Ultrasound Guided Injections in Cambridge

What is Arthrosamid®?

Arthrosamid® is a permanent injectable hydrogel developed specifically for knee osteoarthritis. Unlike other joint injections, Arthrosamid® integrates with the synovial tissue lining the knee joint over six to twelve weeks, becoming a permanent part of the joint. It softens and improves the elasticity of the joint tissue, reducing pain and stiffness. A single injection is all that is required.

Arthrosamid® is a permanent treatment that cannot be removed or reversed. Your clinician will discuss this with you in full at your consultation before you proceed.

What does Arthrosamid® treat?

Arthrosamid® is indicated for knee osteoarthritis in patients who:

• Continue to have significant pain despite other treatments
• Want a long-lasting solution without repeated injections
• Want to avoid or delay knee replacement surgery

Clinical studies demonstrate effectiveness for up to five years, with around 80% of patients under 70 experiencing positive results.

What happens during the procedure?

Antibiotics are given before the injection as a standard precaution. The knee is cleaned and numbed with local anaesthetic. Arthrosamid® is injected into the knee joint under ultrasound guidance. You may notice it feels thicker than other injections — this is normal. The procedure takes 15 to 20 minutes and is performed as a day case; you go home the same day.

What are the benefits of Arthrosamid®?

• A single Arthrosamid® injection with proven pain relief lasting up to five years and beyond
• No need for repeated treatments
• Significant improvements in pain and daily function
• Most patients return to their desired activity level
• Does not prevent knee replacement surgery if needed in the future

Before your Arthrosamid® appointment

You cannot have Arthrosamid if you have an active skin infection near the knee, an acutely infected or inflamed knee joint, any previous permanent joint implant or foreign material in the knee, knee arthroscopy within the last six months, uncontrolled bleeding disorders, or if you are pregnant or breastfeeding. Please bring a full list of current medications and details of any previous knee treatments or surgery.

After your appointment

Some mild pain and swelling is normal in the first few days. Avoid strenuous activities for the first few weeks while Arthrosamid integrates with the joint tissue. Gentle daily activities can be resumed as comfortable. Structured physiotherapy is recommended. Full integration is complete at six to twelve weeks, after which most patients can return to their normal activity level.

You must always inform any future healthcare provider — including your GP, hospital doctors, surgeons, and dentists — that you have an Arthrosamid implant in your knee. It is visible on medical scans and providers need to be aware of it. You will be given an implant identification card after your procedure.

Anthrosamid® FAQs

What are the risks of Arthrosamid®?

Because Arthrosamid® is permanent, thorough pre-treatment assessment and patient selection is essential. Mild temporary pain and swelling at the injection site is the most common side effect, usually resolving within days to weeks. Joint infection is rare but serious. Arthrosamid has an excellent safety record with over 20 years of clinical use.

Can Arthrosamid® be removed if it does not work?

No. It permanently integrates with the knee tissue and cannot be removed or reversed. This is why the pre-treatment consultation is thorough and unhurried.

Will it show up on future scans?

Yes. Always tell any healthcare provider — including surgeons and dentists — about your implant. Carry your implant card with you.

Can I have both knees treated?

Yes, though your clinician will advise on appropriate timing between treatments.

What if I need a knee replacement in the future?

Having Arthrosamid® does not prevent future knee replacement surgery. Always inform your surgeon about the implant.

How successful is it?

Clinical studies show that around 80% of patients under 70 experience positive results, with benefits proven for up to five years.

What is it?

Steroid injections use corticosteroids — powerful anti-inflammatory medicines that reduce swelling, pain and stiffness in joints and soft tissues. These are medical steroids that work by mimicking cortisone, a hormone your body produces naturally. They are not the same as anabolic steroids.

What does it treat?

Steroid injections are used for a wide range of joint and soft tissue conditions, including:

• Osteoarthritis (knee, hip, shoulder, ankle)
• Frozen shoulder (adhesive capsulitis)
• Bursitis
• Tendonitis (rotator cuff, Achilles, patellar)
• Tennis and golfer’s elbow
• Trigger finger
• Plantar fasciitis

What happens during the procedure?

