Advertisement


Advertisement


Advertisement


Author Topic: Hyalgan injections for torn meniscus  (Read 5306 times)

Offline blabramowitz

  • Forum Faithful
  • ****
  • Posts: 210
  • Liked: 0
Hyalgan injections for torn meniscus
« on: March 13, 2007, 07:19:27 PM »
My left knee has been hurting whenever I would crouch and stand from a crouching position, for years.  In recent months it has been feeling worse, but when the orthopedist read my X-ray of that knee a few months ago, he didn't think I needed anything other than to exercise and lose weight.  He prescribed physical therapy, and I was doing exercises in physical therapy mostly for spondylolistheses, which the ortho. diagnosed, and for plantar fasciitis, another condition the ortho. missed but a podiatrist diagnosed.  I think some of the physical therapy exercises made my knee feel worse, but when I told the therapist my knee hurt, he never said anything.  The day after I "finished" phys. therapy, I took a long walk for exercise (neither the ortho. nor the therapist said I shouldn't) and the next day I could hardly walk from the pain in my left knee! I went to see a rheumatologist, who had me get MRI's, and found I have OA of the knees and neck, and also a torn meniscus in my left knee.  She is to start me on a 5 week course of weekly Hyalgan injections in both knees next week, after last week she injected something that may have been a corticosteroid in the left knee.  I know hyaluronic acid injections are an established treatment for knee arthritis, but she thinks it can also repair the torn cartilege.  Anyone have any thoughts on this?

Offline ruggerite

  • MINIgeek (20-50 posts)
  • **
  • Posts: 40
  • Liked: 0
Re: Hyalgan injections for torn meniscus
« Reply #1 on: March 13, 2007, 07:31:43 PM »
I received my first sequence of 5 supartz injections last spring and I'm getting my second sequence now. Based on my discussions with my doctor here's what I know.
Sad to say it will not "repair" the torn cartilege. The torn cartilege cannot be repaired by simply letting it heal. Hyalgan will only provide temp. relief by acting as a cushion for the knee. Temp. meaning forabout 4-6 months depending on how bad your knees are. It can help if you have had menisectomies or if your cartilege has worn down quite a lot. If you have a torn cartilege it can provide relief in the areas where there is less cushioning between the top and lower portions of the knee but if your cartilege continues to tear, then it may not help that much.
1994 - Right knee menisectomy
2002 - Right knee menisectomy
2003 - Right knee ACL reconstruction and Menisectomy
2007 - Right knee lateral meniscus tranplsant + oats + microfracture

Offline blabramowitz

  • Forum Faithful
  • ****
  • Posts: 210
  • Liked: 0
Re: Hyalgan injections for torn meniscus
« Reply #2 on: March 13, 2007, 09:09:57 PM »
So why does my doctor tell me it will repair it?  And I presume that that would have to be verified by a follow-up MRI or some kind of arthroscopic procedure.  I don't expect the arthritis to reverse either, but I do hope that if I do the right things I can slow down its progress as much as possible.  I want to be able to walk and exercise again without fear of making the tear worse or experiencing nearly crippling pain from aggravating it.  Should I take the course of injections and start shopping for a new rheumatologist?  I don't want to go back to the orthopedist I was seeing - should I start shopping for a new orthopedist?  It was after a few visits to the orthopedist (the one my PCP recommended) that I went to my PCP and he suggested seeing a rheumotologist (but I didn't go to the one he recommended).

I really appreciate your reply.

Offline ruggerite

  • MINIgeek (20-50 posts)
  • **
  • Posts: 40
  • Liked: 0
Re: Hyalgan injections for torn meniscus
« Reply #3 on: March 13, 2007, 10:02:27 PM »
I'm guessing that the doctor was referring to the swelling of the knee and was also referring to the overall pain level. The extent of the damage can only be verified by an MRI or through arthroscopy. If you think you have a lot of cartilege wear, you could try glucosamin chondritin, and fish oil. Both are supposed to help rebuild cartilege. To slow down arthritis you should strengthen your knee and thats sort of a catch-22 since the condition of the knee prevents you from strengthening it. You could get your dr to recomment physiotherapy and they would show you the best way to strengthen you knee without worsening its condition.

