Dr Arj Imbuldeniya - OrthoLongevity

17/04/2026

My much cleverer wife Annie showed me a research paper a few breakfasts ago that stopped me mid coffee .

Stanford University published research in Science identifying a protein that doubles in our cartilage as we age and essentially switches off the joint’s own repair signal. When researchers blocked it, something happened that they themselves called remarkable.
The cartilage grew back.
Not scar tissue. Proper hyaline articular cartilage — the smooth, load-bearing tissue that osteoarthritis destroys and that surgeons have been trained to believe cannot regenerate in adults. It grew back through changes in the behaviour of cells that were already there. No stem cells, no surgery. Just the right biological environment.
They tested it in aged joints, in ACL-injury models, and in human cartilage taken from patients already undergoing knee replacement. End-stage tissue, already removed from the body, began to regenerate after just one week.
This is nowhere near an approved therapy. But what it changes right now is not the treatment — it is the argument. The fifty-year assumption that adult cartilage cannot regenerate appears to be wrong. And if that premise is wrong, the threshold at which we recommend replacing a joint needs to change well before any new drug reaches the clinic.
I have written the full analysis over on The Ortholongevity Journal — free to read, no medical degree required.
If you know someone who has been told their cartilage is worn and there is nothing to be done except wait for a joint replacement, please share this with them.
Link in the comments.

15/04/2026

I spent years telling patients to train, eat better, and sleep more — while quietly not doing it myself.
That changed. And it changed everything about how I practice medicine.
I’m a consultant orthopaedic surgeon. I’m 49. I strength train three times a week, I don’t drink, I’ve run the London Marathon, and I take my own joint health as seriously as I take my patients’.
Not because I’m trying to look good in a gym photo — but because I genuinely believe you cannot ask people to change their behaviour if you haven’t wrestled with it yourself.
The hardest part of joint health isn’t the diagnosis. It isn’t even the treatment. It’s getting someone to consistently do the right things on a tired Wednesday morning when no one is watching.
That’s the problem OrthoLongevity™ is built to solve.
Find your Knee Age at the link in bio — it takes sixty seconds and gives you something real to work with.

15/04/2026

I spent years telling patients to train, eat better, and sleep more — while quietly not doing it myself.
That changed. And it changed everything about how I practice medicine.
I’m a consultant orthopaedic surgeon. I’m 49. I strength train three times a week, I don’t drink, I’ve run the London Marathon, and I take my own joint health as seriously as I take my patients’.
Not because I’m trying to look good in a gym photo — but because I genuinely believe you cannot ask people to change their behaviour if you haven’t wrestled with it yourself.
The hardest part of joint health isn’t the diagnosis. It isn’t even the treatment. It’s getting someone to consistently do the right things on a tired Wednesday morning when no one is watching.
That’s the problem OrthoLongevity™ is built to solve.
Find your Knee Age at the link in bio — it takes sixty seconds and gives you something real to work with.
MSK PreventSurgery StrengthTraining

06/04/2026

How old are your knees?

Are they the same age as you — or older
than you think?

Your knees have a biological age. And
most people have no idea what theirs is.

I’m a consultant knee and hip surgeon.
My job is to keep people away from
surgery — by fixing the biology before
it’s too late.

Find out your Knee Age free in 60
seconds 👇
ortholongevity.ai

Then send it to someone whose knees
you’ve been quietly worried about.


BiologicalAge
KneePain Longevity MedTok HealthTok
SurgeonAdvice FreeHealthCheck
SendThisToSomeone LondonSurgeon
BiologyFirst

05/04/2026

This Easter weekend, I watched someone I love struggle to get up from the table after lunch (no not my 82 year old mum, she's actually fine !
They're not old, they're just not being helped by the current health system.
It made me think about how many people I know — friends, family, people I genuinely care about — who are in the same position without realising it.
As an orthopaedic surgeon, I spend my weeks seeing patients who come to me too late. Not because they ignored the problem — but because nobody told them there was one, or because they were not sure who to see. By the time most people get to me, years of quiet deterioration have already happened. Biology shifting, muscles weakening, inflammation building. None of it hurts until it becomes significant and then you start to feel pain, tightness, stiffness or swelling.
Joint health isn't one thing. It's a complex system — biology, movement, strength, injury history, and genetic risk.
So I got together with excellent colleagues, physiotherapists, osteopaths, sports medicine doctors, strength coaches, and functional medicine clinicians, and we built something to measure all of it.
👉 Knee Age™ www.ortholongevity.ai
A free 60-second test that tells you your biological knee age — how old your joints actually are, compared to how old you are.
Some people find out they're doing better than they thought.
Others find out they're further along than they realised.
Both are worth knowing. Now, not later.
This isn't just for people with bad knees. It's for anyone who wants to know where they stand before it becomes a problem.
This weekend felt like exactly the right time to share it — because most of us have someone around the Easter table we're thinking about.
👉 www.ortholongevity.ai — free, 60 seconds.
Do it yourself, do it with your partner, your friends, your family, do it with your parents. Drop your score in the comments and I'll tell you what it means. Have an amazing weekend.