You will be positioned comfortably with the treatment area accessible. The skin is cleaned and local anaesthetic is used to numb the area. Your clinician will use ultrasound to guide the injection precisely into the target tissue, delivering a mixture of steroid and local anaesthetic into the joint or soft tissue. The procedure takes 15 to 30 minutes.

What are the benefits?

• Significant pain relief and improved movement in most patients
• Effects typically last three to six months, sometimes longer
• Can be repeated if effective, generally up to twice per year at any single site

Before your appointment

Tell us if you are diabetic — steroid injections can raise blood sugar levels for two to three days and you may need to monitor more closely. Tell us if you are a competitive athlete, as anti-doping considerations apply. Blood-thinning medications may need to be temporarily stopped — contact us for advice as soon as possible.

After your appointment

A steroid flare — a temporary increase in pain for 24 to 48 hours — affects up to one in four patients and is a normal response. Apply ice for 15 to 20 minutes several times a day and take paracetamol if needed. Avoid strenuous activity and swimming for 48 hours. Most patients notice the steroid beginning to take effect within a few days, with maximum benefit at two to six weeks.

Steroid Injection FAQs

What are the risks?

Steroid flare affects up to 25% of patients and is normal. Diabetic patients should monitor blood sugar closely for two to three days. Women may notice slight menstrual irregularity for one to two cycles. With superficial injections, there is a small risk of minor skin lightening or a small dip at the injection site.

Are these the same steroids athletes use illegally?

No. Corticosteroids are medical steroids that reduce inflammation. They are entirely different from anabolic steroids.

How long before I can drive?

You cannot drive for at least 24 hours due to the local anaesthetic and the possibility of a steroid flare.

Will this cure my condition?

Steroid injections treat symptoms and inflammation effectively but do not alter the underlying condition. They are most effective as part of a broader management plan, ideally alongside physiotherapy.

What if I am a competitive athlete?

Please inform us when booking. Steroid injections may require a therapeutic use exemption under anti-doping regulations.

Can I have injections in more than one joint?

Yes, though not usually on the same day.

What is it? 

Hydrodistension is a procedure in which a larger volume of fluid — typically saline combined with steroid and local anaesthetic — is injected to stretch tight or scarred tissues, break down adhesions and improve range of motion. It is most commonly used for frozen shoulder and Achilles tendon problems.

What does it treat?

• Frozen shoulder (adhesive capsulitis)
• Achilles tendon disease
• Joint stiffness following injury or surgery

What happens during the procedure? 

You will be positioned comfortably with the treatment area accessible. The skin is cleaned and local anaesthetic used to numb the area. Your clinician will use ultrasound to guide the needle precisely into the target tissue. A larger volume of fluid is slowly injected — you may feel a sensation of pressure or stretching, which is normal. The procedure takes 15 to 30 minutes.

What are the benefits?

• Stretching the joint capsule forms part of the therapeutic effect, making this particularly effective for frozen shoulder
• Breaks down adhesions and restores range of motion
• Combined steroid component provides additional anti-inflammatory relief

Before your appointment 

Tell us if you are diabetic — the steroid component can raise blood sugar levels for two to three days and you may need to monitor more closely. Blood-thinning medications may need to be temporarily stopped — contact us for advice as soon as possible.

After your appointment 

Begin gentle exercises within 24 hours — the window created by the distension is limited and physiotherapy should ideally start within 48 hours to make the most of the improved range of motion. Avoid strenuous activity and swimming for 48 hours.

Hydrodistension FAQs

What are the risks? 

A temporary increase in pain for 24 to 48 hours following the procedure is common and normal. Diabetic patients should monitor blood sugar closely for two to three days. Women may notice slight menstrual irregularity for one to two cycles.

How long before I can drive? 

You cannot drive for at least 24 hours due to the local anaesthetic used during the procedure.

Will this cure my condition? 

Hydrodistension is most effective as part of a broader management plan. For frozen shoulder in particular, the procedure works best when followed promptly by physiotherapy to consolidate the improvement in range of motion.

Can I have this alongside other injections? 

Yes, though not usually on the same day as other procedures.

What is it?

Platelet Rich Plasma (PRP) is a regenerative treatment that uses your own blood to promote healing in damaged tissue. Blood is taken from your arm, processed in a centrifuge to concentrate the platelets and growth factors, and then injected into the affected area under ultrasound guidance. Because it uses your own blood, there is no risk of allergic reaction or disease transmission.

