WEBVTT 00:00:00.000 --> 00:00:02.600 Imagine a world where just walking, climbing 00:00:02.600 --> 00:00:05.379 stairs, or even getting out of bed doesn't bring 00:00:05.379 --> 00:00:08.599 that awful grinding pain. For, well, literally 00:00:08.599 --> 00:00:10.500 hundreds of millions globally, that's just not 00:00:10.500 --> 00:00:13.660 the reality. They live daily with knee osteoarthritis. 00:00:14.060 --> 00:00:15.580 And it's a condition that doesn't just affect 00:00:15.580 --> 00:00:17.839 the joint, does it? It fundamentally chips away 00:00:17.839 --> 00:00:20.960 at the quality of life. For, well, for far too 00:00:20.960 --> 00:00:23.359 long, our standard approaches, while offering 00:00:23.359 --> 00:00:26.079 some help, they've mostly been temporary fixes. 00:00:26.539 --> 00:00:28.699 You know, fleeting relief from corticosteroids 00:00:28.699 --> 00:00:31.320 or hyaluronic acid injections that need constant 00:00:31.320 --> 00:00:33.579 top -ups. The real challenge has always been, 00:00:33.659 --> 00:00:36.520 how do we give people truly long -lasting, genuinely 00:00:36.520 --> 00:00:39.240 transformative relief? Not just managing symptoms, 00:00:39.359 --> 00:00:42.359 but really enhancing their functional life. Welcome 00:00:42.359 --> 00:00:44.920 to the Deep Dive. Here we explore the critical 00:00:44.920 --> 00:00:46.960 innovations that are reshaping medicine and patient 00:00:46.960 --> 00:00:49.600 care. Today, we're focusing on a, well, a potentially 00:00:49.600 --> 00:00:51.579 groundbreaking new treatment option that seems 00:00:51.579 --> 00:00:54.380 poised to redefine how we manage knee osteoarthritis. 00:00:54.960 --> 00:00:57.359 And guiding us through this complex but actually 00:00:57.359 --> 00:01:00.259 incredibly hopeful area is Professor Mo Imam. 00:01:00.420 --> 00:01:02.719 He's a truly distinguished figure in the orthopedic 00:01:02.719 --> 00:01:05.219 world, known for his extensive work with novel 00:01:05.219 --> 00:01:07.900 therapies and his really deep clinical insights 00:01:07.900 --> 00:01:11.079 into joint care. Just the expert we need, really, 00:01:11.099 --> 00:01:13.180 to help us get to grips with this innovation. 00:01:14.019 --> 00:01:16.120 OK, let's try and unpack this then. To set the 00:01:16.120 --> 00:01:18.299 scene, could you Let's start by briefly defining 00:01:18.299 --> 00:01:20.579 atherosomid for us. What's its core purpose in 00:01:20.579 --> 00:01:23.500 the sort of wider picture of neo -A treatment? 00:01:24.140 --> 00:01:27.000 Certainly. Atherosomid is, well, it's a novel 00:01:27.000 --> 00:01:30.239 intraarticular hydrogel. Intraarticular meaning 00:01:30.239 --> 00:01:32.879 it's injected directly into the joint space itself. 00:01:33.319 --> 00:01:35.989 It's a polycrylamide hydrogel. and its core purpose 00:01:35.989 --> 00:01:38.829 is to provide genuinely long -lasting pain relief 00:01:38.829 --> 00:01:42.069 and, crucially, significantly improve joint function 00:01:42.069 --> 00:01:44.230 for people suffering with knee osteoarthritis. 00:01:44.969 --> 00:01:46.849 You should probably think of it as perhaps a 00:01:46.849 --> 00:01:49.209 significant evolution in our non -surgical options. 00:01:50.150 --> 00:01:52.650 Moving beyond just transient relief towards something 00:01:52.650 --> 00:01:55.730 offering sustained, durable outcomes, it's specifically 00:01:55.730 --> 00:01:57.730 designed to integrate within the knee, offering 00:01:57.730 --> 00:02:00.069 enduring lubrication and mechanical support. 00:02:00.189 --> 00:02:02.170 That phrase, long -lasting, immediately jumps 00:02:02.170 --> 00:02:05.250 out. Given the limitations, the shortfalls of 00:02:05.250 --> 00:02:07.409 existing therapies we've touched on, what, in 00:02:07.409 --> 00:02:09.729 your view, was the most significant unmet need 00:02:09.729 --> 00:02:11.629 that arthrosamid was really designed to tackle? 00:02:11.909 --> 00:02:14.389 The primary unmet need, without a doubt, was 00:02:14.389 --> 00:02:16.969 the duration of effect and the ability to offer 00:02:16.969 --> 00:02:19.669 a genuine, sustained improvement in joint health 00:02:19.669 --> 00:02:22.710 without needing repeated, often quite burdensome, 00:02:22.830 --> 00:02:25.210 interventions. For decades, you see, trigenal 00:02:25.210 --> 00:02:27.189 injectables have locked patients into this cycle. 00:02:27.319 --> 00:02:30.159 Temporary relief, then that frustrating return 00:02:30.159 --> 00:02:32.939 of pain, then another procedure. And that doesn't 00:02:32.939 --> 00:02:35.460 just burden the patient frequent clinic visits. 00:02:35.840 --> 00:02:38.479 The small but real procedural risks, it also, 00:02:38.580 --> 00:02:40.699 well, it can create a sense of futility, can't 00:02:40.699 --> 00:02:44.139 it? Arthrocemid was engineered specifically to 00:02:44.139 --> 00:02:46.780 break that cycle. It offers a single injection 00:02:46.780 --> 00:02:49.039 solution that integrates with the body's own 00:02:49.039 --> 00:02:51.939 synovial tissue. It provides enduring lubrication 00:02:51.939 --> 00:02:54.099 of this cushioning effect. So it fundamentally 00:02:54.099 --> 00:02:56.849 tackles the REAP problem. of joint friction and 00:02:56.849 --> 00:02:59.590 wear in a much more persistent, a much more profound 00:02:59.590 --> 00:03:01.370 way than anything else we've had in this category 00:03:01.370 --> 00:03:03.849 before. That really does sound like a shift in 00:03:03.849 --> 00:03:05.550 approach. And just one more thing to set the 00:03:05.550 --> 00:03:08.949 scene. What's one particularly surprising characteristic 00:03:08.949 --> 00:03:10.990 about its composition that makes it stand out 00:03:10.990 --> 00:03:12.789 from the more conventional injectables we're 00:03:12.789 --> 00:03:15.870 used to? Well, without question, it has to be 00:03:15.870 --> 00:03:18.770 its non -absorbable and non -migratory nature. 00:03:19.159 --> 00:03:21.620 Unlike pretty much every other injectable substance 00:03:21.620 --> 00:03:24.060 we use in orthopedics, especially hyaluronic 00:03:24.060 --> 00:03:27.060 acid, arthrosome isn't broken down or absorbed 00:03:27.060 --> 00:03:29.879 by the body over time. It actually establishes 00:03:29.879 --> 00:03:32.879 itself within the joint capsule. It forms a continuous 00:03:32.879 --> 00:03:35.960 stable matrix that provides ongoing mechanical 00:03:35.960 --> 00:03:38.919 support and lubrication. And that distinction 00:03:38.919 --> 00:03:41.300 is absolutely critical. It means we're not just 00:03:41.300 --> 00:03:44.159 temporarily topping up a fluid. We're establishing 00:03:44.159 --> 00:03:46.759 a lasting integrated component within the joint, 00:03:47.219 --> 00:03:49.460 something that contributes to its sustained function 00:03:49.460 --> 00:03:52.000 and pain reduction. Well, it's quite revolutionary 00:03:52.000 --> 00:03:55.120 in that sense. OK, so to really appreciate where 00:03:55.120 --> 00:03:57.199 arthritis came from, we need to understand that 00:03:57.199 --> 00:04:00.240 urgent clinical need behind it. Considering how 00:04:00.240 --> 00:04:02.819 widespread knee osteoarthritis is globally, why 00:04:02.819 --> 00:04:04.780 was developing something like this so critically 00:04:04.780 --> 00:04:07.280 important? Well, the urgency really stems from 00:04:07.280 --> 00:04:10.379 the sheer scale in the impact of neo -A. It's 00:04:10.379 --> 00:04:12.759 not just a common condition. It is frankly a 00:04:12.759 --> 00:04:15.340 global health issue, a major one. We're talking 00:04:15.340 --> 00:04:17.439 about a degenerative disease that profoundly 00:04:17.439 --> 00:04:20.100 impacts the quality of life for hundreds of millions 00:04:20.100 --> 00:04:23.220 of people around the world. Patients face, you 00:04:23.220 --> 00:04:25.899 know, debilitating pain, stiffness that really 00:04:25.899 --> 00:04:28.160 restricts their day -to -day lives, a significant 00:04:28.160 --> 00:04:30.480 loss of mobility, and that can lead to social 00:04:30.480 --> 00:04:33.259 isolation, even impact mental well -being quite 00:04:33.259 --> 00:04:35.939 severely. And while traditional conservative 00:04:35.939 --> 00:04:38.339 treatments Physical therapy, exercise, weight 00:04:38.339 --> 00:04:40.480 management are absolutely fundamental. They are 00:04:40.480 --> 00:04:43.660 the cornerstones of care. They often prove insufficient, 00:04:44.319 --> 00:04:46.459 especially for patients with moderate to severe 00:04:46.459 --> 00:04:49.339 symptoms. You see many patients diligently following 00:04:49.339 --> 00:04:51.779 these strategies, yet they still find themselves 00:04:51.779 --> 00:04:54.019 in persistent pain, struggling with