Arthramid
Clinical Research
& Studies

Peer-reviewed research on 2.5% iPAAG — equine, canine, and human joint health applications.

Published Research on Arthramid 2.5% iPAAG

Arthramid 2.5% iPAAG has been investigated across multiple peer-reviewed studies relating to equine and canine joint health, osteoarthritis management, synovial integration, and long-term clinical outcomes.

This research library brings together published studies, retrospective analyses, pre-clinical models, and clinical case applications across veterinary medicine.

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Research Areas Explored

The Arthramid® clinical research library brings together peer-reviewed studies exploring the use of 2.5% iPAAG across equine and canine joint health applications.

Research within this library includes:

  • equine joint health, lameness, and osteoarthritis management
  • synovial membrane integration and joint homeostasis
  • histological and biomechanical response following injection
  • safety, tolerability, and long-term clinical outcomes
  • canine osteoarthritis and emerging companion animal applications

The collection includes pre-clinical research, prospective clinical studies, retrospective analyses, and real-world veterinary case applications across multiple species and disciplines.

Clinical Studies: Research OA Papers

2025
October 2025
The Symptom and Disease-Modifying Effects of Intra-Articular 2.5% Polyacrylamide Gel in an Equine Preclinical Osteochondral Model.
E Contino, K. Seabaugh, B. Nelson, M. King, C.W. McIlwraith and L. Goodrich;
CSU Osteochondral Fragment Model shows improved lameness & effusion scores; lower total radiographic scores; normal synovial fluid cell counts; no gross, arthroscopic or histologic differences at Day 70; significantly better cartilage scores & SOFG staining in 2.5% iPAAG® treated group.
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October 2025
Synovial Transcriptomic Response To Intra-Articular 2.5% Polyacrylamide Hydrogel Therapy In Experimentally Induced Equine Osteoarthritis
L Pezzanite
Transcriptomics demonstrates 2.5% iPAAG® - treated synovium has better innate immune & cell cycle pathways; downregulated inflammatory TNF-α & T cell pathways (peak 2-4 weeks).
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October 2025
Shear Stiffness of Equine Synovial Membrane in Osteoarthritis And Response to 2.5% Injectable Polyacrylamide Hydrogel Treatment.
M.A. Wimmer, M.J. AbuAlia
Primary mechanical Mechanism Of Action confirmed. Normal synovial membrane elasticity demonstrated in joints treated with 2.5%iPAAG® compared to controls in equine OA model.
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October 2025
Efficacy, Safety, and Tolerability of Intra-Articular Injection with 2.5% Polyacrylamide Hydrogel in 18 Dogs with Elbow Osteoarthritis
Corral J, Levine D, Barnhard J, Tringali A, Green M, Brunke M
Key Clinical Outcome: Elbow OA (n=18): significant improvements across CBPI PIS, mGCPS, CSU pain scales; minimal AEs; labs stable.
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October 2025
Owner-Reported Safety and Efficacy of 2.5% Polyacrylamide Hydrogel (iPAAG) Intra-Articular Injections in Dogs with Osteoarthritis
Jennifer A. Barnhard BVetMed, MS, Ashley A. Tringali BS, Nina C. Caldwell BS, Kathryn R. Webb BS, David Levine PT, DPT, MPH, PhD, Arielle Pechette Markley DVM, DACVSMR, Abigail Shoben PhD, Megan M. Green DVM, and Matthew W. Brunke DVM, DACVSMR.
This study evaluates owner-reported safety and efficacy of 2.5% Polyacrylamide Hydrogel (2.5% iPAAG®) intra-articular injections in dogs diagnosed with osteoarthritis (OA).
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July 2025
Retrospective analysis of the long-term use of 2.5% injectable polyacrylamide hydrogel (2.5% iPAAG) in a Thoroughbred racehorse practice: Safety on 701 horses, Efficacy on 205 horses
de Clifford, L., Vallance, S. A., Wood, E., Gieseg, M., Lowe, J.N.
Key Clinical Outcome: Long Term Safety confirmed: 701 TBs/2,312 injections/ 15,959 races/ 6 years: AEs 0.13%; CMI 0.199/1,000 starts (< industry 0.52); Timeform ratings improved; mean retreat ~234 days. Mean time to race following treatment ~40 days.
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June 2025
An injectable 2.5% cross-linked polyacrylamide hydrogel (2.5 iPAAG) demonstrates no neurotoxicity in human induced pluripotent stem cells-derived iCell® GlutaNeurons
Walmod PS, Kusk P, Jøhnk N, Ankorina-Stark I and Essex A (2025)
Key Clinical Outcome: Human iPSC neurons: up to 20% v/v 2.5% iPAAG® for 96 h shows no cytotoxicity/neurotoxicity; neurite network preserved.
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January 2025
The concurrent use of 2.5% polyacrylamide hydrogel and betamethasone esters for intra-articular injection is well tolerated in 10 healthy horses
Whitaker B, Barnhard JA, Webb KR, Levine D, Green MM, Vieira MR.
Key Clinical Outcome: Concurrent 2.5% iPAAG® + betamethasone esters in healthy horses: well tolerated; no AEs.
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2024
December 2024
Review of intra-articular 2.5% polyacrylamide hydrogel, a new concept in the management of osteoarthritis
Tnibar, A.
Reinforces that PAAG formulations differ in manufacturing and composition; data apply to Contura’s 2.5% iPAAG® manufactured in GMP facility.
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February 2024
Histologic and cytologic changes in normal equine joints after injection with 2.5% injectable polyacrylamide hydrogel reveal low-level macrophage-driven foreign body response
Lowe, J., de Clifford, L., Julian, A., & Koene, M. BVSc jason@imsvet.com, Leigh de Clifford BVSc, Alan Julian DACVP, and Marc Koene DVM
Histology: 2.5% iPAAG® integrates into sub intima by day 14; normal cell counts; low level transient macrophage response; no fibrosis/granulomas.
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2023
June 2023
