND YOUR OPTIONS

Arthrosamid vs knee replacement

An injection and an operation answer different needs. Explore symptom management, joint replacement and how the decision is made.

NON-ABSORBABLE HYDROGEL

Arthrosamid

HydrogelJoint liningSymptom management

A polyacrylamide hydrogel that integrates with the joint lining. Intended for knee osteoarthritis symptom management.

Surgical replacement of joint surfaces

Knee replacement

MetalInsert
Worn surfacesReplacementRehabilitation

Partial or total knee replacement replaces worn joint surfaces with implants. It involves surgical planning and rehabilitation.

THE KEY DIFFERENCE

Arthrosamid® vs Knee Replacement — the key difference

Knee replacement removes and replaces the joint surface — it is a major operation for end-stage arthritis with a strong evidence base. Arthrosamid® is a non-surgical injectable hydrogel that treats symptoms through the joint lining without altering the underlying joint. Where the joint and clinical picture make a non-surgical option reasonable, Arthrosamid may be discussed for symptoms; where the disease is end-stage, replacement may be the more appropriate and predictable route.

01

HOW IT WORKS

Two approaches to the same problem

Arthrosamid

HydrogelJoint liningSymptom management

Arthrosamid® is a polyacrylamide hydrogel injected into the knee joint under ultrasound guidance. The gel integrates into the synovial membrane and is intended to remain in the joint. It is not regenerative.

Once in place it is incorporated into the inner capsule, and the effect is on that lining: less irritation, less tightness. Nothing is added between the joint surfaces, so it is not a lubricant and not a cushion for the cartilage. It does not regenerate cartilage, does not reverse arthritis and does not alter the joint surface.

Knee replacement

MetalInsert
Worn surfacesReplacementRehabilitation

Total or partial knee replacement is a definitive surgical procedure in which the worn joint surfaces are removed and replaced with metal and polyethylene implants. The underlying arthritic surface is no longer present.

Modern knee replacement has a mature evidence base. Outcomes and risks vary, so an individual surgical consultation is needed rather than a promise of pain relief or longevity.

02

LOOKING AHEAD

What can you expect over time?

Arthrosamid

24-month study follow-up
An observation period, not a duration guarantee

Observed to 24 months

The prospective observational cohort reports group-level outcomes through 24 months. It has no randomised control group and does not show that replacement was delayed or predict individual response duration.

Knee replacement

Long-term implant
Implant longevity and revision are discussed at assessment

Long-term surgical implant

Knee replacement has a mature evidence base and long-term implant-survival data. Results, implant longevity and revision risk vary with patient, implant, surgery and follow-up; these are discussed in a surgical consultation.

Direct comparison of duration is misleading: Arthrosamid® treats symptoms in a joint that still has its own surface; replacement is a definitive operation that replaces the surface. They sit at different points on the treatment ladder.

03

YOUR TREATMENT PLAN

What does the course involve?

Arthrosamid

  1. 01Clinical assessment
  2. 02Injection appointment
  3. 03Six-week review

One injection is the standard treatment course in suitable patients. A further Arthrosamid® treatment may be considered at a future date if symptoms recur and the joint is still suitable.

Knee replacement

  1. 01Surgical planning
  2. 02Operation
  3. 03Rehabilitation

Knee replacement is performed as one operation, but some implants later need revision. Longevity and revision risk depend on patient, implant, surgery, activity and follow-up.

04

CARE & PRECAUTIONS

Understanding the risks

BEFORE · DURING · AFTERPrecautions.
Clear advice.
Ongoing support.
Understand the pathway around the treatment.

These are very different procedures with very different risk profiles. Arthrosamid® is an outpatient injection; a serious potential risk is joint infection. Knee replacement is major surgery with the risks inherent in any joint replacement — infection, venous thromboembolism, anaesthetic complications, and a rehabilitation period of weeks to months.

Arthrosamid® at London Cartilage Clinic uses routine IV antibiotic cover and ultrasound guidance. Knee replacement is delivered through hospital admission with the standard peri-operative care that surgery requires. See Arthrosamid® infection risk and prevention for the injection-specific protocol.

05

YOUR KNEE, YOUR GOALS

Where does each option fit?

A consultation to discuss the right approach for your knee
Your symptoms, scans and goals guide the decision.

Knee replacement is the right answer for end-stage osteoarthritis — bone-on-bone change, severe deformity, persistent symptoms despite conservative measures, and a clinical and imaging picture that supports it. We will say so honestly when this is the case.

Arthrosamid may be discussed for symptom management where a non-surgical option is reasonable, expectations are realistic and the safety protocol is acceptable. It is not proved to delay replacement and is not a substitute where surgery is clinically appropriate. See who is suitable for Arthrosamid?.

06

PLANNING THE COST

Compare the complete care package

Published London Cartilage Clinic prices. The specialist consultation is £350 separately for each pathway.

OUTPATIENT INJECTION

Arthrosamid

From£3,000

One box. Two boxes £5,500; three boxes £8,000. Your clinical assessment confirms the requirement.

