Arthramid Hydrogel

Arthramid® Vet is used to treat non-infectious causes of joint lameness in animals, including both early and late stages of osteoarthritis (OA).

Arthramid® Vet is a biocompatible, non-absorbable, non-pyrogenic, neuro-innocuous injectable 2.5% cross-linked polyacrylamide hydrogel for intra-articular injection in animals. Arthramid® Vet consists of approximately 2.5% cross-linked polyacrylamide and 97.5% water for injection. The hydrogel is supplied in a sterile pre-filled 1 mL syringe sealed with a Luer lock fitting.

Arthramid® Vet hydrogel acts as a dynamic tissue scaffold that increases the elasticity and load transfer capacity of the joint, restoring the joint to healthy function.

Download User Guide : Arthramid Vet User Guide

Understanding the complexity of disease processes associated with joint pain remains a constant dilemma in clinical practice and as with any disease process, an accurate diagnosis is essential.

Arthritis describes inflammation of a joint and can occur after single or repetitive episodes of trauma. The term incorporates synovitis, capsulitis, sprain, intra-articular fractures, meniscal tears, and osteoarthritis(OA). Sub-chondral bone injury also plays a role.

These pathological conditions are ‘a group of overlapping distinct diseases which may have different aetiologies, but with similar biologic, morphologic, and clinical outcomes.’

Although conventional concepts of OA emphasize the direct and predominant involvement of cartilage and bone in OA development, it is increasingly recognized that the synovium also contributes to the central pathophysiological event of cartilage matrix depletion.

Cases suitable for treatment with Arthramid® Vet are those in which lameness is localised to the joint by clinical examination, intra-articular analgesia, radiography, ultrasound, MRI, CT and/or Scintigraphy. Conditions that respond to treatment with Arthramid® Vet include acute and chronic synovitis, capsulitis, meniscal tears, OA, and subchondral bone cysts. It is essential that anamnesis of data of ongoing infection, concomitant medication, surgery or potential fracture is reviewed prior to injection to prevent possible infections or use of the product for conditions other than for which it is indicated.

Animals should be rested for 48 hours immediately after treatment. After this time the animal can return to exercise commiserate to its level of comfort.

Clinical studies show that tissue integration and subsequent augmentation of the joint capsule takes between 2 and 4 weeks to occur, although a response to treatment can be seen earlier than that in some cases.

Animals typically show a gradual reduction in lameness and synovitis during the first week after treatment and a concurrent reduction in reaction to passive flexion. This continues to improve over the ensuing 2 to 3 weeks. By 4 weeks no further improvement is expected. Re-examination at 4 weeks is therefore indicated to either administer a second dose in those that have only partially responded or to reassess accuracy of the diagnosis.

It is important for owners to understand the time lag for a treatment effect to be seen as this contrasts with conventional therapies. In this respect and due to its long lasting effect it may also be prudent to consider treating the animal during periods of reduced exercise demands or early on in the animals training programme.

Arthramid® Vet must be stored below 25°C (air conditioning) protected from direct sunlight. Do not freeze. Do not store unsealed syringes for later use.

The owner of the animal should be informed about the indications, expected results, contraindications, precautions, warnings, and potential complications. The owner of the animal should be advised that in the case of post-application complications, the veterinarian who performed the Arthramid® Vet injections should be contacted immediately for necessary treatment.

Arthramid® Vet is for intra-articular use only and must be administered by a qualified veterinarian familiar with the procedure in the intended species. 

Animals may be sedated to minimise stress and discomfort. Strict aseptic conditions must be followed at all times.

A 20G to 23G needle is placed intra-articularly. Synovial fluid should be observed. Care should be taken to avoid unnecessary damage of the intra-articular tissue, as this may result in diffuse swelling lasting for 24 to 48 hours. Remove the protective tip cap from the Arthramid® Vet syringe. Attach the syringe firmly into the Luer lock socket on the needle. Make sure the syringe is correctly mounted. The amount of Arthramid® Vet used is 1 – 4 mL. If necessary, attach a new Arthramid® Vet syringe during the procedure and continue the injection.

An ointment can be applied to the injection site immediately after treatment. A cold pack can be used on the injection site in case of an oedema. A bandage can be applied around the injection site if possible. Local or systemic corticosteroids should not be administered to the animal within two weeks of injection of Arthramid® Vet since this may mask a possible infection. The animal should be rested for 48 hours after the treatment.

Some animals can develop pain within the first postoperative hours. In addition, there is also a slight risk of haematoma and mild oedema. Within 1-2 weeks after treatment, there is a small risk that the animal may develop transient oedema and tenderness at the treatment site as the tissue integration is occurring. If not caused by infection, these reactions are self-limiting and will resolve within a couple of weeks. Non-steroidal anti-inflammatory drugs (NSAIDs) can be administered for pain relief and to reduce swelling. Allergic reactions to Arthramid® Vet have never been observed.

As with any intra-articular procedure, an Arthramid® Vet injection carries a risk of infection. Standard precautions and strict aseptic injection technique is essential. In the event of infection, the use of broad spectra antibiotics is recommended as a first-line treatment. Any use of corticosteroids is contraindicated in case of infection.

Due to Arthramid® Vets’ unique mode of action, the following dosage recommendations have been made based on observed clinical responses to treatment. 

• Distal Interphalangeal (DIP/ Coffin)- 1-2 mls
• Metacarpo/tarso-phalangeal (Fetlock)- 2 mls
• Carpus- 2mls
• Tarso-metatarsal (TMT)/ Distal-intertarsal (DIT)- 1 ml
• Tarsocrural- 2-3 mls
• Shoulder- 3 mls
• Stifles- 1-2 ml per compartment or 3-4mls for medial-femorotibial joint.

There is evidence to suggest that a dose-dependant response does exist and that these doses can be altered depending on the severity or chronicity of the disease. For example; mild, moderate or severe Fetlock disease can be treated with either 1ml, 2mls, or 3mls respectively. 

It is always important to reassess cases 4-6 weeks after first treatment. Published clinical trials indicate horses that partially respond to initial treatment may benefit from a second dose at 4 to 6 weeks later.

Safety Studies indicate that concurrent treatment of multiple joints in the same animal is safe.