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Nstride Autologous Protein Solution Therapy

nSTRIDE autologous protein solution (APS) is a novel treatment for joint pain and osteoarthritis (OA) which has been approved by Health Canada and the FDA for treatment of knee OA.

The treatment involves a single injection of a protein liquid derived from your own blood. It’s drawn from an arm vein prior to the injection and centrifuged to remove unwanted blood components and then spun again to obtain the protein liquid. APS has proven to be a safe and effective treatment, which has been shown to reduce pain and protect cartilage by reducing further destruction. As a result, there is a decrease in pain and an improvement in joint function, often within a few weeks of the injection. In clinical studies, patients reported little or no pain in 85% of cases after the procedure and about 70% symptom improvement even 24 months after the treatment.

This treatment has been evaluated most extensively in the knee, and is most effective in treatment of mild-moderate OA. For best results, we recommend a single injection. There is a fee for this treatment.

HOW DO I PREPARE FOR MY PROCEDURE?

  • Avoid anti-inflammatories (ibuprofen, etc.) for two weeks before and two weeks after your injection.
  • Do not stop taking low-dose aspirin if prescribed by your doctor.
  • Take all prescribed medications as directed.
  • This procedure is contraindicated for patients with inflammatory arthritis (i.e., rheumatoid arthritis).
  • You are encouraged to have a small snack one hour before your exam.
  • If you take insulin to manage your diabetes, please let your booking coordinator know. You may have some juice and a small snack after taking your insulin.
  • Wear comfortable clothing.
  • Please arrive 15 minutes prior to your appointment.

WHAT HAPPENS DURING MY PROCEDURE?

  • A team member will go over your consent form, explain the procedure, and answer any questions you may have.
  • We will take a small volume of blood from your arm to prepare the injection.
  • The blood sample is placed in a centrifuge and then prepared in a sterile manner. You can rest in a waiting room during this process; it takes 10-20 minutes.
  • A technologist will bring you into the treatment room and position you on the table. A radiologist will evaluate the area, clean the skin, and inject a local anesthetic.
  • Once frozen, using image guidance, the radiologist will inject the APS preparation into the affected joint using a sterile needle.
  • You will be assessed post-injection by our team and, if there are no concerns, you will be free to leave.

POST-PROCEDURE INSTRUCTIONS

  • First 24 hours: Keep the treatment area clean. Leave the Band-Aid on. Do not shower. Please rest the injected area for the rest of the day after your injection.
  • First 48 hours: Avoid bathtubs, hot tubs, and pools. Avoid strenuous activity and lifting.
  • After one week: Avoid strenuous activity or physiotherapy for at least five days following your injection with a gradual return to activity. Be mindful of your pain and stop if it hurts too much, or other symptoms worsen. You may resume physiotherapy, but notify your physiotherapist that you have had this injection so they can modify your exercises if necessary.
  • If possible, please avoid anti-inflammatory medication for two weeks (such as ibuprofen – Advil). It may interfere with the effectiveness of your injection. 
  • Watch for infection: If you develop worsening pain, skin redness at the site of injection, or a temperature greater than 38.5°C, please proceed to an urgent care or emergency centre.
  • If you have pain or other symptoms beyond 48 hours after your injection, please call our office at 403-568-3890 or email us at paintherapy@radiology.ca during business hours. You may apply heat and ice to the treatment area.

WHEN WILL I SEE RESULTS?

  • Results from early healing may be appreciated after 1-2 weeks, although healing and repair will continue gradually for many months.
  • Continued symptoms improvement is expected for up to 24 months. If an injection does not help relieve your symptoms after three months, then you may need further evaluation.

HOW MUCH WILL IT COST?

We advise a single APS treatment, which is $1,150.

FOR YOUR APPOINTMENT

Please ensure that you bring your requisition with to your appointment.


DURATION

30-45 minutes

LOCATION

FREQUENTLY ASKED QUESTIONS

How long does the procedure take to work?

As APS promotes healing by recruiting the body’s own repair system, the process can take a few weeks. Most patients begin to notice improvement after 1-2 weeks, and should see continued improvement over many months.

Are there restrictions after the procedure?

No strenuous activity for five days following your procedure. Please avoid anti-inflammatories for two weeks after the procedure.

How long will the injection last?

Studies suggest symptoms will be improved for up to 24 months or longer. The goal is to promote your body to decrease inflammation in the joints, and protect cartilage from further thinning.

How many injections can I have?

A single injection therapy is adequate. Repeat treatments could be considered if effective after 1-2 years.

What are the side effects?

A common side effect of the procedure is mild but temporary pain or aching of the joint that gradually subsides within 24-48 hours. There may also be mild bruising at the site of injection or blood draw. Over-the-counter pain medications (not anti-inflammatory) or using heat on the area can help.