nSTRIDE® Autologous Protein Solution (APS) at Highgate Hospital

What is nSTRIDE® APS?

nSTRIDE® Autologous Protein Solution (APS) is a non-surgical treatment option for knee osteoarthritis. It uses your own blood to help reduce joint pain and inflammation.

This treatment is designed for people with mild to moderate knee osteoarthritis, helping to restore balance in the affected knee.

Your blood is used to make a special protein solution that is injected into your knee to help:

• Restore joint balance.
• Ease inflammation.
• Slow the progression of osteoarthritis.
• Provide long-lasting relief.

How do nSTRIDE® APS injections work?

This treatment uses “good” proteins, such as anti-inflammatory cytokines and growth factors, that are already found in your body. These proteins are concentrated and injected into your joint to help:

• Block the “bad” proteins that result in joint inflammation and pain.
• Protect and support the cartilage in your knee.
• Help restore a healthy balance inside your joint.

The nSTRIDE® injection can help reduce pain and discomfort. It also supports your joint health over time.

What’s inside the nSTRIDE® APS injection?

Each nSTRIDE® APS injection is made entirely from your own blood. It contains:

• White blood cells – which help control joint inflammation
• Anti-inflammatory proteins – including IL-1ra and sTNF-R
• Growth factors – such as IGF-1 and TGF-β, which support cartilage repair

Since the injection uses your own cells, the risk of side effects is very low. It is considered a safe, non-surgical option instead of steroid injections or synthetic treatments.

How nSTRIDE® compares to platelet-rich plasma (PRP) injections?

Both nSTRIDE® and PRP (platelet-rich plasma) treatments use your own blood to help healing, but there are some key differences:

• nSTRIDE® is processed a second time to remove harmful inflammatory parts
• This process creates a more targeted and stronger anti-inflammatory solution
• It also has certain white blood cells and proteins that are not usually found in standard PRP treatments

This added precision may make nSTRIDE® a better choice than PRP for knee pain, especially for people from osteoarthritis.

What conditions can nSTRIDE® APS treat?

nSTRIDE® APS is mainly used as a biological treatment for knee pain, especially if you have mild to moderate knee osteoarthritis.

Our consultants often recommend this knee therapy when other non-surgical options have not provided lasting relief. Options include physiotherapy, over-the-counter painkillers, or steroid injections.

If you are looking into non-surgical joint pain treatments, you might want to join our Free Joint Pain Programme. It can help you address symptoms and stay active.

Can nSTRIDE® APS help with other types of osteoarthritis?

nSTRIDE® injections are mainly used for the knee, but early research indicates it might also help with other joints, such as:

• Mild to moderate hip osteoarthritis
• Mild to moderate ankle osteoarthritis

Your Consultant will let you know if this treatment is suitable for joints other than your knee. This will depend on your symptoms and medical history.

Are nSTRIDE® APS injections right for me?

nSTRIDE® APS is a good option if you want a natural, non-surgical way to treat knee osteoarthritis and want to delay or avoid more invasive procedures like knee replacement surgery.

You may benefit from nSTRIDE® if you:

• Have been diagnosed with mild to moderate knee osteoarthritis
• Experience ongoing knee pain, stiffness or limited mobility
• Have tried physiotherapy, medication or steroid injections without lasting relief
• Show early signs of knee cartilage damage or thinning
• Want to slow the progression of arthritis while staying active
• Are seeking a long-term, non-surgical alternative to help manage your symptoms

This treatment works by injecting concentrated anti-inflammatory proteins into your joint. It can help reduce inflammation, ease discomfort, and slow the progression of osteoarthritis.

Who nSTRIDE® APS is most suitable for

This treatment is suitable for people who are:

• Aged between 21 and 80
• Have a BMI of 40 or under
• Haven’t had a steroid injection in the last 3 months
• Haven’t had hyaluronic acid or other knee injections in the last 6 months
• Aren’t pregnant or breastfeeding
• Willing to follow a rehabilitation programme post-treatment to support recovery

nSTRIDE APS is particularly helpful if your symptoms are affecting your quality of life, making it more difficult to stay active, work, or enjoy daily activities.

Typical patients are in their 40s, 50s or 60s, live active lifestyles and are not yet ready for surgery.

Who should avoid nSTRIDE® APS? Contraindications and considerations

nSTRIDE® APS might not be suitable for you if you:

• Have advanced or bone-on-bone arthritis, where little cartilage remains
• Have an active infection, bleeding disorder, or history of cancer
• Are unable to temporarily pause certain medications (like some blood thinners)
• Have known allergies to ingredients that may be used in the procedure
• Have been diagnosed with inflammatory arthritis, such as rheumatoid arthritis
• Are currently being treated for another joint or autoimmune condition

During your consultation, your Consultant will carry out a detailed assessment (including a review of your medical history) to go over recent scans and treatment goals. This will help you decide if this approach is right for your knee pain.

