nSTRIDE® Treatment for Joint Pain in Singapore

Living with chronic joint pain can significantly impact your daily activities and quality of life. If you have been struggling with knee osteoarthritis or persistent joint discomfort despite conservative treatments, you may be searching for alternative options. nSTRIDE® autologous protein solution (APS) offers an innovative biological approach to managing joint pain, particularly in patients with mild to moderate knee osteoarthritis. This treatment harnesses your body’s own healing proteins to reduce inflammation and provide sustained pain relief.

Dr Zackary Chua

Senior Consultant Orthopaedic Surgeon (Adult & Paeds)

MBBS (Aus)MMed (SG)MRCS (Glasgow)FRCSEd (Orth)

Suitability Techniques Process Recovery Benefits Risks Cost FAQ Conclusion

What is nSTRIDE® Treatment?

nSTRIDE® is an autologous protein solution (APS) therapy that uses your own blood to create a personalised treatment for joint pain. The procedure involves drawing a small amount of your blood, processing it through a specialised device to concentrate anti-inflammatory proteins and growth factors, then injecting this solution back into your affected joint.

This biological approach delivers high concentrations of anti-inflammatory proteins directly to the joint, including interleukin-1 receptor antagonist (IL-1ra), other anti-inflammatory cytokines, and anabolic growth factors that may help reduce pain and improve joint function. Unlike traditional steroid injections, nSTRIDE® uses your body’s own proteins, offering a natural alternative for managing osteoarthritis symptoms.

The treatment is primarily intended for patients with knee osteoarthritis, though suitability for other joints can be assessed by an orthopaedic surgeon. Some patients notice improvements in joint comfort and function following treatment, though responses can vary depending on individual factors.

Ideal Candidates

Patients with mild to moderate knee osteoarthritis (Kellgren-Lawrence grades 2-3)
Individuals who have not responded adequately to conservative treatments (physiotherapy, medications, activity modification)
Those seeking alternatives to repeated steroid injections
Active individuals wanting to maintain their lifestyle while managing joint pain
Patients who prefer biological treatments using their body’s own healing properties
Those looking to delay or avoid joint replacement surgery
Individuals without active infections or blood disorders
Patients with realistic expectations about treatment outcomes

Contraindications

Active infection in or around the joint
Systemic infections or fever
Blood disorders or clotting abnormalities
Patients on blood-thinning medications (requires special consideration)
Severe osteoarthritis with complete joint space loss
Inflammatory arthritis conditions (rheumatoid arthritis, gout)
Pregnancy or breastfeeding
Known allergies to components of the processing system

A comprehensive evaluation by a fellowship-accredited orthopaedic surgeon is essential to determine if nSTRIDE® treatment is appropriate for your specific condition. Your medical history, current medications, and joint condition will all be carefully assessed before proceeding with treatment.

Treatment Techniques & Approaches

The nSTRIDE® APS System

The nSTRIDE® system uses a patented cell separation technology to concentrate naturally occurring proteins from your own blood. The process selectively concentrates anti-inflammatory cytokines and growth factors while maintaining the natural balance of these proteins. This creates a solution with significantly higher concentrations of therapeutic proteins than standard platelet-rich plasma (PRP) treatments.

Blood Processing Technology

Your blood sample is processed using a specialised nSTRIDE® device through a series of separation and concentration steps. This isolates platelets, white blood cells, and plasma proteins, creating a solution rich in IL-1 receptor antagonist (IL-1ra) and other anti-inflammatory mediators. The entire processing takes approximately 20 minutes and is performed in the clinic setting.

Injection Technique

Once the APS solution is prepared, it is injected into the affected joint using sterile technique. Ultrasound guidance may be used to ensure accurate placement, depending on the joint and clinical assessment. The entire procedure typically takes less than an hour from blood draw to injection completion.

