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Non-Surgical Management of Knee Osteoarthritis

Osteoarthritis is the most well-known form of arthritis. It mainly affects the knees, hands, spine and hips. This joint disorder is characterised by inflammation and loss of cartilage which causes pain and stiffness. Pain caused by osteoarthritis can be treated a number of ways, usually in combination; with exercise, weight loss, topical and oral medication, injections and surgery. Hawke’s Bay Sports Medicine now has n-STRIDE Autologous Protein Solution (APS) injections available for the management of knee pain caused by osteoarthritis.


What are n-STRIDE APS injections?


An n-STRIDE APS injection is a portion of the patients own blood, collected from a vein at the elbow and injected into the affected joint. The blood sample is centrifuged, allowing separation of the red blood cells which are then discarded. The remaining fluid, called plasma, and the buffy coat, which contains white blood cells (WBC) and platelets is then centrifuged again along with polyacrylamide beads. These beads help to dehydrate the sample, they bind with the WBC’s which allows the WBC to release protein/anti-inflammatory cytokines to the remaining low volume plasma. This is then injected into the knee joint.



How do n-STRIDE APS injections work?


Patients with knee osteoarthritis have a higher concentration of inflammatory cytokines (bad protein) than anti-inflammatory cytokines (good protein). This protein imbalance causes inflammation and may also contribute to the gradual cartilage degeneration. n-STRIDE injections contain anti-inflammatory cytokines, which inhibit the activity of inflammatory cytokines in the affected knee, therefore reducing inflammation. The concentrated volume of platelets in the sample have an additional similar effect to standard platelet rich plasma (PRP) injections. Platelets release growth factors to offer anti-inflammatory and potential healing effects.


What is PRP? Are n-STRIDE APS injections the same as PRP injections?


PRP (Platelet Rich Plasma) is a portion of blood used in the treatment of osteoarthritis and tendon pathologies. A volume of blood is taken from a vein at the elbow, the red blood cells separated and discarded and the platelets and white blood cells collected. Some PRP collection techniques then perform a second separation, to collect predominantly platelets in a low volume of the plasma, which is then injected into the joint/tendon. Multiple studies have demonstrated a reduction of pain following these injections. A common method of administering PRP is 3 injections at weekly intervals, offering pain reduction for up to 12 months in patients with knee osteoarthritis. PRP can be used to reduce pain in chronic tendinopathies, but there is less research to suggest this gives a clear benefit.


n-STRIDE injections initially separate the PRP, before then utilising a second spin with polyacrylamide beads, which increase the release of anti-inflammatory cytokines from the WBC. This extra step confers further benefit than PRP alone, demonstrated in clinical trials which demonstrate a significant reduction in pain for up to 2 years following a single injection in patients with knee osteoarthritis.


What can I expect when getting an n-STRIDE APS injection?


You will have a consultation with us prior to see if n-STRIDE APS injection is right for you. On the day of the procedure, you will need to be well hydrated, and avoid anti-inflammatory medication for 2 weeks prior and 2 weeks post your injection. The procedure is straightforward. We will draw blood from your arm and separate it using an APS kit to get the concentrated solution. The solution is then injected into the affected joint. After the injection, you might experience a little pain and stiffness, but this should subside after a few days. You should avoid strenuous physical activities for at least two weeks after the treatment is administered to increase the efficacy.


Studies have shown a decrease in pain following n-STRIDE APS injection for up to 2 years. Patients with mild-moderate arthritis appear to gain the greatest improvement in symptoms. We will monitor your symptoms with regular questionnaires.


For any inquiries about n-stride APS injections, contact us to book an appointment.

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