simple everyday 00:04:54.019 --> 00:04:56.779 tasks. Right, so the standard approaches just 00:04:56.779 --> 00:04:59.209 weren't enough for many. Exactly. And then when 00:04:59.209 --> 00:05:01.310 you look at the existing injectable therapies 00:05:01.310 --> 00:05:04.269 like corticosteroids and hyaluronic acid, their 00:05:04.269 --> 00:05:08.449 relief is, almost by definition, transient. Corticosteroids, 00:05:08.629 --> 00:05:11.129 yes, they can offer rapid pain reduction, which 00:05:11.129 --> 00:05:13.629 is certainly valuable for acute flare -ups, but 00:05:13.629 --> 00:05:15.790 the effects are typically short -lived, often 00:05:15.790 --> 00:05:17.970 just a few weeks, maybe a couple of months, and 00:05:17.970 --> 00:05:20.389 moreover, repeated steroid use carries well -known 00:05:20.389 --> 00:05:23.209 risks. Potential systemic side effects like increased 00:05:23.209 --> 00:05:25.709 blood sugar, a real concern for diabetic patients, 00:05:26.069 --> 00:05:28.209 and local risks too, like potential cartilage 00:05:28.209 --> 00:05:30.449 damage or weakening of tissues around the joint 00:05:30.449 --> 00:05:32.910 over time. And hyaluronic acid, that's meant 00:05:32.910 --> 00:05:35.939 to help lubrication, isn't it? It is. Hyaluronic 00:05:35.939 --> 00:05:38.800 acid injections aim to replenish the viscoelastic 00:05:38.800 --> 00:05:41.639 properties of the synovial fluid, the joint's 00:05:41.639 --> 00:05:44.579 natural lubricant. However, HA is a naturally 00:05:44.579 --> 00:05:46.620 occurring substance, and crucially, once it's 00:05:46.620 --> 00:05:49.639 injected, it's biodegradable. This means the 00:05:49.639 --> 00:05:51.860 body's own enzymes, particularly hyaluronidase, 00:05:52.000 --> 00:05:54.000 break it down, typically within a few months. 00:05:54.339 --> 00:05:56.540 So you need frequent injections, sometimes every 00:05:56.540 --> 00:05:59.319 three months, just to maintain the effect. This 00:05:59.319 --> 00:06:01.759 constant cycle, temporary relief, return of symptoms, 00:06:01.879 --> 00:06:04.660 need for another procedure It highlights this 00:06:04.660 --> 00:06:07.300 massive gap, this shortfall in truly effective 00:06:07.300 --> 00:06:10.680 long -term non -surgical options. Arthrosamide 00:06:10.680 --> 00:06:13.540 really emerged directly from that critical unmet 00:06:13.540 --> 00:06:16.000 need. The search for something that could offer 00:06:16.000 --> 00:06:17.720 sustained and meaningful improvement without 00:06:17.720 --> 00:06:20.100 being absorbed or needing constant re -administration. 00:06:20.430 --> 00:06:22.529 That really does paint a clear picture of the 00:06:22.529 --> 00:06:24.370 gap it was designed to fill, and how did that 00:06:24.370 --> 00:06:26.709 translate into its journey through clinical investigation? 00:06:27.009 --> 00:06:29.029 I understand it started gaining significant traction 00:06:29.029 --> 00:06:31.970 around 2018. That's right. The initial clinical 00:06:31.970 --> 00:06:34.730 investigations into arthrosomid's potential really 00:06:34.730 --> 00:06:37.810 kicked off around 2018. These were initial observational 00:06:37.810 --> 00:06:40.470 studies, proof -of -concept cohort studies, and 00:06:40.470 --> 00:06:42.350 those early findings were incredibly promising. 00:06:42.560 --> 00:06:45.519 They indicated positive outcomes for pain reduction 00:06:45.519 --> 00:06:48.060 and improved function, suggesting it could be 00:06:48.060 --> 00:06:50.819 a viable long -lasting alternative to the established 00:06:50.819 --> 00:06:54.259 but limited treatments. Then a really pivotal 00:06:54.259 --> 00:06:57.379 moment came in 2021 with the publication of comprehensive 00:06:57.379 --> 00:06:59.699 long -term follow -up results. This is from a 00:06:59.699 --> 00:07:01.779 five -year prospective study and the results 00:07:01.779 --> 00:07:04.500 were, well, quite remarkable actually. They showed 00:07:04.500 --> 00:07:06.839 sustained pain reduction and improved joint function 00:07:06.839 --> 00:07:09.180 in patients for up to five years after just a 00:07:09.180 --> 00:07:11.300 single injection. Five years from one injection? 00:07:11.300 --> 00:07:14.100 That's significant. It really is. And that long 00:07:14.100 --> 00:07:16.579 -term efficacy truly grabbed the attention of 00:07:16.579 --> 00:07:19.259 orthopedic leaders and innovators. People like 00:07:19.259 --> 00:07:21.259 Rakesh Taylor, the CEO of the Contour Group, 00:07:21.379 --> 00:07:24.139 the developers, have been quite vocal, emphasizing 00:07:24.139 --> 00:07:27.300 the treatment's potential to fundamentally redefine 00:07:27.300 --> 00:07:29.720 knee OA management. They particularly highlight 00:07:29.720 --> 00:07:32.379 the importance of making it accessible to a wider 00:07:32.379 --> 00:07:35.550 patient population. This whole progression really 00:07:35.550 --> 00:07:38.589 underscores a global effort to enhance the treatment 00:07:38.589 --> 00:07:41.209 landscape for OA patients, moving towards more 00:07:41.209 --> 00:07:43.970 durable, more impactful solutions. As we're talking 00:07:43.970 --> 00:07:47.389 now in 2023, while Arthur Smith isn't yet widely 00:07:47.389 --> 00:07:49.589 covered by national health services, say like 00:07:49.589 --> 00:07:51.930 the NHS here in the UK, private clinics across 00:07:51.930 --> 00:07:53.930 Europe and increasingly elsewhere have begun 00:07:53.930 --> 00:07:56.199 offering it. And that resets a growing acceptance, 00:07:56.199 --> 00:07:58.339 doesn't it? A strong demand within the medical 00:07:58.339 --> 00:08:00.279 community for genuinely effective long -lasting 00:08:00.279 --> 00:08:02.699 options, even while those broader regulatory 00:08:02.699 --> 00:08:05.399 pathways are still being navigated. Okay, let's 00:08:05.399 --> 00:08:08.019 delve into the science now. The unique blueprint 00:08:08.019 --> 00:08:10.860 of arthrosamide, which seems to be the core of 00:08:10.860 --> 00:08:13.300 how it works. You've stressed it's not just another 00:08:13.300 --> 00:08:15.800 injection. What makes its physical makeup so 00:08:15.800 --> 00:08:18.019 distinct and how does that translate into its 00:08:18.019 --> 00:08:20.100 action within the joint? Indeed, it's far more 00:08:20.100 --> 00:08:22.459 than just another injection. Its distinction 00:08:22.459 --> 00:08:25.139 lies squarely in its very precise, unique formulation. 00:08:26.319 --> 00:08:28.379 Which is quite elegant, actually, in simplicity. 00:08:28.800 --> 00:08:32.299 It consists of 97 .5 % non -pyrogenic water. 00:08:32.620 --> 00:08:35.259 That means it's meticulously purified, free from 00:08:35.259 --> 00:08:37.899 any fever -causing agents, absolutely crucial 00:08:37.899 --> 00:08:41.639 for intraarticular safety, and just 2 .5 % cross 00:08:41.639 --> 00:08:44.460 -linked polyacrylamide. That specific composition 00:08:44.460 --> 00:08:47.039 is the key to its persistent effect. When it's 00:08:47.039 --> 00:08:49.259 injected, this hydrogel effectively integrates 00:08:49.259 --> 00:08:51.200 with the synovial tissue, the lining inside the 00:08:51.200 --> 00:08:53.419 knee joint. It forms a stable persistent layer. 00:08:53.720 --> 00:08:55.740 This integration allows it to provide a continuous 00:08:55.740 --> 00:08:58.259 lasting cushioning effect. And that's vital for 00:08:58.259 --> 00:09:00.100 minimizing friction and wear on the joint surfaces 00:09:00.100 --> 00:09:02.220 when you move. So it's not just acting like a 00:09:02.220 --> 00:09:04.320 temporary lubricant that eventually gets washed 00:09:04.320 --> 00:09:07.399 away. It actually becomes an integral working 00:09:07.399 --> 00:09:09.279 part of the joints environment, almost like a 00:09:09.279 --> 00:09:11.940 permanent internal shock absorber. Precisely. 00:09:12.269 --> 00:09:15.850 way to think about it. The cross -linked polyacrylamide 00:09:15.850 --> 00:09:18.389 forms a stable three -dimensional structure, 00:09:18.570 --> 00:09:21.289 often described as a honeycomb structure. Can 00:09:21.289 --> 00:09:24.070 it do? This structure is very specifically engineered. 00:09:24.590 --> 00:09:27.070 Its microporous architecture allows it to integrate 00:09:27.070 --> 00:09:30.169 efficiently with the synovial membrane, yet it 00:09:30.169 --> 00:09:33.509 maintains remarkable elasticity. It's not a rigid 00:09:33.509 --> 00:09:36.549 implant, but a dynamic, biocompatible scaffold. 00:09:36.779 --> 00:09:39.320 It can flex and absorb forces within the joint, 00:09:39.740 --> 00:09:41.940 a bit like LV cartilage, but without being a 00:09:41.940 --> 00:09:44.279 biological replacement itself. It essentially 00:09:44.279 --> 00:09:46.500 enhances the viscoelastic properties of the joint 00:09:46.500 --> 00:09:49.220 fluid and provides that sustained physical buffer. 