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The Treatment Process

Pre-Treatment Preparation

Before your nSTRIDE® treatment, you will undergo a comprehensive evaluation including physical examination and review of recent imaging studies. Your orthopaedic surgeon will advise on any medications that may need to be temporarily discontinued, particularly blood thinners or anti-inflammatory drugs. On the day of treatment, you should:

Eat a normal meal and stay well-hydrated
Wear comfortable, loose-fitting clothing that allows easy access to the treatment area
Arrange for transportation home, though most patients can drive themselves
Inform your surgeon of any recent illnesses or infections

During the Procedure

The nSTRIDE® treatment begins with a blood draw, similar to a routine blood test. Blood is collected into specialised nSTRIDE® collection tubes. This blood is then placed in the nSTRIDE® device for processing.

While your blood is being processed (approximately 20 minutes), the injection site will be cleaned with antiseptic solution. Once the APS is ready, your orthopaedic surgeon will inject the concentrated solution into your joint using a thin needle. The injection itself typically takes only a few minutes and causes minimal discomfort, compared to other joint injections you may have experienced.

Immediate Post-Treatment

After the injection, you will be observed briefly. Most patients can walk immediately following the procedure, although mild discomfort or a sense of fullness in the joint is common. Ice packs may be applied to ease any injection-site discomfort. Detailed post-treatment instructions will be provided, including guidance on activity levels and what to expect in the days following the injection.

Recovery & Aftercare

First 24-48 Hours
In the first couple of days after treatment, mild swelling or discomfort at the injection site is normal and usually resolves quickly. During this period:
- Apply ice to the treated area for 15-20 minutes several times daily
- Avoid strenuous activities or excessive weight-bearing on the treated joint
- Continue normal daily activities as tolerated
- Take paracetamol for pain relief if needed (avoid NSAIDs unless approved by your surgeon)
- Monitor for any signs of infection (increasing pain, redness, warmth, fever)
First Week
During the first week after treatment, gradually resume normal activities while following your surgeon’s advice:
- Perform gentle range-of-motion exercises to maintain joint flexibility
- Avoiding high-impact activities or sports
- Continuing with prescribed physiotherapy, if applicable
- Monitoring your response to treatment
- Attending your follow-up appointment as scheduled
Some patients begin noticing improvements in pain and function within 2-4 weeks, though individual responses vary.
Long-term Recovery
The effects of nSTRIDE® treatment typically develop over several weeks to months. To support the best possible outcomes:
- Maintain a healthy weight to reduce joint stress
- Continue with recommended exercises and physiotherapy
- Follow activity modification guidance provided by your surgeon
- Attend follow-up appointments to monitor progress
- Report any changes in symptoms or concerns to your surgeon

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Benefits of nSTRIDE® Treatment

Evidence-based research has demonstrated several benefits of nSTRIDE® therapy for appropriate candidates. Patients who undergo this treatment may experience significant reduction in joint pain, with studies showing sustained improvements lasting months after a single injection. The treatment often leads to improved joint function and mobility, allowing patients to return to activities they previously found difficult or painful.

Compared with repeated steroid injections, nSTRIDE® uses naturally occurring proteins, providing a more physiological way to address joint inflammation. Typically, only a single injection per treatment cycle is needed, rather than a series of injections required by some other therapies.

Because the treatment uses autologous proteins, the risk of allergic reactions or rejection is minimal. For some patients, nSTRIDE® may provide an option to manage symptoms without immediately considering more invasive interventions, such as joint replacement.

Common Side Effects

Some patients may experience temporary side effects following nSTRIDE®, which usually resolve without intervention:

Mild pain or discomfort at the injection site lasting 1-3 days
Slight swelling or stiffness in the treated joint
Minor bruising at the blood draw site
Temporary increase in joint discomfort before improvement begins

These effects are generally mild and can be managed with ice application and rest.

Rare Complications

Though uncommon, potential complications can include:

Infection at the injection site (less than 1% risk with proper sterile technique)
Prolonged joint swelling or effusion
Failure to respond to treatment
Vasovagal reaction during blood draw (dizziness, fainting)
Allergic reaction to antiseptic or other materials used

Precautions are taken to minimise these risks, including strict sterile technique, thorough pre-treatment assessment, and careful patient evaluation. Any unusual symptoms should be reported promptly for appropriate management.