What does it treat?

PRP is used for chronic conditions that have not responded adequately to other treatments, including:

• Tennis elbow and golfer’s elbow
• Achilles and patellar tendinopathy
• Ligament injuries
• Meniscal problems
• Bursitis
• Chronic joint inflammation and osteoarthritis of the knee, hip, and shoulder

What happens during the procedure?

A small blood sample (approximately 16ml) is taken from your arm. This is processed in a centrifuge for around five minutes to concentrate the platelets. The treatment area is numbed with local anaesthetic and the PRP injected precisely into the damaged tissue under ultrasound guidance. The entire process takes approximately 30 minutes.

What are the benefits?

• Stimulates the body’s own healing response without surgery
• Most patients notice improvement within two to six weeks
• Full effects develop over up to three months
• Results can last six to twelve months or longer
• Repeat treatment is possible if symptoms return

Before your appointment

You must stop anti-inflammatory medications one week before your procedure. This includes ibuprofen (Nurofen), naproxen, aspirin (unless prescribed for a heart condition), and diclofenac (Voltarol). 

This is essential — anti-inflammatory drugs suppress platelet activity and will undermine the treatment if taken too close to the procedure.

Blood-thinning medications may need to be temporarily adjusted — contact us as soon as possible if you take warfarin, apixaban, rivaroxaban, or clopidogrel. You can eat and drink normally on the day.

After your appointment

Do not take anti-inflammatory medications for four weeks after your procedure. Use paracetamol for pain relief instead. Keep activity minimal for the first three days, then gradually increase as comfortable. Most patients can return to desk work within a few days; manual work involving heavy lifting may require approximately a week off.

FAQs

What are the risks of PRP?

Because PRP uses your own blood, the risk of allergic reaction is negligible. The most common side effects are temporary soreness and swelling at the injection site in the first 48 hours. A temporary increase in pain is normal and usually resolves quickly. Infection is extremely rare (fewer than 1 in 25,000 procedures).

Why can’t I take anti-inflammatories?

Anti-inflammatory medications suppress platelet activity, directly undermining the mechanism by which PRP works. Avoiding them before and after treatment is essential, not optional.

How soon will I see results?

PRP works gradually. Some patients notice improvement within days; others take several weeks. Full benefits can take up to three months to develop.

Will I need more than one injection?

Most patients have a single injection. Repeat treatment can be considered if symptoms return after a period of improvement.

Is physiotherapy recommended alongside PRP?

Yes, and often as part of a structured plan to maximise and sustain the benefits of treatment.

Is PRP suitable for everyone?

Not for every condition. Your clinician will assess whether PRP is appropriate for your specific situation and will discuss realistic expectations with you.

What is it?

Hyaluronic acid (HA) is a substance found naturally in joint fluid, where it provides lubrication and shock absorption. In osteoarthritis, the amount and quality of this fluid decreases over time, leading to increased friction, pain, and stiffness. 

An HA injection — also called viscosupplementation — restores lubrication to the joint, reduces pain, and may help protect remaining cartilage. We use Ostenil Plus, a high-quality HA product from TRB Chemedica, developed specifically for osteoarthritis treatment.

What does it treat?

HA injections are most commonly used for knee osteoarthritis, and can also be effective for:

• Hip, shoulder, and ankle osteoarthritis
• Post-injury joint stiffness
• Patients who cannot tolerate anti-inflammatory medications
• Those wanting to avoid or delay joint replacement surgery

What happens during the procedure?

You will be positioned comfortably with the affected joint accessible. The skin is cleaned and local anaesthetic may be used to numb the area. If there is excess fluid in the joint, your clinician may remove some before the injection. The HA product is then slowly injected into the joint space under ultrasound guidance. The procedure takes 15 to 20 minutes.

What are the benefits?

• Longer-lasting relief than steroid injections — typically six to twelve months
• Can be repeated periodically for ongoing joint management
• Improvement typically begins at one to three weeks, with maximum benefit at four to twelve weeks
• Studies suggest 60 to 80% of patients experience meaningful benefit

Before your appointment

Tell us about any allergies, particularly to previous HA products. Blood-thinning medications may need to be temporarily stopped — contact us for advice. You can eat and drink normally before your appointment.