00:09:49.480 --> 00:09:51.700 There's even some preliminary research suggesting 00:09:51.700 --> 00:09:53.980 this scaffold might encourage a favorable biological 00:09:53.980 --> 00:09:56.539 response or stabilization within the knee environment, 00:09:56.899 --> 00:09:59.179 though further work is definitely needed to fully 00:09:59.179 --> 00:10:01.220 understand those intricate biological mechanisms. 00:10:01.679 --> 00:10:03.960 That's an ongoing area of intense interest. And 00:10:03.960 --> 00:10:06.399 the high water content. That contributes to the 00:10:06.399 --> 00:10:09.000 gel -like feel. Exactly. The high water content 00:10:09.000 --> 00:10:12.039 gives it that gel -like consistency, which significantly 00:10:12.039 --> 00:10:14.740 enhances joint lubrication and directly supports 00:10:14.740 --> 00:10:17.139 the mechanical function of the joint. It ensures 00:10:17.139 --> 00:10:19.440 the articulating surfaces glide smoothly over 00:10:19.440 --> 00:10:22.379 each other. This gel -like matrix is fundamental 00:10:22.379 --> 00:10:24.620 to its remarkable durability and persistence. 00:10:25.399 --> 00:10:27.340 Now, contrast that with traditional hyaluronic 00:10:27.340 --> 00:10:30.740 acid injections. As we discussed, they're biodegradable. 00:10:30.980 --> 00:10:33.080 The body breaks them down enzymatically over 00:10:33.080 --> 00:10:35.220 time, which is why you need repeated injections. 00:10:36.240 --> 00:10:39.059 Arthrosenid, by stark contrast, is non -absorbable 00:10:39.059 --> 00:10:41.860 and non -migratory. It isn't broken down, and 00:10:41.860 --> 00:10:43.820 crucially, it stays exactly where it's injected 00:10:43.820 --> 00:10:46.419 within the joint capsule. So it provides sustained 00:10:46.419 --> 00:10:48.299 cushioning and protection for the inner joint 00:10:48.299 --> 00:10:51.279 surfaces, offering prolonged relief without degradation 00:10:51.279 --> 00:10:54.440 or, importantly, dispersing to other areas. This 00:10:54.440 --> 00:10:56.620 unique physical chemistry truly sets it apart. 00:10:56.980 --> 00:10:58.799 It allows it to address the symptoms of knee 00:10:58.799 --> 00:11:01.379 osteoarthritis with both immediate and remarkably 00:11:01.379 --> 00:11:04.080 prolonged efficacy. It really offers a new frontier 00:11:04.080 --> 00:11:05.980 in joint preservation and symptomatic relief. 00:11:06.120 --> 00:11:08.120 Right. We've dissected the science, which is 00:11:08.120 --> 00:11:10.940 fascinating. Let's bridge that now to its practical 00:11:10.940 --> 00:11:13.879 use. Who really stands to benefit most from this 00:11:13.879 --> 00:11:15.899 approach? For our medical audience listening, 00:11:15.980 --> 00:11:18.700 what are the primary indications and the crucial 00:11:18.700 --> 00:11:21.620 patient selection criteria for arthrosamide? 00:11:22.220 --> 00:11:24.779 Okay, so arthrosamide is primarily indicated 00:11:24.779 --> 00:11:28.059 for patients with knee osteoarthritis, particularly 00:11:28.059 --> 00:11:30.460 those experiencing moderate to severe symptoms. 00:11:31.120 --> 00:11:32.940 We're generally talking about individuals whose 00:11:32.940 --> 00:11:35.220 daily activities and overall quality of life 00:11:35.220 --> 00:11:37.879 are significantly impacted by their knee pain 00:11:37.879 --> 00:11:40.620 and where, importantly, conservative measures 00:11:40.620 --> 00:11:43.399 haven't provided adequate relief. The main goal 00:11:43.399 --> 00:11:45.799 is to provide substantial, durable pain relief, 00:11:46.379 --> 00:11:48.460 significantly improve their joint function, and 00:11:48.460 --> 00:11:50.700 restore overall mobility, essentially allowing 00:11:50.700 --> 00:11:52.860 patients to regain a sense of normality and activity. 00:11:53.159 --> 00:11:55.500 And how do you select those patients? What specifically 00:11:55.500 --> 00:11:57.759 are you looking for? Patient selection involves 00:11:57.759 --> 00:12:00.100 a careful assessment. combining both clinical 00:12:00.100 --> 00:12:03.100 features and radiological evidence. Clinically, 00:12:03.340 --> 00:12:05.820 suitable candidates are typically aged 35 or 00:12:05.820 --> 00:12:08.019 older. They present with persistent movement 00:12:08.019 --> 00:12:10.940 -related knee pain, often stiffness after periods 00:12:10.940 --> 00:12:13.740 of inactivity, perhaps crepitus, that grating 00:12:13.740 --> 00:12:16.159 or crackling sound in the joint, and usually 00:12:16.159 --> 00:12:19.519 some limitation in their range of motion. Radiologically, 00:12:19.899 --> 00:12:21.779 we look for clear evidence of osteoarthritis 00:12:21.779 --> 00:12:24.639 on imaging, like x -rays. That means looking 00:12:24.639 --> 00:12:27.519 for things like osteophytes, bone spurs, and 00:12:27.519 --> 00:12:29.899 characteristic joint space narrowing, which indicates 00:12:29.899 --> 00:12:33.000 cartilage loss and disease progression. Crucially, 00:12:33.320 --> 00:12:35.080 patients are generally considered suitable only 00:12:35.080 --> 00:12:36.860 when those traditional conservative measures 00:12:36.860 --> 00:12:39.100 have been properly tried and haven't worked well 00:12:39.100 --> 00:12:41.200 enough. So they should have diligently tried 00:12:41.200 --> 00:12:43.580 things like physiotherapy, regular appropriate 00:12:43.580 --> 00:12:46.419 exercise, weight management if needed, and maybe 00:12:46.419 --> 00:12:48.480 even failed to get sustained benefit from other 00:12:48.480 --> 00:12:51.059 types of injections. Also, the patient's commitment 00:12:51.059 --> 00:12:53.179 to the aftercare and rehabilitation process is 00:12:53.179 --> 00:12:55.620 quite important. We find optimal results are 00:12:55.620 --> 00:12:57.379 usually achieved through a holistic approach, 00:12:57.759 --> 00:12:59.860 not just the injection alone. It sounds like 00:12:59.860 --> 00:13:02.659 a very comprehensive assessment is needed, not 00:13:02.659 --> 00:13:05.779 just looking at one symptom or one X -ray finding. 00:13:08.250 --> 00:13:10.250 What are the specific treatment goals you're 00:13:10.250 --> 00:13:12.909 aiming for, and what should patients realistically 00:13:12.909 --> 00:13:15.509 expect in terms of outcomes and the timeline? 00:13:15.990 --> 00:13:18.070 Absolutely. That holistic assessment, factoring 00:13:18.070 --> 00:13:20.830 in their overall health, activity levels, expectations, 00:13:20.990 --> 00:13:23.730 it's paramount. The primary goals when administering 00:13:23.730 --> 00:13:27.049 arthrosamide are essentially threefold. First, 00:13:27.269 --> 00:13:29.490 to restore and enhance the lubricating properties 00:13:29.490 --> 00:13:32.600 of the synovial fluid. Second, critically, to 00:13:32.600 --> 00:13:35.139 significantly reduce that intraarticular friction, 00:13:35.759 --> 00:13:38.039 and third, to provide that sustained cushioning 00:13:38.039 --> 00:13:40.600 and biomechanical support we talked about. Taken 00:13:40.600 --> 00:13:42.820 together, this promotes much smoother joint movement, 00:13:43.139 --> 00:13:45.639 which directly translates into reduced pain and 00:13:45.639 --> 00:13:47.519 significantly improved function for the patient. 00:13:47.960 --> 00:13:50.039 That's the aim. And in terms of expectations 00:13:50.039 --> 00:13:52.519 for relief... In terms of patient expectations, 00:13:53.240 --> 00:13:55.639 we aim for profound and long -lasting relief 00:13:55.639 --> 00:13:58.720 from pain, and a substantial improvement in their 00:13:58.720 --> 00:14:01.460 joint function. For many patients, actually, 00:14:01.559 --> 00:14:03.740 a single injection may well be sufficient to 00:14:03.740 --> 00:14:06.399 achieve these quite remarkable outcomes, providing 00:14:06.399 --> 00:14:08.539 relief for an extended period often measured 00:14:08.539 --> 00:14:12.220 in years based on the data so far. However, it's 00:14:12.220 --> 00:14:14.519 really important to manage expectations realistically 00:14:14.519 --> 00:14:18.240 and be transparent. As with any medical intervention, 00:14:18.700 --> 00:14:21.480 individual responses can vary. Some individuals, 00:14:21.620 --> 00:14:23.919 perhaps those with very advanced disease or unique 00:14:23.919 --> 00:14:26.720 biomechanics, might potentially require a second 00:14:26.720 --> 00:14:28.960 injection down the line to achieve their optimal 00:14:28.960 --> 00:14:31.840 outcome. So the precise treatment plan must always 00:14:31.840 --> 00:14:34.340 be meticulously tailored. It has to consider 00:14:34.340 --> 00:14:36.919 the individual specific condition, their lifestyle, 00:14:37.019 --> 00:14:39.259 their personal needs. It requires a thorough 00:14:39.259 --> 00:14:41.340 discussion and a shared decision -making process 00:14:41.340 --> 00:14:43.419 between the patient and their qualified health 00:14:43.419 --> 00:14:45.919 care provider. This ensures everyone's on the 00:14:45.919 --> 00:14:48.500 same page with realistic expectations and a plan 00:14:48.500 --> 00:14:50.080 that aligns with their goals for getting mobile 00:14:50.080 --> 00:14:52.820 again. It sounds incredibly promising, but as 00:14:52.820 --> 00:14:56.200 you say, patient safety is always the top priority. 