Regarding a new orthopedist, I would recommend getting a better explanation from her about the condition of your knee first. Sometimes they think that non-medical people have a harder time understanding the internals of the knee and they try to use simple language. If you feel that your doctor isn't knowledgable or helpful enough you probably should start thinking about getting a second opinion. I've never seen a rheumotologist so I really can't offer any advice on that topic.
1994 - Right knee menisectomy
2002 - Right knee menisectomy
2003 - Right knee ACL reconstruction and Menisectomy
2007 - Right knee lateral meniscus tranplsant + oats + microfracture

Offline Nettan

  • SuperKNEEgeek
  • *****
  • Posts: 13852
  • Liked: 2
  • Stronger then yesterday...thanks Sis...
Re: Hyalgan injections for torn meniscus
« Reply #4 on: March 13, 2007, 10:22:44 PM »
I would go get a second opinion regarding this meniscus injury..if that is wear and tear a degenerative one and if you need a scope to fix that or not.
Why not see a new OS and bring your Mri ?
Surgery 6 times left knee torn meniscus, RSDS,chondromalacia, nervdamage cause constant nervpain,chronic inflamm.
Spinaldamage wheeler 100%.
Right knee damaged aug-06, use brace surgery 4/9-07.LCL tear.

Offline blabramowitz

  • Forum Faithful
  • ****
  • Posts: 210
  • Liked: 0
Re: Hyalgan injections for torn meniscus
« Reply #5 on: March 13, 2007, 10:35:45 PM »
Yup, right now I do feel I'm in a Catch-22.  Though I have lost almost 15 pounds this year so far, I have not been able to do any CV exercise which I think would help me lose more weight.  My doctor (the rheumatologist) doesn't want me to do any CV exercise yet - not walking/treadmill, not recumbent ex. bike, not the machine you "pedal" with your arms (because I also have rotator cuff tendinitis and she's afraid that might tear), though I haven't asked her about aqua exercise (not swimming - those movements would probably also be bad for my shoulder and dangerous for my lower back condition). Yet all you hear is how important exercise is for arthritis, and how important it is to lose any excess weight if you have arthritis.  I also can't work out with weights, even light ones.  I have in the past but it may have hurt me more than helped.  And resistance workouts also help burn more calories.  I look at the exercises for strengthening quads/other muscles around the knees, and I think, that might also make my problem worse.  The PT I get at the doctor's office includes massage, e-stim and ultrasound, but that's only once a week.  (They would let me come more often but their office hours are not convenient for me.) They did give me a few exercises to do on my own.  I do those, and some other range-of-motion and stretching exercises that I don't think can hurt. 

Offline DeborahinNC

  • SuperKNEEgeek
  • *****
  • *
  • Posts: 770
  • Liked: 0
Re: Hyalgan injections for torn meniscus
« Reply #6 on: March 14, 2007, 03:54:54 AM »
Hi,

One more to chime in.  The injections, mine were Orthovisc (same stuff different name) do nothing to repair a torn mensicus.  I've now had two medial tears both requiring surgery and have lost over half of it.  The injections are just a temporary solution but if they work can be repeated.  I got the injections to see if they would help the joint pain because of OA not for the tear.  I have know some people who had great results and did repeat the series because it gave them several months of relief.  Unfortunately for me they did nothing.  I don't know about others but just be aware you may have an increase in pain after the injection and then that should subside.  The orthovisc is a series of three and after the second one I felt like there was gravel in my knee.  Because they are only a week apart it only got worse but hang tight - that "additional" pain did subside and it was not horrible.

I would also add that I would consider a second opinion.  No let me change that, I would get a second opinion.  While the injections will probably cause no harm, they are expensive, time consuming and you do want to make sure they have potential to help the arthritis in your knee.

Whatever you choose to do I do wish you the very best.  It sounds like you have a lot on your plate besides the knee issues that are currently causing you problems.

Let us know how you make out.

