Nicky Ponsford, 57, is the Head of Women's High Performance at World Rugby and had struggled with problems in her right knee for four to five years before undergoing a partial knee replacement in 2016. The results from that surgery were positive and gave her significant relief. However, a few years later, her left knee began to deteriorate.
The degeneration in her left knee led to increasing pain and difficulty with basic movements. “The biggest challenges were going up and down stairs, putting socks on — really fundamental things,” Nicky explained. At one point, the pain in her right leg before her operation had felt like a persistent toothache, even affecting her sleep. While the left knee had not reached quite that intensity, it was heading in the same direction.
She managed the discomfort with paracetamol and anti-inflammatories but avoided heavy reliance on medication due to health concerns.
Despite her previous success with surgery, Nicky was hesitant to go down that route again. “The recovery was long—six to nine months before I was properly up and running again,” she noted. With a busy schedule, she could not afford to spend that amount of time recovering and wanted to explore alternative options to delay or avoid another surgical intervention.
A friend had been chatting with Dr. George Bownes about an unrelated issue, and mentioned his work with Arthrosamid®, Nicky was intrigued. “If it doesn’t involve an operation, I’m pretty open to giving it a go,” she said. Nicky met with Dr. Bownes, who introduced her to the new Retired Athlete Programme; a partnership between Citius Health and Contura Orthopaedics to deliver world-leading clinical care to retired high-performance athletes. Nicky was intrigued and became one of the first athletes to be treated as part of the ground-breaking programme. “You can um and ah about these things, but all that happens is your knee gets worse. So, I thought, "Let's just try it and see.”
The injection process itself was straightforward. “It was absolutely fine—yes, it’s an injection, so it’s going to be a bit uncomfortable, but no issues at all,” she recalled. Within about three weeks, Nicky began returning to her usual levels of physical activity. Day-to-day mobility was unaffected immediately after the injection, and she gradually resumed her exercise regime.
One of the standout aspects of the programme for Nicky was the focus on pre- and post-injection strength testing. Dr. George’s approach included measuring the objective strength in her affected leg and monitoring changes over time.
“This really highlighted just how much muscle I had lost in that leg from compensating,” she said. It made her realise how essential a targeted strengthening programme would be alongside the injection.
Nicky has been working closely with her physiotherapist, seeing him once a month. Rather than manual manipulation, the sessions focus on assessing her knee and progressing a personalised rehab exercise plan. Although her frequent travel has made regular appointments difficult, the system has worked well for her self-led recovery.
When it comes to daily life, Nicky has noticed clear improvements. She can now go upstairs without pain and put her socks on without difficulty—two of her original goals. Going downstairs can still cause some discomfort, especially due to flexion limitations, but she feels she is in a much better place overall.
“It hasn’t been a completely linear recovery,” she admits. “Sometimes I overdo it and need to back off for a couple of days, but I’m making real progress.”
Nicky has recommended Arthrosamid® to others but does so with thoughtful consideration.
“It has made a significant improvement for me, but everyone’s situation is different. It is not a miracle cure—nothing is. But it can be a powerful part of the solution.”
For her, one of the most important benefits is that it enables long-term rehab. “Unlike cortisone, which gives short-term relief, Arthrosamid® gives you a window to work on your strength and actually make progress.”
Beyond everyday improvements, Nicky is working toward returning to the activities she loves. She aims to get back into cycling, and in the future, hopes to participate in park runs and return to dinghy sailing—activities that require better flexion and strength in her knee.
“My goals are longer-term. It is not about quick fixes—it is about doing the right work to get back to doing the things I love.” She appreciates that the treatment has given her a meaningful head start and the ability to engage in rehab seriously and consistently. “It's an ongoing journey, but I'm getting there.”