00:14:56.759 --> 00:14:59.840 No treatment is without nuances. What are the 00:14:59.840 --> 00:15:02.159 key contraindications and precautions that health 00:15:02.159 --> 00:15:05.480 care providers absolutely must consider before 00:15:05.480 --> 00:15:07.639 administering arthrosamide? You're absolutely 00:15:07.639 --> 00:15:10.639 right to stress that. Patient safety is paramount. 00:15:11.019 --> 00:15:13.059 And while arthrosamide injections are generally 00:15:13.059 --> 00:15:16.159 very well tolerated, there are definite contraindications 00:15:16.159 --> 00:15:18.960 and crucial precautions we must observe. Firstly, 00:15:19.340 --> 00:15:22.159 Any active infection at or even near the proposed 00:15:22.159 --> 00:15:24.820 injection site is an absolute contraindication. 00:15:25.220 --> 00:15:27.480 Introducing any foreign material into an infected 00:15:27.480 --> 00:15:30.139 joint carries a significant risk of causing septic 00:15:30.139 --> 00:15:31.799 arthritis, which can be a really devastating 00:15:31.799 --> 00:15:34.399 complication. So infection must be ruled out. 00:15:34.879 --> 00:15:36.879 We also need to exercise caution with patients 00:15:36.879 --> 00:15:39.000 who have certain systemic autoimmune conditions. 00:15:39.399 --> 00:15:42.059 These might predispose them to inflammatory responses. 00:15:42.279 --> 00:15:44.580 And of course, those with known specific allergic 00:15:44.580 --> 00:15:46.700 reactions to any component of the injection, 00:15:46.919 --> 00:15:49.529 however minute. A thorough allergy history is 00:15:49.529 --> 00:15:51.470 essential. So checking for infection and allergies 00:15:51.470 --> 00:15:54.110 is key. Any other conditions to be wary of? Yes. 00:15:54.590 --> 00:15:56.870 A careful and comprehensive medical evaluation 00:15:56.870 --> 00:15:59.289 is essential for any patient with underlying 00:15:59.289 --> 00:16:02.049 medical conditions that could potentially complicate 00:16:02.049 --> 00:16:04.929 the treatment or their recovery. This means a 00:16:04.929 --> 00:16:07.120 detailed review of their medical history, current 00:16:07.120 --> 00:16:11.019 medications, and ecomorbidities. Then post -procedure, 00:16:11.179 --> 00:16:13.259 it's vital to monitor for potential side effects. 00:16:13.759 --> 00:16:15.840 These are typically transient and mild, like 00:16:15.840 --> 00:16:18.419 temporary stiffness, some localized pain, or 00:16:18.419 --> 00:16:20.559 maybe swelling at the injection site. These are 00:16:20.559 --> 00:16:22.639 usually benign and resolve quickly, often within 00:16:22.639 --> 00:16:25.519 a few days. However, rare allergic reactions, 00:16:25.580 --> 00:16:27.539 though uncommon, must always be considered a 00:16:27.539 --> 00:16:29.960 possibility. Patients need to be thoroughly advised 00:16:29.960 --> 00:16:32.460 on what signs to look out for things like persistent 00:16:32.460 --> 00:16:34.580 or spreading redness, severe pain that isn't 00:16:34.580 --> 00:16:37.840 getting better, or fever. Vigilant monitoring 00:16:37.840 --> 00:16:39.960 ensures a safe treatment experience and allows 00:16:39.960 --> 00:16:42.860 for prompt intervention if any unexpected reactions 00:16:42.860 --> 00:16:46.019 do occur. That detailed pre -screening and proper 00:16:46.019 --> 00:16:48.720 patient education are absolutely key to minimizing 00:16:48.720 --> 00:16:50.919 risks and maintaining the highest safety standards. 00:16:51.379 --> 00:16:53.480 Let's shift now to the practical side of things. 00:16:53.899 --> 00:16:56.440 How exactly is Arthur Submit administered and 00:16:56.440 --> 00:16:58.820 what does the post -procedure care involve to 00:16:58.820 --> 00:17:01.000 make sure patients get the best possible outcomes? 00:17:02.039 --> 00:17:04.759 Okay, the administration itself is a minimally 00:17:04.759 --> 00:17:07.000 invasive procedure. It's typically performed 00:17:07.000 --> 00:17:10.019 in a dedicated outpatient setting by experienced 00:17:10.019 --> 00:17:12.380 clinicians who have expertise in joint injections. 00:17:13.220 --> 00:17:15.500 A crucial element, which significantly enhances 00:17:15.500 --> 00:17:18.420 both the efficacy and safety, is that the procedure 00:17:18.420 --> 00:17:21.279 is universally ultrasound guided. This allows 00:17:21.279 --> 00:17:24.700 for incredibly precise, real -time visualization. 00:17:25.180 --> 00:17:26.940 You can see the needle's path, and you can see 00:17:26.940 --> 00:17:29.519 the hydrogel being deposited directly into the 00:17:29.519 --> 00:17:31.849 intraarticular space of the knee. That precision 00:17:31.849 --> 00:17:34.269 is absolutely vital. It ensures the material 00:17:34.269 --> 00:17:36.829 goes exactly where it needs to, optimizing its 00:17:36.829 --> 00:17:39.269 cushioning and lubricating effect, while minimizing 00:17:39.269 --> 00:17:41.650 the risk of accidentally injecting it into surrounding 00:17:41.650 --> 00:17:44.049 tissues. So definitely not a blind injection 00:17:44.049 --> 00:17:46.329 then. That real -time view must provide a clear 00:17:46.329 --> 00:17:48.789 advantage for both precision and safety. Could 00:17:48.789 --> 00:17:50.789 you walk us through the typical steps a patient 00:17:50.789 --> 00:17:52.789 would go through? You're entirely correct. It's 00:17:52.789 --> 00:17:55.289 an image -guided procedure, a significant enhancement. 00:17:56.029 --> 00:17:58.369 The process starts with thorough patient preparation. 00:17:58.650 --> 00:18:01.569 This usually involves administering a local anesthetic 00:18:01.569 --> 00:18:04.210 to the skin of the tissue just beneath it around 00:18:04.210 --> 00:18:06.829 the injection site to minimize any discomfort 00:18:06.829 --> 00:18:09.650 during the actual injection. Once the area is 00:18:09.650 --> 00:18:12.170 sufficiently numb, the doctor uses the ultrasound 00:18:12.170 --> 00:18:15.309 probe, not just to visualize the joint structures, 00:18:15.450 --> 00:18:17.609 the bones, the cartilage surface, the joint lining, 00:18:18.049 --> 00:18:21.049 but also to assess for any excess synovial fluid. 00:18:21.650 --> 00:18:25.140 We call that an effusion. If a significant effusion 00:18:25.140 --> 00:18:28.160 is present, that fluid might be aspirated, drawn 00:18:28.160 --> 00:18:30.819 off, before the arthrocemit is injected. This 00:18:30.819 --> 00:18:33.039 is often done to create the best possible space 00:18:33.039 --> 00:18:35.259 within the joint capsule and potentially remove 00:18:35.259 --> 00:18:37.259 some inflammatory fluid, which could enhance 00:18:37.259 --> 00:18:39.400 the effectiveness of the arthrocemit. Okay, so 00:18:39.400 --> 00:18:41.799 prepare the patient, use ultrasound, potentially 00:18:41.799 --> 00:18:45.079 drain fluid, then the injection itself. Precisely. 00:18:45.339 --> 00:18:48.319 Following that preparation, the arthrosomid gel 00:18:48.319 --> 00:18:51.519 is carefully and slowly injected directly into 00:18:51.519 --> 00:18:54.160 the joint space, guided by the ultrasound image. 