30/03/2026

The knee injection that integrates into your joint.
Not a lubricant. Not a steroid.
Arthrosamid becomes part of the synovial lining — and as far as we know, it doesn’t get broken down.
One injection. Results that last years for most patients.
8 out of 10 people with mild to moderate knee arthritis do really well — if they’re the right candidate and it’s part of a proper plan.
I’m Mr Arj Imbuldeniya — Consultant Orthopaedic Knee and Hip Surgeon in London. I’ve been using this in selected patients for several years. This is my honest take.
Full video with all the trial evidence — link in bio.
🦴 Free Knee Age assessment → ortholongevity.ai
JointHealth KneeSurgeon NonSurgicalTreatment KneeHealth LondonSurgeon

20/03/2026

My grandfather died at 42. My father died at 50.
I'm 49 years old, with four children — aged 17, 15, 2, and three months.
That arithmetic sits with me every single day.
For a long time, I wasn't living the way I knew I should be. Overweight, eating poorly, drinking regularly, keeping late nights, spending too much time on my phone — all while advising patients to do the opposite. I knew exactly what the evidence said. I just wasn't applying it to myself.
The shift came when my third daughter was born extremely prematurely — at 27 weeks, weighing less than a kilogram. She spent three months fighting for her life in neonatal intensive care. Watching that happen made something completely clear: staying strong enough to genuinely show up for my family wasn't a lifestyle choice. It was the whole point.
So I started practising what I prescribe. Strength training, real nutrition, adequate protein, no alcohol, proper sleep. In 2024, at 48, I ran the London Marathon completely injury-free — having never run more than 5km before in my life — and lost over 20kg in the process.
But the thing that journey made undeniable — as both a patient and a surgeon — is that the knowledge which changed my health wasn't complicated or secret. It simply wasn't joined up, personalised, or delivered in a way that made it easy to act on consistently.
That gap is what OrthoLongevity™ exists to close.
After 25 years as a Consultant Knee and Hip Surgeon, I've built a platform around a single metric I call Knee Age — the biological age of your joints, updated weekly based on how you're actually living. No scan. No blood test. No clinic appointment. Just a clear signal and three specific actions to improve it this week.
This week I published the full story on my Substack and released a new YouTube video going through everything — the science, the personal journey, and the R.E.P.A.I.R.™ framework I use with every patient. Both are linked in the first comment below.
If you've ever been told you have "wear and tear" and weren't sure what to do next — this is for you. Share it with someone who needs to hear it.

Most people with knee or hip pain are told two things: manage it, or have surgery. I've spent 25 years as a knee and hip surgeon finding everything in between. This channel is built on Ortholongevity™ — a biology-first, surgery-last approach to joint health that treats the whole person, not just...

18/03/2026

The questions I hear most in clinic aren't about surgery.

They're these:

"Have I made it worse?" "How long will my knees last?" "Why did nobody tell me this before?"

Most patients who reach me have already seen multiple people. A physio. A GP. An osteopath. Maybe another Surgeon. They've been given different opinions, conflicting advice, and often — nothing that actually explains what's happening inside their joint or why.

They haven't been given bad care. They've been given incomplete care. Because the traditional model looks at structure — what shows up on a scan — and misses the biology entirely and often the whole, wonderfully complex, unique person in front of them.

Whether your knees age well or badly comes down to five biological factors. Strength. Load tolerance. Metabolic health. Recovery capacity. Injury history. Most people have never had these assessed. Most professionals don't routinely look at them together.

That's why 9 in 10 patients who come to see me don't need an operation. Not because their pain isn't real. But because once you understand the biology, you can change the trajectory.

I built a free 3-minute assessment that looks at exactly these factors. You get your Knee Age — your actual biological joint age — and your three most impactful actions this week.

It won't replace a proper consultation. But it will give you a framework. And it might be the clearest picture of your joint health you've ever had.

If you want to go deeper — I'm building something more comprehensive. The OrthoLongevity™ app will give you a full personalised joint longevity plan, tracked over time, built on the same biology-first framework I use with patients at Lanserhof Mayfair.

It's not launched yet. But if you want early access — join the waitlist at ortholongevity.ai

Early access is free. No spam. Just a notification when we go live.

Take the free Knee Age assessment → link in comments 👇

— Dr Arj

10/03/2026

The old orthopaedic model has a problem.

It waits.

It waits for pain to become severe. For scans to look bad enough. For conservative options to run out. And then — finally — it operates.

By that point, a lot has already been lost.