Cost Considerations

The cost of nSTRIDE® treatment varies based on several factors unique to each patient’s situation. Pricing considerations include the complexity of your condition, the number of joints being treated, and any additional consultations or follow-up care required. The treatment cost typically encompasses the initial consultation, the nSTRIDE® processing kit, the injection procedure, and immediate post-treatment care.

A detailed cost estimate will be provided during your consultation, allowing you to make an informed decision about your treatment options.

nSTRIDE®

Frequently Asked Questions

How long does the pain relief from nSTRIDE® typically last?

Many patients report noticeable pain relief for 6–12 months or longer following a single nSTRIDE® injection. Duration varies depending on factors such as the severity of osteoarthritis, activity level, and overall joint condition. Your orthopaedic surgeon will monitor your progress and discuss additional treatments if needed.

Can nSTRIDE® be repeated if the first treatment is successful?

Yes, nSTRIDE® treatment can be repeated if the initial injection provides symptom relief. The timing of repeat treatments varies by individual. Your orthopaedic surgeon will help determine the appropriate treatment schedule based on your response and symptom progression.

How does nSTRIDE® differ from PRP or steroid injections?

nSTRIDE® concentrates anti-inflammatory proteins, including IL-1ra, at higher levels than standard PRP. PRP mainly focuses on platelets and growth factors, while nSTRIDE® provides a targeted anti-inflammatory solution. Unlike corticosteroid injections, which act temporarily, nSTRIDE® uses your own proteins to help manage joint inflammation. Repeated steroid injections may negatively affect cartilage, whereas nSTRIDE® is designed to support a healthier joint environment.

What activities should I avoid after nSTRIDE® treatment?

Immediately following treatment, avoid high-impact activities such as running, jumping, or contact sports for at least one week. Light walking and daily activities are generally encouraged. Your orthopaedic surgeon will provide specific guidelines based on your condition and treatment response. Most patients can gradually return to their regular activities, including sports, within 2-4 weeks. Swimming and cycling are often good low-impact options during the recovery period.

Is nSTRIDE® treatment painful?

The nSTRIDE® procedure involves two components: blood draw and joint injection. The blood draw feels similar to routine blood tests. The joint injection may cause brief discomfort as compared to other joint injections, but most patients tolerate it well. Your orthopeadic surgeon may use local anaesthetic to minimise discomfort. Any post-injection discomfort is typically mild and resolves within 1-3 days with ice and rest.

Who is not suitable for nSTRIDE® treatment?

Patients with active infections, blood disorders, or severe end-stage osteoarthritis are typically not candidates for nSTRIDE®. Those taking blood-thinning medications may need special consideration or temporary medication adjustment. Inflammatory arthritis conditions like rheumatoid arthritis require different treatment approaches. Your orthopaedic surgeon will conduct a thorough evaluation to determine if nSTRIDE® is appropriate for your specific situation.

Conclusion

nSTRIDE® autologous protein solution offers a promising biological approach for managing knee osteoarthritis and joint pain. By concentrating your body’s own anti-inflammatory proteins, this treatment may provide sustained pain relief and improved function for appropriate candidates. While individual results vary, many patients find nSTRIDE® helps them maintain active lifestyles and delay more invasive interventions.

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Dr Zackary Chua (蔡克祥医生)

Senior Consultant Orthopaedic Surgeon (Adult & Paeds)

MBBS (AUS)|MMed (Singapore)|MRCS (Glasgow)|FRCSEd (Orth)

A senior consultant orthopaedic surgeon with dual specialisations in Foot & Ankle Surgery and Paediatric Orthopaedics. Backed by his extensive years of training and experience, Dr Chua brings the necessary knowledge and skills to ensure a smooth recovery journey.

Rooted firmly by two fundamental philosophies: “When one’s feet hurt, one hurts all over” and “Children are not little adults”, Dr Chua’s approach to patient care reflects his compassionate care for adults and children.

Singhealth Quality Excellence Award – Silver (2011)
Service From the Heart Award (2021)
Singapore Health Quality Service Award – Gold (2023)
NUS Medicine Dean’s Award for Teaching Excellence (2023)

His active participation in the medical community extends to mentoring, research supervision, and contributions to key professional forums and symposiums, both locally and internationally.