For Veterinary Use Only
Proven Science. Proven Results.
Arthramid® Vet is labeled for the management of all stages of non-infectious osteoarthritis and degenerative joint disease in horses. Trust the only polyacrylamide manufactured in an FDA approved GMP facility for veterinary use in the USA.
- Novel technology for treating arthritis in horses
- Patented 2.5% cross-linked polyacrylamide hydrogel
- Long lasting - non resorbable
- 82.5% successful resolution of joint lameness for up to 24 months
- Integrates into the joint tissue
- Safe, biocompatible, non-toxic and neuro-innocuous
*Federal law restricts this device to sale by or on the order of a licensed veterinarian and it must be used under the supervision of a licensed veterinarian for the application of intra-articular administration. Orders will only be shipped to licensed Veterinary Practices.
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 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 prefilled 1 mL syringe sealed with a luer lock fitting.
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 minimize stress and discomfort. Strict aseptic conditions must be followed at all times.
A 16-23G 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. If more than 1 mL of Arthramid® Vet is required for the joint, detach the empty Arthramid® Vet syringe from the hypodermic needle and repeat the process until the required dose is delivered.
Dosages - Equine
Due to Arthramid® Vet’s 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- 2 mLs
- 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
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.
Mode of action – not all polyacrylamide hydrogels are the same
Polyacrylamide hydrogel products, although often considered equal, have clear differences in composition, manufacturing quality and injection techniques as well as their ability to interact with surrounding tissues. These characteristics determine the safety and effectiveness of each hydrogel.
Upon injection into joints, Arthramid® Vet, a uniquely cross-linked 2.5% polyacrylamide hydrogel, adheres to the synovial lining through its ability to exchange water molecules. Over a period of 14 days, the gel becomes integrated into the synovial lining and its immediate surrounding tissue of the inner capsule by a combination of cell migration and vessel ingrowth forming a thick, cushion-like membrane consisting of vessel integrated gel covered by a new and hypercellular synovial cell lining.
As a result, Arthramid® Vet has an augmentation effect on both the joint capsule and synovium. It increases the elasticity and tensile strength of the capsule, improving its capacity to transfer load. It is believed that this augmentation and cushioning causes a subsequent reduction in mechanoreceptor activation in the capsule itself. It also causes the formation of a new and hypercellular synovial cell lining, improving the quality of synovial fluid within the joint itself. These actions both help reduce synovitis and its successively deleterious effects.
Unlike other hydrogels, Arthramid® Vet becomes fully integrated into the surrounding tissue (rather than encapsulated) and is therefore long-lasting. Arthramid® Vet does not elicit a foreign body reaction or harbour infection. Arthramid® Vet is non-pyrogenic, neuro innocuous and contains no heavy metals.
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 may also play 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.
Following the procedure, broad-spectrum antibiotics may be administered to decrease the risk of infection.
Post injection instructions
An ointment can be applied on the injection site immediately after treatment. A cold pack can be applied 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 few hours post- administration. In addition, there is also a slight risk of haematoma and mild oedema at the site of injection. Within 1-2 weeks after treatment there is a slight risk that the animal may develop a 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 spectrum antibiotics is recommended as a first line treatment. Any use of corticosteroids is contraindicated in case of infection.
Information to the owner
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 case of complications, the veterinarian who performed the Arthramid® Vet injections should be contacted immediately for necessary treatment.
Arthramid® Vet must be stored protected from direct sunlight. Do not freeze. Do not store unsealed syringes for later use.
Information For Use (IFU)
Please click on the link below to download the Arthramid® Vet Information For Use document.
Have you seen any adverse reactions following the intra-articular injection of Arthramid® Vet?
We have not seen any abnormal reaction in the joints in the research population. There are a few reported cases of granulomatous reactions when PAAG has been used concurrently with IA corticosteroids.
Does the articular treatment need to be repeated at a specific interval or 1 dose is enough?
One dose is often enough but this is something we are wanting to find out. Anecdotally repeating the dose either at 4 weeks for partial responders or at 6 months has been beneficial.
If horse does not improve, what is the course of action?
We recommend trying to understand why it didn’t work (further imaging, synovial fluid, other factors ( e.g. foot imbalance, conformation, work surface)...etc...). This is different from horses that are partial responders. These horses should be re-examined at 4-6 weeks and another dose administered as there is strong evidence that the mechanical effect is dose-dependent. This is another aim of this study.
Can horses have NSAID’s or other anti-inflammatory medications concurrent with Arthramid®Vet?
NO NSAID, corticosteroids or other anti-inflammatory medication should be injected within 30 days of Arthramid®Vet. Oral NSAID's are ok.
Is it ok to inject several OA joints in the same horse?
In the field trial, several joints can be injected in the same horse.
Any trials on horses with no visible arthritis but blocking to joint with suspicion of sub-chondral bone damage and or stress fractures?
AV is indicated for horses with a proper diagnosis of OA. If these horses show signs of sub-chondral damage, we think that we can also treat such cases with Arthramid® Vet.
Is Arthramid® Vet indicated for osseous cyst-like lesions?
Practitioners have reported good results on cases with osseous cyst-like lesions in the stifle and fetlock.
I was one of the first vets to use Arthramid® worldwide and have now used Arthramid® for over 10 years in our clinic. We have injected over a thousand horses and have found it to be very safe. It has been a major game-changer in the way we treat OA in our patients.Dr Marc Koene DVM - Founder and Partner at Tierklinik Lüsche GmbH Equine Hospital in Northern Germany
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