00:18:54.740 --> 00:18:56.839 It's actually common practice and often recommended 00:18:56.839 --> 00:18:59.660 to also inject a small amount of steroid medication 00:18:59.660 --> 00:19:02.380 at the same time, or immediately afterwards through 00:19:02.380 --> 00:19:05.119 the same needle track. This is done primarily 00:19:05.119 --> 00:19:08.160 to mitigate any potential post -injection inflammatory 00:19:08.160 --> 00:19:11.089 response or flare -up. Sometimes the joint can 00:19:11.089 --> 00:19:13.329 react a little to the new material being introduced, 00:19:13.849 --> 00:19:16.109 so this co -injection helps ensure a smoother, 00:19:16.390 --> 00:19:18.529 more comfortable initial recovery period for 00:19:18.529 --> 00:19:20.809 the patient. Once the injection is complete, 00:19:20.970 --> 00:19:23.210 the needle is withdrawn, and the site is simply 00:19:23.210 --> 00:19:25.509 covered with a sterile dressing or a small plaster 00:19:25.509 --> 00:19:28.250 for protection. The whole procedure is relatively 00:19:28.250 --> 00:19:30.829 quick. usually takes only about 15 to 20 minutes 00:19:30.829 --> 00:19:32.710 from start to finish, including the preparation 00:19:32.710 --> 00:19:35.289 time. And after those 15 -20 minutes, what does 00:19:35.289 --> 00:19:37.309 the patient need to do or perhaps, importantly, 00:19:37.450 --> 00:19:39.910 not do to ensure the best recovery and the optimal 00:19:39.910 --> 00:19:42.690 long -term benefit? Post -procedure care is generally 00:19:42.690 --> 00:19:45.250 straightforward, but it is critically important 00:19:45.250 --> 00:19:47.950 for getting the best results. Patients are typically 00:19:47.950 --> 00:19:50.549 monitored for about 10 to 15 minutes immediately 00:19:50.549 --> 00:19:52.769 after the injection just to ensure there are 00:19:52.769 --> 00:19:55.190 no immediate adverse reactions, which are very 00:19:55.190 --> 00:19:58.789 rare. The main advice then is to avoid strenuous 00:19:58.789 --> 00:20:01.069 activities and to consciously rest the treated 00:20:01.069 --> 00:20:04.390 knee for approximately one week. This period 00:20:04.390 --> 00:20:07.630 of relative rest is crucial. It minimizes the 00:20:07.630 --> 00:20:09.910 risk of inflammation or any initial flare -ups 00:20:09.910 --> 00:20:12.150 as the joint starts to accommodate and integrate 00:20:12.150 --> 00:20:14.769 the hydrogel. So patient should avoid high -impact 00:20:14.769 --> 00:20:17.329 activities, heavy lifting, or prolonged standing 00:20:17.329 --> 00:20:19.470 during that initial phase. Okay, rest for about 00:20:19.470 --> 00:20:21.589 a week. And when can patients expect to feel 00:20:21.589 --> 00:20:23.730 the benefits? That's a key point for managing 00:20:23.730 --> 00:20:27.470 expectations. While some initial benefits, perhaps 00:20:27.470 --> 00:20:29.930 a subtle reduction in discomfort, can occasionally 00:20:29.930 --> 00:20:32.009 be felt relatively quickly, sometimes within 00:20:32.009 --> 00:20:34.529 a few days or a couple of weeks, patients should 00:20:34.529 --> 00:20:36.910 understand that the more significant pain relief 00:20:36.910 --> 00:20:39.630 and functional improvement are generally observed 00:20:39.630 --> 00:20:42.230 around the four -week mark. The optimal benefits 00:20:42.230 --> 00:20:44.349 often seem to peak around the 12 -week mark. 00:20:45.170 --> 00:20:47.809 So having this timeline helps manage expectations 00:20:47.809 --> 00:20:49.930 and encourages patients to adhere to that initial 00:20:49.930 --> 00:20:52.650 rest period for the best long -term outcome. 00:20:52.859 --> 00:20:55.259 We usually advise patients to, you know, listen 00:20:55.259 --> 00:20:57.400 to their bodies and gradually return to their 00:20:57.400 --> 00:21:00.299 usual activities, incorporating gentle, low -impact 00:21:00.299 --> 00:21:03.339 exercises as they feel able. Open communication 00:21:03.339 --> 00:21:05.000 with their doctor about how they're progressing 00:21:05.000 --> 00:21:07.400 is always encouraged. Of course, the clinical 00:21:07.400 --> 00:21:09.599 data is what really underpins practice and gives 00:21:09.599 --> 00:21:11.920 us confidence in a new treatment. What do the 00:21:11.920 --> 00:21:14.359 studies consistently tell us about arthrosamid's 00:21:14.359 --> 00:21:17.299 efficacy and its overall safety profile? The 00:21:17.299 --> 00:21:19.460 clinical evidence we have for arthrosamid is, 00:21:19.480 --> 00:21:21.500 well, it's robust and actually quite compelling. 00:21:22.100 --> 00:21:25.160 Clinical trial data consistently indicates significant 00:21:25.160 --> 00:21:27.339 pain relief occurring within just four weeks 00:21:27.339 --> 00:21:30.220 of administration. But what's particularly noteworthy 00:21:30.220 --> 00:21:33.079 and really a key differentiator is this sustained 00:21:33.079 --> 00:21:35.740 effect. Studies have shown these benefits lasting 00:21:35.740 --> 00:21:38.819 up to 156 weeks, that's over three years, and 00:21:38.819 --> 00:21:41.720 indeed, longer follow -up is ongoing. When we 00:21:41.720 --> 00:21:43.759 look at patient outcome data collected from various 00:21:43.759 --> 00:21:46.440 studies and cohorts, it suggests that approximately 00:21:46.440 --> 00:21:48.940 80 % of patients experience a significant improvement 00:21:48.940 --> 00:21:51.220 in their pain levels and their functional capacity. 00:21:51.369 --> 00:21:54.750 80 % is a high responder rate. It is a very encouraging 00:21:54.750 --> 00:21:57.589 rate And we've seen numerous anecdotal reports, 00:21:57.789 --> 00:21:59.490 which are consistent with this clinical data, 00:21:59.970 --> 00:22:02.450 of patients achieving really remarkable reductions 00:22:02.450 --> 00:22:05.309 in pain, sometimes even complete freedom from 00:22:05.309 --> 00:22:07.690 discomfort, which allows for a significantly 00:22:07.690 --> 00:22:10.390 restored range of motion. This means they can 00:22:10.390 --> 00:22:12.529 resume daily activities that they previously 00:22:12.529 --> 00:22:15.170 found challenging, climbing stairs, walking longer 00:22:15.170 --> 00:22:17.829 distances, engaging in recreational pursuits, 00:22:18.150 --> 00:22:21.089 and even, in some reported cases, returning to 00:22:21.089 --> 00:22:23.329 athletic training without that prior debilitating 00:22:23.329 --> 00:22:26.319 pain. While, as I mentioned, some early relief 00:22:26.319 --> 00:22:28.599 might be felt quite quickly, sometimes within 00:22:28.599 --> 00:22:31.640 24 hours for a few individuals, the most substantial 00:22:31.640 --> 00:22:34.000 and optimal benefits typically manifest between 00:22:34.000 --> 00:22:36.940 that four to 12 -week window as the hydrogel 00:22:36.940 --> 00:22:39.519 fully integrates and the joint environment responds 00:22:39.519 --> 00:22:41.839 positively. That five -year mark for a single 00:22:41.839 --> 00:22:43.519 injection, which you touched on earlier, that 00:22:43.519 --> 00:22:46.019 really is quite remarkable. Is that from specific 00:22:46.019 --> 00:22:47.859 studies that are still ongoing or is that fully 00:22:47.859 --> 00:22:51.170 published data now? Yes, absolutely. There are 00:22:51.170 --> 00:22:53.809 ongoing prospective studies, and the initial 00:22:53.809 --> 00:22:56.329 findings from those continue to reinforce this 00:22:56.329 --> 00:22:58.970 potential for long -term benefit. They indicate 00:22:58.970 --> 00:23:01.109 that patients can experience sustained benefits 00:23:01.109 --> 00:23:04.490 up to five years after a single injection. These 00:23:04.490 --> 00:23:06.410 studies are showing notable reductions in pain 00:23:06.410 --> 00:23:09.170 scores and consistently improved mobility over 00:23:09.170 --> 00:23:12.039 that extended period. Initial assessments conducted 00:23:12.039 --> 00:23:14.839 after just one year already demonstrated profoundly 00:23:14.839 --> 00:23:17.339 positive outcomes and these seem to be largely 00:23:17.339 --> 00:23:19.740 maintained at the later time points being assessed. 00:23:20.400 --> 00:23:22.640 This sustained effectiveness data really does 00:23:22.640 --> 00:23:25.019 position Arthrosemit as a potentially durable 00:23:25.019 --> 00:23:27.559 solution in our orthopedic toolkit. It moves 00:23:27.559 --> 00:23:29.619 us closer to a long -term management strategy 00:23:29.619 --> 00:23:31.960 rather than just episodic treatment for flare 00:23:31.960 --> 00:23:34.700 -ups. And the safety profile alongside that efficacy. 00:23:35.000 --> 00:23:37.710 Regarding its safety profile, It's notably reassuring, 00:23:38.349 --> 00:23:40.130 actually. Clinical studies conducted so far, 00:23:40.289 --> 00:23:42.410 which encompass the significant number of patients 00:23:42.410 --> 00:23:45.609 now, have indicated no serious adverse events 00:23:45.609 --> 00:23:48.309 directly associated with the treatment itself. 00:23:48.869 --> 00:23:51.269 That's a critical finding. Most of the reported 00:23:51.269 --> 00:23:53.349 side effects have been, as we discussed, mild 00:23:53.349 --> 00:23:56.650 and transient. This affirms a high level of tolerability 00:23:56.650 --> 00:23:59.730 among patients. These are typically those temporary 00:23:59.730 --> 00:24:02.609 injection site reactions, a bit of pain, swelling, 00:24:02.970 --> 00:24:05.970 stiffness. The studies also highlight a very 00:24:05.970 --> 00:24:08.549 low incidence of complications overall, which 00:24:08.549 --> 00:24:10.869 again underscores the importance of having experienced 00:24:10.869 --> 00:24:13.089 healthcare providers administering these injections 00:24:13.089 --> 00:24:15.710 effectively, which is why that ultrasound guidance 00:24:15.710 --> 00:24:18.029 is so critical for safety as well as efficacy. 00:24:18.299 --> 00:24:21.079 Patient safety and comfort are absolutely paramount. 