After your appointment

Some discomfort and mild swelling at the injection site is normal in the first 24 to 48 hours. Avoid strenuous activity and swimming for 48 hours. 

Take paracetamol if needed and apply ice if the joint feels warm or swollen. You can usually drive after the injection unless you feel unwell — if local anaesthetic was used, wait until numbness has fully worn off. A follow-up appointment is usually arranged at six to twelve weeks.

Hyaluronic Acid Injections FAQs

What are the risks of hyaluronic acid injections?

HA injections are generally very well tolerated. Temporary pain, swelling, or warmth at the injection site is the most common side effect and usually settles within 48 hours. Allergic reaction to the HA product is very rare. Joint infection is extremely rare.

How is HA different from a steroid injection?

Steroid injections reduce inflammation and typically last six to twelve weeks. HA injections lubricate the joint and can provide relief for six to twelve months. They address different aspects of osteoarthritis and can be used in combination or in sequence.

Will I need more than one injection?

Most patients receive a single injection of Ostenil Plus. Repeat treatment can be given when effects wear off, typically after six to twelve months.

Can HA injections cure arthritis?

No. HA injections manage symptoms effectively and may slow cartilage degeneration, but they do not reverse or cure arthritis.

Can I have physiotherapy alongside HA treatment?

Yes, and it is often recommended as part of a broader management plan.

Can different joints be treated?

Yes, though not usually on the same day.

What is it?

Joint aspiration is a procedure in which excess fluid is removed from a joint using a needle and syringe. Joints can accumulate fluid as a result of inflammation, injury, or conditions such as gout or calcium crystal disease. 

Removing this fluid relieves pressure and pain, and the fluid can be sent for laboratory analysis to help identify the underlying cause.

Aspiration can also be used to break down and remove calcium deposits within a joint — sometimes called barbotage — which can be particularly effective for calcium crystal conditions affecting the shoulder.

What does it treat?

Joint aspiration is used where a significant build-up of fluid is causing pain, swelling, and restricted movement. It is commonly performed on:

• Knee, shoulder, hip, ankle, elbow, and wrist
• Joints with calcium deposits (barbotage)

It is often combined with a steroid or local anaesthetic injection in the same appointment.

What happens during the procedure?

You will be positioned with the affected joint accessible. The skin is cleaned and local anaesthetic used to numb the area. Your clinician will use ultrasound to guide the needle into the joint space and withdraw the fluid. If calcium removal is being performed, the needle is used to break up the deposit before aspiration. A small dressing is applied at the end. Most procedures take 15 to 30 minutes.

What are the benefits?

• Immediate relief from the pressure and discomfort of excess fluid
• Fluid can be sent for analysis to identify the underlying cause
• Can be combined with a steroid injection in the same appointment for added effect

Before your appointment

Tell us if you are taking blood-thinning medication, as this may need to be temporarily adjusted. Tell us about any allergies. You can eat and drink normally before your appointment.

After your appointment

Some soreness and mild swelling at the aspiration site is normal and usually settles within 48 hours. Take paracetamol if needed and apply ice if the area feels warm. Avoid strenuous activity for 48 hours. Fluid can re-accumulate after aspiration, particularly if the underlying cause has not been addressed — your clinician will discuss a follow-up plan before you leave.

Joint Aspiration FAQs

What are the risks of joint aspiration?

In addition to the general risks listed above, there is a small possibility that not all fluid can be removed in a single procedure, or that fluid re-accumulates. Where a calcium deposit is being broken down, a temporary flare of pain may occur in the days following as calcium particles disperse into the joint fluid. This usually settles within a week.

Will the fluid come back?

It can, particularly if the underlying cause of inflammation has not been treated. Your clinician will discuss whether further treatment such as a steroid injection or physiotherapy is appropriate.

Will the fluid be tested?

If clinically appropriate, fluid may be sent for laboratory analysis to check for infection, gout crystals, or other findings. Your clinician will advise whether this is relevant in your case.

Can aspiration and injection be done at the same appointment?

Yes, and it is common to aspirate fluid and inject steroid or local anaesthetic into the same joint in a single procedure.

Is this the same as draining a joint?

Yes — aspiration and drainage refer to the same procedure.