New piece out today in The Ortholongevity Journal:

👉 The Future of Orthopaedics Is Prevention, Not Surgery

Why the field needs to change. What the new model looks like. And what it means for anyone managing knee or hip pain right now.

— Dr Arj Imbuldeniya

09/03/2026

🦴 I'm a surgeon. And the longer I've practised, the more honest I've had to be about something uncomfortable.
By the time many patients reach surgery, we've already failed them upstream.
They've lost strength. Lost confidence. Lost years. Moving between clinics, scans, opinions, and treatments that never quite matched the problem.
I've been an orthopaedic surgeon for 25 years. I still operate every week. I believe in surgery completely — when it's the right answer, at the right time, for the right reason.
But around 9 in 10 patients I assess for knee or hip pain don't need an operation.
Not because the pain isn't real. Not because the scan is normal. But because most joint pain is a systems problem, not just a structural one.
Scans show damage. They don't show why you're in pain — or what will actually fix it.
That's why I created Ortholongevity™ — a biology-first, surgery-last approach to joints, delivered through a multidisciplinary clinic at Lanserhof Mayfair in London.
We treat muscle as medicine. We treat strength as treatment. We use surgery strategically — not reflexively.
If you want to go deeper:
📖 I write about the science weekly → The Ortholongevity Journal
▶️ Videos → YouTube
📍 Consultations → Lanserhof Mayfair | 020 7859 4016
Follow this page for evidence-based insights on joint health, longevity, and what modern orthopaedics should look like.

03/03/2026

When I trained as a surgeon, I was taught that PRP (platelet rich plasma) injections were basically a waste of time.
The early research evidence was poor. Inconsistent results. No standardisation. The message that filtered down to young surgeons like me was pretty clear: it probably doesn't work, and patients who think it does are probably just experiencing placebo.
I believed that for years.
What changed my mind wasn't a research paper.
It was my patients.
Over time I started seeing a pattern. When PRP had worked for people — and for some it had worked remarkably well — there were always the same ingredients. Ultrasound-guided delivery. The right type matched to their tissue. Proper preparation. Adequate dose. And a clinician who had actually thought about them as a whole biological system, not just a joint that needed an injection.
When it hadn't worked, the opposite was almost always true.
Blind injection. No thought about preparation quality. No consideration of the patient's metabolic or biological state.
I started to realise the real question wasn't whether PRP works.
It was: which PRP, delivered how, to what tissue, in which patient?
Once I started asking that question properly — everything changed.
I now use PRP every week. I've seen it help people avoid joint replacements they thought were inevitable. I've seen patients return to sport after injuries I would have taken straight to surgery earlier in my career.
But here's the part that almost nobody talks about.
PRP comes from your own blood. Which means the quality of what comes out depends entirely on the quality of what goes in.
Poor sleep. Chronic stress. Insulin resistance. Carrying excess weight. Low muscle mass. These things don't just affect your joints. They directly blunt your body's ability to respond to PRP. The tissue simply isn't ready to receive the signal.
This is why I always describe PRP to patients the same way:
It's a biological amplifier. Not a repair kit.
If your biology is overloaded, inflamed and running on empty — the amplifier turns up noise.
If your body is in reasonable shape — it turns up signal.
That's the difference between PRP that transforms someone's life and PRP that does nothing.
I've written the full story in my latest article — including what the evidence actually shows, the five variables that determine whether PRP works or fails, and what it means if you've had it before and it didn't help.
It's completely free to read.
Link in the comments 👇
And if you've had PRP before — good experience or bad — I'd genuinely love to hear about it below. Every comment helps someone else make a better decision.

28/02/2026

🩺 I've just published something I've never written before.
Not about surgery. Not about scans or injections.
Something more honest than any of that.
There's a moment that happens in almost every consultation I do.
A patient sits down. They've googled their symptoms at 2am. They've watched videos that frightened them. Someone has told them they probably need surgery.
They sit down. And they brace.
Because they're expecting me to confirm it.
And then I don't.
I've been a Consultant Orthopaedic Surgeon for over a decade. I do robotic knee replacements. Knee ligament ACL reconstructions. High risk revision surgery other surgeons are not willing nor able to take on.
But nine out of ten patients who walk through my door don't need me to operate.
In this article I explain why — including:
👉 What the evidence actually says about the most common knee operations
👉 Why the system is built backwards
👉 What I do differently — and why it works
👉 My own honest story of transformation at 49
Last year I weighed 103 kilos. I'm a knee surgeon who teaches patients about body weight and joint load every single day. I knew all the science.
I still had to make the decision to change.
I now weigh 83 kilos. I've run a marathon. And my knees feel better at 49 than they did at 39.
This article is for anyone who has been told they need knee surgery and wonders if there's another way.
It's free to read. Link in the comments 👇