Talk to one of our specialists today to see if nSTRIDE® is a good fit for you.

What happens during the nSTRIDE® APS procedure?

This simple procedure usually takes between 30 to 60 minutes. You’ll be awake throughout the procedure, and most of our patients find it comfortable and straightforward.

Step 1: Blood draw – collecting your sample for treatment
We’ll start by drawing a small amount of blood from your arm, just like a routine blood test. This blood has proteins your body uses to fight inflammation and help healing.

Step 2: Blood processing – creating your personalised protein solution
Your blood is then placed in a special nSTRIDE® device, which spins it in two stages. This separates and concentrates the helpful cells and proteins. Processing takes 20 to 30 minutes, and you can relax in our waiting area during this time.

The final solution has a high concentration of:

• Anti-inflammatory proteins
• White blood cells
• Growth factors

These are the key parts that make the treatment effective.

Step 3: Knee injection – targeted treatment for your joint
Once the solution is ready, your Consultant will prepare your knee. A local anaesthetic can be used to help with any discomfort. Ultrasound guidance is often used to make sure the injection goes exactly where it needs to.

The injection only takes a few minutes. You may feel a little pressure or a mild pinch, but it shouldn’t be painful.

Step 4: After your injection – what happens next
Afterwards, our team will check how you are feeling before you go home. You’ll be able to walk out of the clinic the same day.

We advise arranging for someone to drive you home. This is especially important if your knee is sore or you feel a little anxious after the procedure.

Preparing for nSTRIDE® knee injections

To help you get the most out of your nSTRIDE® treatment, here are a few simple steps to follow in the days leading up to your appointment.

Stop NSAIDs in advance
You may need to stop taking certain anti-inflammatory medications (NSAIDs) such as ibuprofen, naproxen or Voltarol for 1 to 2 weeks before and after your injection. These medicines can affect your body’s natural healing after the treatment.

Tell your doctor or healthcare team about any medication you are taking.
If you're not sure which medications to pause, we'll give you personalised advice based on your health profile.

Do not stop low-dose aspirin unless advised by your doctor. If you take blood thinners (like Warfarin or Coumadin) or are on antibiotics, please let our team know in advance.

Avoid intense physical activity
Avoid intense exercise or high-impact activities for 2 days before your injection. Resting your joint helps set up the best conditions for your treatment.

Eat a light snack before your visit
You don’t need to fast before your treatment. We recommend eating a light snack about an hour before your appointment, especially if you take insulin or have diabetes.

Wear comfortable and flexible clothing
Wear loose, comfortable clothing. We’ll need easy access to your arm for the blood draw and your knee for the injection. Shorts or loose-fitting trousers are work well.

Arrive early and bring your ID
Please arrive 30 minutes before your appointment to complete check-in and consent forms. Bring a form of ID plus any medical cards you need.

Drink water before you arrive
Keeping hydrated can make the blood draw quicker and easier.

Recovery from nSTRIDE® APS

Most people recover quickly after their nSTRIDE® APS injection and can get back to their usual routines with little disruption. You can usually go home within an hour, but keep in mind that improvements will appear gradually over the next few weeks.

Here’s what you can expect and how to support your recovery at home:

Supporting your recovery

To make the most of your nSTRIDE® treatment:

• Join our Joint Pain Programme – This free, clinically designed programme supports your recovery with gentle physiotherapy, mobility exercises and expert advice. It’s great for building strength and easing stiffness. Explore our Joint Pain Programme.
• Maintain a healthy weight to support your knees – Losing extra weight can take pressure off your joints. Even small changes can improve your mobility and reduce pain. Read more about weight management for healthy joints.
• Use supportive braces or orthotics if recommended – Devices like knee braces or insoles can take strain off your knee and make moving around easier.

What are the benefits of nSTRIDE® APS?

nSTRIDE® APS does more than provide short-term relief. It is designed to help your knee feel and function better over the long term.

This one-time injection targets inflammation at its source. It can ease pain, protect cartilage, and help you stay active, all without surgery.

In just one injection, nSTRIDE® can:

• Reduce knee pain and stiffness: Many patients notice less pain, swelling, and stiffness, which makes everyday movement more comfortable.
• Improve joint mobility and everyday function: With less inflammation, daily tasks such as walking, climbing stairs or standing for longer periods often become easier.
• Slow cartilage breakdown: The injection provides anti-inflammatory proteins and growth factors that help protect the cartilage and slow down the progressions of knee osteoarthritis.
• Use your body’s natural healing ability: nSTRIDE® is made from your own blood (autologous), so it’s a natural option with very little risk of allergic reactions or side effects.
• Deliver long-lasting relief: One injection can provide relief for up to 1 to 2 years or longer. Some of our patients continue to benefit for 3 to 5 years, depending on their health, joint condition, and activity level.
• Help delay or avoid knee surgery: nSTRIDE® can help reduce symptoms and slow joint damage, which may lower the need for invasive treatments like knee replacement surgery.
• Quick, convenient procedure: The entire treatment takes less than an hour in the clinic, with no need for a hospital stay or long recovery time.