A retrospective case-series of joint disease in dogs treated with intra-articular 2.5% polyacrylamide hydrogel in clinical practice
McGarrell G., Cook K., Eden J. & Reilly J.D.
A range of breeds and ages of dogs were treated with 2.5% PAAG. The mean age of dogs treated was 9.7 years. The most common reasons for treatment included osteoarthritis and elbow dysplasia. A reduction in lameness was seen from one month post PAAG treatment and maintained to at least six months in 71.7% of dogs. It was possible to reduce or stop systemic analgesics in case management in 67.4% of dogs. Up to 72.8% of owners were extremely pleased or pleased with the outcome of PAAG. Up to 86.4% of owners saw improvements in quality of life in their dogs with 2.5% PAAG. Up to 81.9% of owners were extremely likely or likely to recommend 2.5% PAAG to other dog owners. The safety of the treatment was good, with two of the practices reporting no adverse events, and one practice reporting adverse events in 6.5% of treated dogs. Clinical significance Intra-articular 2.5% PAAG is safe and well-tolerated in dogs with OA and reduced lameness from one month post treatment in 85.5% of dogs and this was maintained to 6 months in 71.7% of dogs in this retrospective study. It is an exciting prospect for the management of canine OA and deserves further investigation.
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2021
January 2021
A double-blinded positive control study comparing the relative efficacy of 2.5% polyacrylamide hydrogel (PAAG) against triamcinolone acetonide (TA) and sodium hyaluronate (HA) in the management of middle carpal joint lameness in racing Thoroughbreds
de Clifford, L.D., Lowe, J.N., McKellar, C.D., Bolwell, C., and David, F. (2021). Journal of Equine Veterinary Science 2021
Key Clinical Outcomes: Middle carpal lameness: 2.5% iPAAG® 83.3% resolved at 6 weeks vs 27.3% (TA) and 40% (HA).
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2019
July 2019
Use of a 2.5% Cross-Linked Polyacrylamide Hydrogel in the Management of Joint Lameness in a Population of Flat Racing Thoroughbreds: A Pilot Study
de Clifford, L.D., Lowe, J.N., McKellar, C.D., Bolwell, C., and David, F. Journal of Equine Veterinary Science. 2019
Osteoarthritis (OA) is cited as the most important musculoskeletal disorder in both humans and horses [1]. Several medications have been evaluated in the treatment of horses with OA, including nonsteroidal anti-inflammatory drugs (NSAIDs),
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2017
October 2017
Mechanisms of Action of an Intraarticular 2.5% Polyacrylamide Hydrogel (Arthramid Vet) in a Goat Model of Osteoarthritis: Preliminary Observations
Tnibar, Aziz & Persson, Ann & Jensen, Henrik.
Key Clinical Outcomes: Normal nerve morphology; increased joint capsule load transfer; early viscoelastic/mechanical mechanism evidence.
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September 2017
Initial Estimates of Efficacy of Intra-Articular 2.5% Polyacrylamide Hydrogel for the Treatment of Knee Osteoarthritis: An Observational Proof-of-Concept Study
Henrikson, M., Overgaard, A., and Bliddal, H. Arthritis Rheumatol. 2017;
There is a draught of available effective treatments of knee osteoarthritis (OA) and tests of new therapies are needed. Polyacrylamide hydrogel (PAAG) is a non-toxic, non-degradable synthetic product, used for years in the augmentation of soft tissues.
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June 2017
An observational assessment of Arthramid® : A novel intra-articular injection and its relationship with veterinary physiotherapy on patient outcomes in Labrador Retrievers with elbow osteoarthritis.
Harkin, C. L., & Mansbridge, S. C.
4 week improvements. Ref: Research project (unpublished)
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2016
July 2016
Synovial incorporation of polyacrylamide hydrogel after injection into normal and osteoarthritic animal joints
Christensen, L., Illigen, K.E., Hansen, M., Sarvaa, R., and Conogham, P.G. (2016).
Polyacrylamide hydrogel (PAAG) is a non-toxic, non-degradable synthetic product, used for years in the augmentation of soft tissues. Preliminary results in animals and humans have suggested long-lasting beneficial effects on symptoms of osteoarthritis (OA).
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July 2016
Intra-articular polyacrylamide hydrogel for the treatment of 20 horses with non-responsive osteoarthritis of the interphalangeal joints: a prospective study
Bathe, A.P., Read, R.M., and Briggs, C. (2016).
Our objective was to determine the effect of an omega-3 fatty acid rich diet (JM) with and without rehabilitation therapy (R) postoperatively on radiographic bone healing, radiographic osteoarthritis (OA) progression,
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2015
March 2015
An international multi-centre prospective study on the efficacy of an intraarticular polyacrylamide hydrogel in horses with osteoarthritis: a 24 months follow-up
Tnibar, Aziz & schougaard, hans & Camitz, Linus & Rasmussen, Jonas & Koene, Marc & Jahn, Werner & Markussen, Bo. (2015).
Key Clinical Outcomes: Multicentre prospective (n=43), 24 month follow up. 82.5% lame free at 24 months after a single injection; no AEs
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2014
April 2014
A controlled clinical trial on the efficacy of an intra-articular Polyacrylamide Hydrogel in horses with osteoarthritis
Tnibar, Aziz & Schoogaard, Hans & Koene, Marc & Christensen, Lise & Markussen, Bo. (2014)
Key Clinical Outcomes: iPAAG soundness 55/65/75% at 1/3/6 mo vs 15/40/35% with TA/HA; p=0.001.
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2012
November 2012
Intra-articular application of polyacrylamide hydrogel as a treatment of osteoarthritis in the distal interphalangeal joint: case series with 12 horses
Janssen I, Koene M, Lischer C
Key Clinical Outcomes: 67% lame free at 6 months; no AEs reported
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Arthramid White Papers