00:24:21.299 --> 00:24:23.660 If we put Arthur Smith's safety profile into 00:24:23.660 --> 00:24:25.779 the broader context of other joint interventions, 00:24:26.059 --> 00:24:28.539 how does it really differentiate itself, especially 00:24:28.539 --> 00:24:30.599 in what seems like an increasingly crowded market? 00:24:30.920 --> 00:24:33.279 What are the common reactions, the rare complications, 00:24:33.440 --> 00:24:35.940 and, crucially, how do we advise patients to 00:24:35.940 --> 00:24:37.960 manage them? That's an excellent question, and 00:24:37.960 --> 00:24:40.019 it's really where Arthur Ossomid does appear 00:24:40.019 --> 00:24:42.200 to shine, particularly when you compare it to, 00:24:42.200 --> 00:24:45.619 say, repeated corticosteroid injections or perhaps 00:24:45.619 --> 00:24:48.940 even multiple rounds of hyaluronic acid. For 00:24:48.940 --> 00:24:51.480 the common reactions, as we've said, patients 00:24:51.480 --> 00:24:54.299 typically report temporary pain, maybe a feeling 00:24:54.299 --> 00:24:57.019 of fullness or some swelling, general discomfort 00:24:57.019 --> 00:24:59.740 right at the injection site. These are almost 00:24:59.740 --> 00:25:01.960 universally transient, usually settling down 00:25:01.960 --> 00:25:04.420 within a few days. You might also see slight 00:25:04.420 --> 00:25:07.160 bruising, a little redness, or perhaps an initial 00:25:07.160 --> 00:25:09.920 feeling of warmth at the site as the body adjusts. 00:25:10.539 --> 00:25:12.660 We advise patients that if these symptoms persist 00:25:12.660 --> 00:25:14.859 beyond a few days or if they seem to worsen, 00:25:15.119 --> 00:25:16.400 they should definitely get in touch with their 00:25:16.400 --> 00:25:19.059 health care provider. For managing these common 00:25:19.059 --> 00:25:21.000 side effects, the practical tips are straightforward. 00:25:21.819 --> 00:25:23.740 Applying ice packs to the injection site can 00:25:23.740 --> 00:25:26.359 help reduce swelling and discomfort. Using over 00:25:26.359 --> 00:25:28.000 -the -counter pain relievers, as recommended 00:25:28.000 --> 00:25:30.660 by their doctor, paracetamol, perhaps ibuprofen 00:25:30.660 --> 00:25:33.339 can be helpful. Keeping the injection area clean 00:25:33.339 --> 00:25:35.779 and dry minimizes any tiny risk of infection, 00:25:36.359 --> 00:25:38.140 and maintaining that open communication with 00:25:38.140 --> 00:25:40.700 your doctor about any unusual or persistent symptoms 00:25:40.700 --> 00:25:44.130 is always crucial. OK, so manageable local reactions 00:25:44.130 --> 00:25:46.829 mostly. How does that compare to something like 00:25:46.829 --> 00:25:48.970 corticosteroids, then? Well, when we compare 00:25:48.970 --> 00:25:51.069 it with corticosteroids, the differentiation 00:25:51.069 --> 00:25:54.009 becomes much clearer. Corticosteroids, while 00:25:54.009 --> 00:25:56.210 very effective for acute pain and inflammation 00:25:56.210 --> 00:25:58.730 in the short term, do carry that potential for 00:25:58.730 --> 00:26:01.369 increasing blood sugar levels. That's a significant 00:26:01.369 --> 00:26:03.470 concern for many patients, especially those with 00:26:03.470 --> 00:26:06.309 diabetes. They also pose a risk of local tissue 00:26:06.309 --> 00:26:09.390 damage with repeated use over time, things like 00:26:09.390 --> 00:26:11.710 cartilage degradation or even tendon weakening 00:26:11.710 --> 00:26:14.029 have been reported. And they don't offer that 00:26:14.029 --> 00:26:16.609 same long -term mechanical cushioning and integration 00:26:16.609 --> 00:26:19.210 with the joint's own tissue that Arthrosymit 00:26:19.210 --> 00:26:22.009 is designed to provide. So, arthrosumid avoids 00:26:22.009 --> 00:26:24.130 those systemic effects and potential long -term 00:26:24.130 --> 00:26:27.009 tissue issues associated with steroids. Exactly. 00:26:27.670 --> 00:26:30.569 Arthrosumid, in contrast, aims for that long 00:26:30.569 --> 00:26:33.230 -lasting relief without the same degradation 00:26:33.230 --> 00:26:36.589 or the systemic effects seen with repeated corticosteroid 00:26:36.589 --> 00:26:39.970 use. Its non -absorbable nature means it stays 00:26:39.970 --> 00:26:43.109 put and functions as intended, providing sustained 00:26:43.109 --> 00:26:45.130 support without being broken down by the body. 00:26:45.480 --> 00:26:48.700 So, this durable, local action, combined with 00:26:48.700 --> 00:26:51.319 a generally mild and transient side effect profile, 00:26:51.819 --> 00:26:53.819 and the absence of serious systemic adverse events 00:26:53.819 --> 00:26:56.180 reported in the clinical trials so far, truly 00:26:56.180 --> 00:26:58.880 sets it apart. It makes it an intervention designed 00:26:58.880 --> 00:27:00.819 for prolonged benefit without the cumulative 00:27:00.819 --> 00:27:03.079 risks associated with more frequently administered 00:27:03.079 --> 00:27:06.200 or potentially systemic alternatives. This really 00:27:06.200 --> 00:27:08.279 positions it as a very attractive and distinct 00:27:08.279 --> 00:27:10.420 option for patients who are seeking durable relief 00:27:10.420 --> 00:27:12.819 from their neo -A. And the rare complications. 00:27:13.000 --> 00:27:14.819 You mentioned infection or allergic reaction 00:27:14.819 --> 00:27:18.339 earlier. Yes. Regarding rare complications, though 00:27:18.339 --> 00:27:21.039 infrequent, they can occur. The main ones would 00:27:21.039 --> 00:27:23.319 be infection, which is a risk with any joint 00:27:23.319 --> 00:27:25.519 injection or potentially an allergic reaction 00:27:25.519 --> 00:27:28.680 to a component. This again just emphasizes the 00:27:28.680 --> 00:27:30.500 critical importance of skilled administration 00:27:30.500 --> 00:27:33.400 in a sterile environment and that close post 00:27:33.400 --> 00:27:36.299 -procedure monitoring. We always alert patients 00:27:36.299 --> 00:27:39.700 to the red flag signs of potentially severe complications. 00:27:40.420 --> 00:27:42.740 Things like increasing redness that spreads rapidly 00:27:42.740 --> 00:27:45.180 away from the injection site, significant or 00:27:45.180 --> 00:27:47.440 worsening swelling that extends beyond the immediate 00:27:47.440 --> 00:27:50.400 joint area, or intense pain that doesn't improve 00:27:50.400 --> 00:27:53.000 with standard pain relief and might be accompanied 00:27:53.000 --> 00:27:56.180 by a fever. If any of these occur, prompt medical 00:27:56.180 --> 00:27:59.059 attention is absolutely necessary. Patient education 00:27:59.059 --> 00:28:01.140 on spotting these red flags is paramount for 00:28:01.140 --> 00:28:03.920 safety. Let's widen the lens now, thinking about 00:28:03.920 --> 00:28:06.019 the regulatory landscape and the path to broader 00:28:06.019 --> 00:28:09.019 adoption. What's Arthur Samid's current regulatory 00:28:09.019 --> 00:28:11.440 status, particularly thinking about key agencies 00:28:11.440 --> 00:28:13.900 like the FDA and the U .S.? And what are the 00:28:13.900 --> 00:28:15.700 implications of this for access and practice 00:28:15.700 --> 00:28:18.039 globally? Okay, so Arthur Samid is currently 00:28:18.039 --> 00:28:20.460 well into the process of seeking FDA approval 00:28:20.460 --> 00:28:23.779 in the United States. This signifies an incredibly 00:28:23.779 --> 00:28:26.460 rigorous evaluation. It involves extensive lab 00:28:26.460 --> 00:28:29.220 research, preclinical studies, multiple phases 00:28:29.220 --> 00:28:32.000 of human clinical trials, all designed to thoroughly 00:28:32.000 --> 00:28:34.319 assess the product's safety, its effectiveness, 00:28:34.980 --> 00:28:37.079 and the consistency of its manufacturing quality 00:28:37.079 --> 00:28:38.920 before it can be made widely available there. 00:28:39.200 --> 00:28:41.700 The FDA process is, as you know, considered a 00:28:41.700 --> 00:28:43.859 global benchmark, so progress on that front is 00:28:43.859 --> 00:28:46.700 very significant. Beyond the U .S., Contura, 00:28:46.980 --> 00:28:49.519 the company behind orthostamid, is also actively 00:28:49.519 --> 00:28:52.160 pursuing, and in many cases has already secured 00:28:52.160 --> 00:28:54.420 regulatory approvals in other key international 00:28:54.420 --> 00:28:56.740 markets. That includes places like Australia, 00:28:57.000 --> 00:28:58.740 Canada, and numerous European nations where it 00:28:58.740 --> 00:29:02.109 already has CE marking. This comprehensive international 00:29:02.109 --> 00:29:04.150 approach is designed to ensure global access 00:29:04.150 --> 00:29:07.009 while obviously adhering to diverse local regulations 00:29:07.009 --> 00:29:09.589 and standards aiming to maximize patient reach. 