Be well,
Deborah


Offline blabramowitz

  • Forum Faithful
  • ****
  • Posts: 210
  • Liked: 0
Re: Hyalgan injections for torn meniscus
« Reply #7 on: March 14, 2007, 04:40:48 PM »
I am going to get the knee injections (Hyalgan).  I think afterwards I am going to:
1. Ask current rheumatologist about arthroscopy to investigate and repair the tear.  If she is not responsive (maybe she doesn't do these procedures herself?) will seek another doctor - orthopedist or some other type of doctor who does these procedures for another opinion.  She already told me I should continue to see an orthopedist (and a podiatrist, but my plantar fasciitis pain has gotten a lot better, to the point where my knee and upper back pains are more predominant).
2. Look into nonsurgical spinal decompression.  I have nerve impingement in more than one place in my spine which is (I think) the cause of some other pains that have not responded to OTC pain meds, exercise, acupuncture or chiropractic manipulation. 

Apparently my insurance covers the Hyalgan injections, so the cost is not an issue.  I hope I will not be in too much pain afterward; all I read and was told is that I should not run or jog (as if!) or be on my feet too much for a day or two afterward.  I can ask about what med I can take if I have bad post-injection pain.  Maybe she can prescribe something a little stronger than the OTC stuff, or at least give "permission" to take more than the usual OTC dosage.

Thanks again for the responses!  I appreciate your support!

knee deep in Goo

  • Guest
Re: Hyalgan injections for torn meniscus
« Reply #8 on: April 04, 2007, 03:00:18 AM »
, but she thinks it can also repair the torn cartilege.  Anyone have any thoughts on this?

The injections will not repair the cartlidge.   Once it is gone it is gone.  Unless you do something like ACI or MACI or OATS.

These injections act like a bandaid .. Think of them as fix a flat.   Your tire is compromised but the fix a flat may get you a few extra miles. maybe six or 12 months if you are very lucky.

Repairs are done via scope or maybe open knee surgery and you have to have the correct type of tear for them to tack it. it also entails being  non weight bearing for some time.  ..  or else you are looking at your tear being removed as a meniscectomy or they take it to be cultured for ACI or Maci.  But you have to find the exact type of surgeron who will do ACI or MACI and you have to fit this list of who is a candidate for it.   OATS is like organ donation .. but its called soft tissue donation from someone who passed away and even than you are on waiting lists for a fresh donor.. and you have to thinking about the failure rate for doing something like that as well.

You mentioned you have Rheumy  Which is a totally different type of arthrtis than I have.    If your cartlidge is that bad you need to see an orthopedic surgeron  you must tell him or bring your RA of treatment as well as any films you may have had done.   MRI xray  CT scans and the radiological reports or any scope photos they may have ever taken if you had a prior surgery on your knee.


But before doing all this above and beyond surgical stuff..  I think viscosupplementation is well worth the small pain that comes with it.. before jumping into something surgical

Offline blabramowitz

  • Forum Faithful
  • ****
  • Posts: 210
  • Liked: 0
Re: Hyalgan injections for torn meniscus
« Reply #9 on: April 05, 2007, 04:00:19 PM »
My left knee feels a little better after the 3rd Hyalgan injection.  I don't expect this to repair the tear and some time within the next few months I do plan to go to an Orthopedist with copies of my X-rays, MRI reports and MRI films (if the Dr. can "read" MRI films) to further consult about what options I have for my knee.  In the meantime I am losing some weight and trying to do the little bit of exercise my rheumatologist has "approved" me to do. 

My arthritis is Osteo- , not Rheumatoid.  Maybe I referred to the rheumatologist as "rheumy". 

It's hard to keep up with all the abbreviations and shorthand terms.  What do ACI, MACI and OATS stand for?

I had to stop taking ibuprofen because I think it was starting to give me abdominal/intestinal pain.  Now if I have a headache I will take acetominophen, but I am not taking any analgesics/NSAIDS regularly.  I did start taking glucosamine, MSM, Hyaluronic Acid and sometimes chondroitin orally, and I take 2 or 3 flax oil capsules a day.