EQUINE WHITE PAPER

Veterinarians: Get your copy of our 24 page white paper today, covering Treatment of Joint Lameness, Pathophysiology, Manufacturing, Mechanism of Action, Clinical Safety and Putting it into Practice.

CANINE WHITE PAPER

Veterinarians: Get your copy of our 21 page white paper today, covering Treatment of Joint Lameness, Pathophysiology, Manufacturing, Mechanism of Action, Clinical Safety and Putting it into Practice.

Testimonials

Dr Dan Carter
Dr. Dan Carter
COUNTRYSIDE VETERINARY HOSPITAL - COVINGTON, GA
“Arthramid is a game changer for all equine athletes. It all starts in the synovium with synovitis and capsulitis, before we get to osteoarthritis. I routinely tell my horse owners, ‘save the synovium, save the joint’.”
Dr. Vern Dryden
BUR OAK SPORTS MEDICINE & LAMENESS, LEXINGTON, KY
“It’s given me another tool in my arsenal to effectively manage all stages of equine osteoarthritis, especially those horses with equine metabolic disease.”
Dr Marc Koene
TIERKLINIK LÜSCHE GMBH EQUINE HOSPITAL – NORTHER GERMANY
"We have injected over a thousand horses and have found it to be very safe. It has been a major game-changer in the way we treat OA in our patients.”
Dr CHarley McColough
Dr Charley McColough
PALM BEACH EQUINE - WELLINGTON, FL
"By incorporating Arthramid into my practice, I’m able to use far fewer steroids while still achieving excellent results, which gives me greater peace of mind for the long-term well-being of the horses under my care."
Dr Bob Peters
MCKINLAY & PETERS EQUINE HOSPITAL - NEWMAN LAKE, WA
"In my opinion, it is efficacious, long-lasting and lower risk to cartilage than many alternatives."
Testimonials

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