How long do the benefits of nSTRIDE® knee injections last?

Everyone’s experience is different. Most people see a big improvement in pain and mobility for 1 to 2 years after just one injection.

Here’s what we typically see:

• Most patients feel relief for 12–24 months and daily activities become easier and less painful.
• Some patients continue to feel the benefits for up to 3–5 years, especially if they follow a healthy lifestyle and rehabilitation plan.
• Ongoing support is available. If symptoms return after this period, your consultant may recommend repeating the treatment or looking at other options.

It’s important to know that nSTRIDE® does not cure osteoarthritis, but it can slow the disease and provide long-term relief from symptoms.

If the effect wears off over time, your consultant will guide you through the next steps, such as repeating the injection or considering alternative treatments.

What are the risks of nSTRIDE® APS treatment?

nSTRIDE® APS is generally a very safe biologic injection for knee osteoarthritis, especially since it’s made from your own blood.

Like any medical procedure, there are some risks and side effects. Most are mild and go away quickly, but it’s important to know what to expect before you decide.

General complications
Most people recover quickly after treatment, but some temporary side effects may include:

• Mild pain or discomfort around the injection site
• Swelling, warmth or a feeling of pressure in the joint
• Bruising at the blood draw or injection site
• Stiffness in the knee for 1–2 days
• Limited symptom relief or a delayed response in some cases

These side effects usually go away on their own. We will give you clear advice on using ice packs or mild pain relief, such as paracetamol, to help with discomfort.

Specific complications of nSTRIDE® APS injections
Although uncommon, some possible complications include:

• Infection at the injection site
• Allergic reaction to the small amount of anticoagulant used in the blood processing kit (very rare)
• Nerve irritation or excess bleeding (minimised by using ultrasound guidance)
• Flare-up of joint discomfort or inflammation
• Reactions in patients with certain blood or autoimmune conditions

Your consultant will discuss these with you before treatment to make sure you feel informed, comfortable, and ready.

When to seek medical advice
Side effects are rare, but please contact us to get urgent care if you experience:

• Worsening pain that doesn’t improve
• Redness, heat or swelling around the injection site
• A high temperature (over 38.5°C)

Most of our patients recover smoothly and start to feel better within a few weeks. If you have any questions or worries, we're here to help.

Are there any alternative treatments to nSTRIDE® APS?

nSTRIDE® APS is a new type of injection that helps reduce knee pain, lower inflammation, and support joint health. However, there are other options you can consider.

The best treatment for you depends on how severe your osteoarthritis is, your lifestyle, and your goals. There are several non-surgical therapies, injections, and surgeries that might help.

Below are some commonly used alternatives, including how they compare to nSTRIDE® injections.

Non-surgical options for knee pain

• Physiotherapy and exercise: Our physiotherapists may suggest movement and strengthening exercises to help with stiffness, pain and knee movement. These plans are often the first step or can be used with other treatments.
• Lifestyle changes: Losing extra weight and staying active with gentle exercises like swimming or cycling may take pressure off your knees. Using braces or orthotics can also help your joints feel more stable and comfortable.
• Pain relief medication: Medicines like paracetamol or ibuprofen can help with symptoms for a short time. They do not treat the cause of osteoarthritis, but they can make daily discomfort easier to manage.

Alternative knee injection therapies

When to consider knee surgery?

If non-surgical treatments are no longer giving you enough relief, your doctor may suggest surgery, especially if pain and mobility problems begin to affect your daily life.

Knee replacement surgery: is a reliable long-term option for advanced osteoarthritis when other treatments have stopped working.

Robotic-assisted knee surgery: Uses advanced robotic technology to improve surgical precision and may support a faster recovery time.

Choosing the right option for you

The right treatment depends on your age, activity level, medical history and how far your osteoarthritis has progressed.

Your consultant will listen to your goals and help you make a plan that fits your needs. This could include non-surgical treatments like physiotherapy, a biologic injection such as nSTRIDE®, or surgery. Our goal is to help you stay active, mobile, and pain-free for as long as possible.

How much does nSTRIDE® APS treatment cost?

For pricing information, please get in touch with your local hospital. Please note that the guide price is an approximate cost of treatment only. You will be given a fixed all-inclusive price for treatment following your initial consultation with a consultant.