The Early Intervention Knee Clinic

Following consultation with The Early Intervention Knee Clinic, patients are booked into one of our injection clinics for the AAI procedure. The procedure takes around 40 minutes and is performed in a treatment room in the outpatient clinic. The autologous anti-inflammatory injection (nSTRIDE) is generated from the patients’ blood.  

Blood is taken from the patient in the standard fashion. This blood is then placed inside a patented cannister and put in a centrifuge and processed for 15 minutes. This process results in the blood being separated into a number of layers. We are then able to removed the L-PRP layer from blood. This is platelet rich plasma with a high concentration of leucocytes (white blood cells). White blood cells are essential for reducing the inflammation and this is therefore very different to standard PRP.  

The L-PRP is then placed in another cannister and mixed with beads which serve to active the components. It is then placed into the centrifuge and processed for a further 2 minutes. The result is nSTRIDE which is a highly concentrated solution of the patients’ own anti-inflammatory cytokines. It also contains a high concentration of other proteins from the patient which have been shown to have a reparative/regenerative effect. 

The nSTRIDE solution is then drawn into a syringe and injected into the patients’ knee under sterile conditions.  

You will be fully consented for the AAI procedure by one of The Early Intervention Knee Clinic team prior to undergoing the procedure.  

This is a low risk procedure and carries the same risks as any knee injection. The injection itself can be uncomfortable when it’s performed but this only takes a few seconds. A small proportion of patients will experience a flare-up of knee pain after the procedure but this is well managed with standard painkillers and usually settles within 48 – 72 hours. All knee injections carry a small risk of introducing infection into the joint no matter what substance is injected into the joint. We quote a risk of infection of 1 in 1000. If an infection does develop then patients will require surgery to wash the knee out. 

The remaining recognised risk is of non-response and/or the effects of the procedure wearing off prematurely. The results demonstrate 82% of patients with early/moderate osteoarthritis still have significant improvement of pain and function at 1 year after procedure. This means that 18% of patients have not had the improvement they hoped for at 1 year after the procedure. 

Patients are advised to avoid sporting activities for 14 days post-procedure. This is because the AAI procedure is aiming to reduce the inflammatory environment in the knee and higher level activities such as sports may cause further inflammation. Patients can continue normal daily activities during this period and build up the intensity of sporting activity once the 14 day period has ended. 

The Early Intervention Knee Clinic encourages patients to engage in a physiotherapy program targeted at managing early/moderate osteoarthritis of the knee starting at 14 days post procedure. We work with a number of local physiotherapists and can arrange this. 

All patients are offered formal follow-up with The Early Intervention Knee Clinic at 6 and 12 weeks post procedure where outcome is assessed using formal scoring systems. All patients undergoing assessment and treatment with The Early Intervention Knee Clinic will have lifelong open access to us.