Full Arthrosamid pricing →

PARTIAL KNEE REPLACEMENT

One compartment

Fixed price£23,000

For selected knees where only one compartment needs replacing. The LCC price reflects custom planning and instrumentation.

What the surgical price includes →

What is included?

Arthrosamid: ultrasound, product, the injection protocol including IV antibiotics, and six-week follow-up.

Knee replacement: theatre, implant, surgeon and consultant anaesthetist fees, two post-operative consultations and a six-month review, with access to the surgical team for concerns.

What should you budget for separately?

The £350 pre-treatment consultation, any required imaging or pre-operative blood tests, onward physiotherapy, and travel or accommodation. Confirm your individual plan and inclusions before proceeding.

These treatments meet different clinical needs. Cost belongs in the discussion alongside suitability, expected benefit, risks and recovery.

LCC prices reviewed October 2026. Your consultation confirms the appropriate treatment and written care plan.

07

MAKING A RECOMMENDATION

When each option may make sense

Arthrosamid

A discussion to have

You have established knee osteoarthritis with mild-to-moderate cartilage wear.

You want to discuss non-surgical symptom management with realistic expectations and willingness to accept the product-specific safety protocol.

Surgery has been suggested but you want to explore a non-surgical option first, and the imaging supports a non-surgical attempt being reasonable.

Knee replacement

A discussion to have

End-stage bone-on-bone osteoarthritis with persistent symptoms despite conservative care.

Significant deformity, instability or mechanical failure of the joint that an injection cannot address.

A clinical and imaging picture that points clearly to definitive surgery as the better answer.

08

CHOOSING ANOTHER PATH

When another approach may be better

Arthrosamid

A reason to reconsider

End-stage bone-on-bone arthritis where Arthrosamid® is unlikely to deliver meaningful benefit and replacement is the appropriate path.

Patients expecting Arthrosamid® to prevent knee replacement — that is not what the treatment can promise.

Active infection or unwillingness to accept the conservative safety protocol.

Knee replacement

A reason to reconsider

Mild-to-moderate osteoarthritis where conservative measures and a non-surgical injection have not yet been tried.

Significant comorbidity that makes major surgery a poor risk-benefit choice, where a less invasive option remains reasonable.

Patients whose current symptoms, imaging or health make further non-surgical management a reasonable discussion before committing to surgery.

Discussing the right knee treatment with a clinician
YOUR KNEE. YOUR DECISION.

Bring the comparison back to you

Arthrosamid® and knee replacement sit at different points on the treatment ladder for knee osteoarthritis. Arthrosamid has not been proved to delay or prevent knee replacement, and it is not a substitute where replacement is clinically appropriate. Where non-surgical symptom management remains reasonable, Arthrosamid may be discussed. Where the disease is end-stage, replacement is usually the right answer. We will tell you honestly which one fits your case.

Arthrosamid® vs Knee Replacement

Prepare for an assessment →
YOUR QUESTIONS

Common questions, clear answers

Can Arthrosamid® help me avoid a knee replacement?

Arthrosamid has not been proved to delay or prevent knee replacement. It may be discussed as symptom management where non-surgical care remains reasonable, but it is not a substitute where replacement is clinically appropriate. The decision depends on symptoms, examination, imaging, function and goals.

Has Arthrosamid® been proved to delay knee replacement surgery?

No. The observational cohort reports group-level symptom outcomes through 24 months, but it has no randomised control group and was not designed to prove that replacement was delayed. Symptom change should not be converted into a surgery-delay claim.

Will Arthrosamid® make a future knee replacement more difficult?

Evidence is not sufficient to promise that a future operation will be unaffected. Tell any future surgeon about the product, injection date, response and any complication. A surgical team can then plan using the complete clinical record.

I have been told I need a knee replacement. Should I try Arthrosamid® first?

That needs individual assessment. Where non-surgical symptom management remains reasonable, Arthrosamid may be one option to discuss. Where the clinical and imaging picture supports replacement, an injection should not be presented as a substitute or a proved way to delay surgery.

Does Arthrosamid® regenerate cartilage or reverse arthritis?

No. Arthrosamid® is a non-absorbable hydrogel, not a regenerative treatment or cure. It does not regenerate cartilage or reverse the underlying arthritis. It manages symptoms while the underlying disease continues to be what it is. See the Arthrosamid® clinical evidence page.

Is knee replacement available on the NHS?

Yes, knee replacement is a routine NHS procedure for clinically appropriate cases, though waiting times vary. Arthrosamid® is not routinely funded by the NHS. See the Arthrosamid® self-pay and payment page for the private-pay context.

Explore related guides

Detailed information on suitability, research, and recovery to help you prepare for your consultation.

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Suitability & Assessment

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Research & Results

The research behind the treatment, including the 24-month prospective cohort study.
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Recovery & Aftercare

Your recovery, one step at a time. Milestones, activity guidelines, and when to seek advice.
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