00:29:10.309 --> 00:29:11.970 The wealth of clinical studies and the real -world 00:29:11.970 --> 00:29:14.190 data generated so far really forms the fundamental 00:29:14.190 --> 00:29:16.630 evidence base that underpins this ongoing regulatory 00:29:16.630 --> 00:29:19.049 evaluation worldwide. And what would approval 00:29:19.049 --> 00:29:21.710 from agencies like the FDA mean, both for patients 00:29:21.710 --> 00:29:24.109 and for health care providers? For patients, 00:29:24.630 --> 00:29:26.990 FDA approval provides access to a treatment that 00:29:26.990 --> 00:29:29.349 has undergone the absolute highest level of scrutiny 00:29:29.349 --> 00:29:32.190 for both safety and effectiveness. It really 00:29:32.190 --> 00:29:34.369 instills immense confidence in its use, knowing 00:29:34.369 --> 00:29:36.490 it has met those stringent quality and performance 00:29:36.490 --> 00:29:39.180 criteria. For healthcare providers, it offers 00:29:39.180 --> 00:29:42.099 a new rigorously validated therapeutic option 00:29:42.099 --> 00:29:45.420 for managing knee osteoarthritis. It significantly 00:29:45.420 --> 00:29:47.279 enhances the range of tools we have available 00:29:47.279 --> 00:29:49.920 for patient care. It broadens our orthopedic 00:29:49.920 --> 00:29:52.559 toolkit, essentially. It allows for more tailored 00:29:52.559 --> 00:29:55.059 and potentially more effective long -term strategies. 00:29:55.759 --> 00:29:57.839 Ultimately, it empowers clinicians to offer a 00:29:57.839 --> 00:30:00.099 durable alternative in cases where conventional 00:30:00.099 --> 00:30:02.539 methods might have fallen short. It really would 00:30:02.539 --> 00:30:05.140 signify a major step forward in the non -surgical 00:30:05.140 --> 00:30:07.630 management of OA. Moving beyond the clinical 00:30:07.630 --> 00:30:09.849 trials and the regulatory side, the real impact 00:30:09.849 --> 00:30:12.450 is often best understood through individual patient 00:30:12.450 --> 00:30:14.930 stories. What are you hearing from patients who've 00:30:14.930 --> 00:30:17.609 actually had arthrosamid injections? What are 00:30:17.609 --> 00:30:20.029 their experiences of renewed mobility like? The 00:30:20.029 --> 00:30:23.009 feedback from patients has been, well, overwhelmingly 00:30:23.009 --> 00:30:25.809 positive and actually quite moving in many cases. 00:30:26.509 --> 00:30:28.650 There are numerous testimonials available now 00:30:28.650 --> 00:30:31.210 with individuals sharing really heartfelt stories 00:30:31.210 --> 00:30:33.609 of significant improvements in their daily activities 00:30:33.609 --> 00:30:36.890 and a profound renewed sense of mobility. We've 00:30:36.890 --> 00:30:39.269 heard reports from patients overcoming long -standing 00:30:39.269 --> 00:30:41.769 knee discomfort that had severely limited their 00:30:41.769 --> 00:30:44.490 lives. They often cite a remarkable improvement 00:30:44.490 --> 00:30:46.730 in their overall quality of lives. For instance, 00:30:46.789 --> 00:30:48.309 we hear about patients who are really struggling 00:30:48.309 --> 00:30:50.710 to climb scares, now enjoying hikes with their 00:30:50.710 --> 00:30:53.130 families, or perhaps individuals who'd given 00:30:53.130 --> 00:30:55.890 up running due to pain, now being back able to 00:30:55.890 --> 00:30:58.089 exercise or play golf again. So it's enabling 00:30:58.089 --> 00:31:00.569 them to get back to things they enjoyed. Exactly. 00:31:00.730 --> 00:31:03.230 And this promise of potentially intervening earlier 00:31:03.230 --> 00:31:05.750 with orthoracimid combined with the use of cutting 00:31:05.750 --> 00:31:08.269 -edge technology like ultrasound for precise 00:31:08.269 --> 00:31:10.470 delivery and creating personalized treatment 00:31:10.470 --> 00:31:13.430 plans, it seems to be leading not just to symptomatic 00:31:13.430 --> 00:31:16.630 relief, but perhaps to truly better overall outcomes, 00:31:17.250 --> 00:31:20.029 potentially delaying or maybe even preventing 00:31:20.029 --> 00:31:22.509 the need for more invasive joint procedures further 00:31:22.509 --> 00:31:25.880 down the line. Patients are, of course, consistently 00:31:25.880 --> 00:31:28.220 encouraged to adhere to the aftercare guidelines 00:31:28.220 --> 00:31:31.259 to optimize their recovery. Their proactive engagement 00:31:31.259 --> 00:31:33.599 plays a really significant role in achieving 00:31:33.599 --> 00:31:35.960 and sustaining the benefit. And the improvement 00:31:35.960 --> 00:31:38.339 isn't just physical, it often seems to be psychological 00:31:38.339 --> 00:31:40.880 and social too, allowing them to reconnect with 00:31:40.880 --> 00:31:43.089 activities and people they care about. Are there 00:31:43.089 --> 00:31:45.769 any particularly striking long -term anecdotal 00:31:45.769 --> 00:31:48.450 cases, perhaps demonstrating relief even beyond 00:31:48.450 --> 00:31:50.329 that five -year mark from the studies you mentioned? 00:31:50.589 --> 00:31:53.549 Yes, absolutely. There's a growing body of real 00:31:53.549 --> 00:31:56.450 -world anecdotal evidence emerging now, particularly 00:31:56.450 --> 00:31:59.130 from clinicians and patients in Denmark, where 00:31:59.130 --> 00:32:01.230 arthrosymed has actually been in use for a longer 00:32:01.230 --> 00:32:03.769 period. These reports suggest that many patients 00:32:03.769 --> 00:32:05.930 are continuing to experience profound positive 00:32:05.930 --> 00:32:08.049 effects from their arthrosymed treatment, even 00:32:08.049 --> 00:32:10.309 five to eight years after their single injection. 00:32:11.230 --> 00:32:13.390 Now, while anecdotal, this really underscores 00:32:13.390 --> 00:32:16.170 its potential for truly sustained, possibly decade 00:32:16.170 --> 00:32:19.210 -long, management of knee osteoarthritis symptoms 00:32:19.210 --> 00:32:22.309 from just one intervention, which is an incredibly 00:32:22.309 --> 00:32:24.289 exciting prospect in managing a chronic disease 00:32:24.289 --> 00:32:27.559 like OA. Furthermore, the availability of comprehensive 00:32:27.559 --> 00:32:30.180 patient support resources, things like downloadable 00:32:30.180 --> 00:32:32.819 information leaflets, exercise guides coupled 00:32:32.819 --> 00:32:35.059 with consistently high patient satisfaction ratings 00:32:35.059 --> 00:32:37.099 being reported by clinics offering the treatment, 00:32:37.640 --> 00:32:39.980 it all suggests a positive overall patient experience 00:32:39.980 --> 00:32:42.099 that extends beyond just the immediate clinical 00:32:42.099 --> 00:32:44.549 interaction. It really seems to be a testament 00:32:44.549 --> 00:32:46.410 to the treatment's ability to genuinely impact 00:32:46.410 --> 00:32:48.789 a patient's life long term. Now, every significant 00:32:48.789 --> 00:32:51.769 innovation inevitably brings its own set of scientific 00:32:51.769 --> 00:32:54.430 discussions and questions. It's crucial we acknowledge 00:32:54.430 --> 00:32:57.049 these for a balanced view. What are some of the 00:32:57.049 --> 00:32:59.549 ongoing points of scientific inquiry, or perhaps 00:32:59.549 --> 00:33:01.769 areas the community is still researching regarding 00:33:01.769 --> 00:33:04.170 arthrosamide? And what does the future really 00:33:04.170 --> 00:33:06.049 hold for this treatment? You're absolutely right. 00:33:06.509 --> 00:33:09.349 No innovation exists in a vacuum without ongoing 00:33:09.349 --> 00:33:12.410 scientific scrutiny. That's a healthy and essential 00:33:12.410 --> 00:33:15.150 part of medical progress. There are certainly 00:33:15.150 --> 00:33:17.549 ongoing debates and vigorous research concerning 00:33:17.549 --> 00:33:20.069 the precise biological mechanisms by which the 00:33:20.069 --> 00:33:23.559 hydrogel exerts its long -term effects. While 00:33:23.559 --> 00:33:25.240 we understand its mechanical properties while 00:33:25.240 --> 00:33:27.819 the cushioning, the integration with the synovial 00:33:27.819 --> 00:33:30.720 membrane, the exact cellular -level interactions 00:33:30.720 --> 00:33:33.240 are still being explored. For example, whether 00:33:33.240 --> 00:33:36.099 it actively promotes any form of tissue regeneration 00:33:36.099 --> 00:33:39.160 or repair beyond simply acting as a passive scaffold 00:33:39.160 --> 00:33:42.220 is an area of intense research interest. And 00:33:42.220 --> 00:33:43.799 while the initial studies looking at sustained 00:33:43.799 --> 00:33:46.339 outcomes are highly positive, the medical community 00:33:46.339 --> 00:33:49.000 naturally continues to seek even more comprehensive 00:33:49.000 --> 00:33:52.130 long -term data. particularly from larger independent 00:33:52.130 --> 00:33:54.369 multi -center studies with very extended follow 00:33:54.369 --> 00:33:56.910 -up periods to further solidify the claims of 00:33:56.910 --> 00:33:59.150 sustained improvement over, say, decades. So 00:33:59.150 --> 00:34:01.309 mechanism of action and very long -term data 00:34:01.309 --> 00:34:04.950 are key areas. Yes, precisely. There are also 00:34:04.950 --> 00:34:07.130 sometimes discussions around the generalizability 00:34:07.130 --> 00:34:09.969 of findings from some of the earlier study populations 00:34:09.969 --> 00:34:13.170 and the ongoing need to ensure that patient expectations 00:34:13.170 --> 00:34:16.329 are managed realistically. As a relatively newer 00:34:16.329 --> 00:34:18.769 treatment compared to, say, joint replacement, 00:34:19.090 --> 00:34:21.510 it's vital to ensure that marketing and communication 00:34:21.510 --> 00:34:24.329 remain balanced. Highlighting the benefits, yes, 00:34:24.329 --> 00:34:26.409 but also clearly outlining what the treatment 00:34:26.409 --> 00:34:28.849 can and perhaps cannot achieve for every single 00:34:28.849 --> 00:34:31.730 individual. This is a standard part of integrating 00:34:31.730 --> 00:34:33.989 any novel therapy responsibly into mainstream 00:34:33.989 --> 00:34:36.670 practice. The call for more robust, independent 00:34:36.670 --> 00:34:38.849 clinical trials with diverse patient cohorts 00:34:38.849 --> 00:34:41.409 and very long follow -up periods is a consistent 00:34:41.409 --> 00:34:44.030 theme, and indeed, such studies are already underway 00:34:44.030 --> 00:34:46.690 or planned. And looking ahead, what does the 00:34:46.690 --> 00:34:49.920 future hold? Looking ahead, the future for arthrosamid 00:34:49.920 --> 00:34:52.320 appears exceptionally promising, I would say. 00:34:52.840 --> 00:34:54.780 There's significant ongoing research and development 00:34:54.780 --> 00:34:57.260 aimed at refining its application and understanding. 00:34:58.000 --> 00:35:00.440 A major new NHS study, for instance, is currently 00:35:00.440 --> 00:35:03.320 underway here in the UK at the Robert Jones and 00:35:03.320 --> 00:35:05.820 Agnes Hunt Orthopaedic Hospital NHS Foundation 00:35:05.820 --> 00:35:08.980 Trust, a world -renowned orthopaedic center. 00:35:09.800 --> 00:35:12.280 This study aims to further confirm arthrosamid's 00:35:12.280 --> 00:35:15.400 efficacy within a large, real -world UK patient 00:35:15.400 --> 00:35:18.860 population. And crucially, it aims to identify 00:35:18.860 --> 00:35:21.400 specific patient markers, perhaps biomarkers, 00:35:21.699 --> 00:35:23.860 or clinical profiles that predict who is most 00:35:23.860 --> 00:35:26.219 likely to have a very positive clinical response. 00:35:26.980 --> 00:35:29.119 That kind of information will be invaluable for 00:35:29.119 --> 00:35:31.619 optimizing patient selection criteria, ensuring 00:35:31.619 --> 00:35:33.980 that those who stand to benefit most are identified 00:35:33.980 --> 00:35:36.260 and prioritized, which also, of course, contributes 00:35:36.260 --> 00:35:38.219 to cost effectiveness within healthcare systems. 00:35:38.380 --> 00:35:40.659 And technology, will that play a role? Almost 00:35:40.659 --> 00:35:43.449 certainly. The integration of advanced technologies 00:35:43.449 --> 00:35:46.590 like Motion Artificial Intelligence or MAI is 00:35:46.590 --> 00:35:49.110 also expected to play a crucial role in its future. 00:35:50.010 --> 00:35:52.590 You can imagine AI analyzing a patient's gait 00:35:52.590 --> 00:35:55.150 patterns, their joint loading characteristics, 00:35:55.730 --> 00:35:58.489 perhaps predicting optimal injection sites, or 00:35:58.489 --> 00:36:00.710 personalizing rehabilitation protocols after 00:36:00.710 --> 00:36:03.570 the procedure based on their movement. This level 00:36:03.570 --> 00:36:05.449 of customized treatment planning and precise 00:36:05.449 --> 00:36:07.650 monitoring could potentially further enhance 00:36:07.650 --> 00:36:09.929 effectiveness in patient outcomes down the line. 00:36:10.079 --> 00:36:13.039 Ultimately, though, continued robust collaboration 00:36:13.039 --> 00:36:15.539 between health care providers, researchers, and 00:36:15.539 --> 00:36:18.360 industry stakeholders is essential. These ongoing 00:36:18.360 --> 00:36:20.559 studies not only validate the treatment's effectiveness, 00:36:20.880 --> 00:36:23.139 but also pave the way for further research initiatives, 00:36:23.659 --> 00:36:25.739 maybe exploring potential expanded indications, 00:36:26.179 --> 00:36:28.559 and facilitating the wider integration of arthrosymed 00:36:28.559 --> 00:36:30.860 as a standard treatment option in orthopedic 00:36:30.860 --> 00:36:33.840 care for chronic knee osteoarthritis. It really 00:36:33.840 --> 00:36:35.840 does represent a genuine shift in our ability 00:36:35.840 --> 00:36:38.699 to offer lasting relief. That has been an incredibly 00:36:38.699 --> 00:36:41.719 insightful deep dive. Let's try and distill everything 00:36:41.719 --> 00:36:44.159 we've discussed into just a few key takeaways 00:36:44.159 --> 00:36:47.400 for everyone listening. First, arthrosamin represents 00:36:47.400 --> 00:36:50.940 a truly novel approach. It's a non -biodegradable 00:36:50.940 --> 00:36:53.579 hydrogel offering the potential for long -lasting 00:36:53.579 --> 00:36:56.480 pain relief and functional improvement for moderate 00:36:56.480 --> 00:37:00.340 to severe knee OA. It really stands apart from 00:37:00.340 --> 00:37:02.860 traditional injectables like HA because it isn't 00:37:02.860 --> 00:37:06.019 absorbed by the body. Second, its unique composition, 00:37:06.179 --> 00:37:08.639 that precise blend of water and cross -linked 00:37:08.639 --> 00:37:11.219 polyacrylamide allows it to integrate with the 00:37:11.219 --> 00:37:14.039 joint lining acting as a stable persistent scaffold. 00:37:14.519 --> 00:37:17.099 This promotes lubrication and protection with 00:37:17.099 --> 00:37:19.219 compelling clinical data supporting its effectiveness 00:37:19.219 --> 00:37:21.579 for up to five years, potentially longer after 00:37:21.579 --> 00:37:24.440 just a single injection. Third, while it's generally 00:37:24.440 --> 00:37:27.099 well tolerated with mostly mild transient side 00:37:27.099 --> 00:37:28.880 effects, understanding the meticulous patient 00:37:28.880 --> 00:37:30.980 selection criteria, the strict point indications, 00:37:31.039 --> 00:37:33.159 and the importance of appropriate post -procedure 00:37:33.159 --> 00:37:35.230 care is absolutely paramount for achieving the 00:37:35.230 --> 00:37:37.820 best outcomes and ensuring patient safety. And 00:37:37.820 --> 00:37:40.820 finally, despite the ongoing regulatory processes 00:37:40.820 --> 00:37:42.840 and the healthy scientific discussions around 00:37:42.840 --> 00:37:45.719 very long -term data, significant research is 00:37:45.719 --> 00:37:48.679 actively underway. That includes a major new 00:37:48.679 --> 00:37:52.019 NHS study here in the UK. This work aims to further 00:37:52.019 --> 00:37:54.480 solidify its role and refine patient pathways. 00:37:55.199 --> 00:37:58.079 The future likely involves enhanced patient selection, 00:37:58.280 --> 00:38:01.199 using advanced diagnostics, integrating technologies 00:38:01.199 --> 00:38:03.960 like Motion AI for more personalized care, and 00:38:03.960 --> 00:38:05.940 continued collaborative efforts to establish 00:38:05.940 --> 00:38:08.519 arthrocemid as as a standard long -term treatment 00:38:08.519 --> 00:38:11.400 option in orthopedics. Thank you so much for 00:38:11.400 --> 00:38:13.039 sharing your expertise and insights during this 00:38:13.039 --> 00:38:15.539 deep dive. Your clarity and analysis have been 00:38:15.539 --> 00:38:18.179 truly invaluable. And for everyone listening, 00:38:18.300 --> 00:38:20.219 if you found this deep dive valuable, please 00:38:20.219 --> 00:38:21.880 do consider sharing it with colleagues who might 00:38:21.880 --> 00:38:24.699 benefit, perhaps on LinkedIn or X. And please 00:38:24.699 --> 00:38:26.360 take a moment to leave us a rating wherever you 00:38:26.360 --> 00:38:28.559 listen. It genuinely helps us reach more professionals 00:38:28.559 --> 00:38:31.099 like you. So, here's a final thought to leave 00:38:31.099 --> 00:38:34.059 you with. As orthopedic innovations like arthrocemid 00:38:34.059 --> 00:38:37.179 continue to reshape patient care, how might embracing 00:38:37.179 --> 00:38:39.340 these novel long -term solutions fundamentally 00:38:39.340 --> 00:38:41.519 alter our whole approach? Not just to treating 00:38:41.519 --> 00:38:44.159 chronic conditions, but perhaps even towards 00:38:44.159 --> 00:38:46.280 preventative joint health in the coming decade.