Steroid injection versus surgery

[carty]

Hi.
I’m new to this board. I’m surprised to read about various injection treatments, that seem to be unknown in Germany. At least I have found nothing on the Internet about PRP and Steroid Injection into the joint in Germany.
Here we only have hyaluronic acid and Orthokin. While some people report results from Orthokin most patients and physicians seem to regard Orthokin as nonsense or at least less effective than the also only low effective hyaluronic acid. I also got the impression it is just there to increase doctors income.

Now I read about steroid injection and other stuff and ask myself how trustworthy that is. Wouldn’t it be used widely if it would improve things significantly? Even in the US or UK only few physicians seem to apply it.

On the other hand some people here report promising results and after all cartilage has receptors for rHGH. Also Deca and Testo might improve things. Cartilage growth is a known side effect of steroid doping, so…
And then there is this regenixx stuff.


When looked at objectively: how are these injections compared to classic cartilage and meniscus surgery? Are they really working? Alleviating symptoms a bit? A lot? Has anyone seen grown cartilage in MRI? How are results after several years, let’s say 3-4 years?

[LindaM]

Hi Carty,

I think you may have the wrong idea about steroid injections.  What is being used for knees are corticosteroids like cortisone injections or prednisone pills, not anabolic steroids that are used by some sports figures.  Cortisone injections for inflamed joints can work wonders- beating down the swelling and knocking out the pain, but often do not last.  I have had some work for a year and some for a day or two-it depends on what is going on in the joint.  And cortisone injections cannot be repeated too often, many doctors will limit the number they give to two or three per year or even less.  Hope this answers a part of your larger question.

I have had a synvisc (hyaluronic acid) injection and because my knee was bone-on-bone it was unsuccessful.  Even if you are not bone-on-bone it is only about 50% successful and then for about a year.  When my second knee started to go my doctor tried cortisone shots (which have worked for me on other joints) and told me that at a recent conference he found out that cortisone is more effective than the $1000 synvisc shots.  Unfortunately my knee was too far gone and I had a PKR in February.

Hope this helps you with some parts of your question and that someone else can help with the rest.

Linda

Linda

[carty]

Thank for your reply.
Actually I do mean anabolic steroids. There are several threads in this forum and elsewhere on the internet about that:
http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=47512.15

Mostly rHGH (recombinant human growth hormon) is used. As I said, in theory cartilage has receptors for that. And it definately can growth cartilage in living humans, like other steriod products can (Deca, testo). Evidence are professional sportmen and-women, who do doping. There hands, feet, node, facial contures growth. Why? because cartilage is growing and on hands, face and feet there is a lot of that. habe you ever seen olympic swimmers? Bodybuilders? Even female bodybuilders habe super size hands and feet. They look manly, because the cartilage in their nose, chin and brows grows.
I have never used doping myself, but I know people, know about that topic, because IÄm from a sports background.

Cortison of cause is an entirely different topic. Thats symptomatic, okay. Anabolic steroids would be treating the cause of the problem.

As for hyaluronic acid, hat would cost only 150-250 Euros here in Germany for a series of 5 shots. I think I might give it a try, even if it is just symptomatic. Regarding Cortison, sure it works, it eliminates the inflammation. here in germy it is mainly used on severe rheumatic  joint, not on OE. Doctors here believe cortison destroys cartilage and tendons. At least in tendons it is true, as far as I know.

Anyway, I'm in search of treatment that might really regrow cartilage. May it be stem calls or anabolic steroids.
Of cause it makes me suspicious that some doctors offer it and most not. At least für both approaches there is evidence from animal models and regarding stem cells success on humans is reportet ins sientific literatur, but only experiemental.

BTW: How are you doing with the PKR? How active can you be? How is the pain level? How old are you?

[LindaM]

Hi Carty,

Both my PKRs are doing great.  I have full range of motion, no issues.  I am a teacher, so I spend a full day on my feet no problem (and I went back to work after 6 weeks with both of them).  I can do a full day's shopping (12 hours) to multiple malls with my daughter and can still race through an airport to make a flight.  I am 62.  I have never been an athlete but I am strong and my knees are a blessing.  I still have some arthritis pain that breaks through on a day when the pressure drops on non-replaced part of my knees, but it is minimal.  Walking out of the hospital the day after my first PKR my knee felt so much better than when I went in that we ran three errands and went out to lunch before going home(and it wasn't just the drugs).  My PKRs have really made a difference in my quality of life.

Linda

[carty]

Hey, I'm really glad, it went so well for you.
I'm just 32 and have severe carilage defects, due to maltracking of the patella and dysplasia. I can still walk fairly okay, because I am/was a keen athlete and still have very good muscles.
Nevertheless, I'm a teacher too, in a hospital, so I have to walk from patient, to patient. I'm verry uncertain about the future.....
My mayor concern are both of my femoropatella-parts, which are harder to treat than other knee parts. That's why I'm interested in that stuff.

Strangely noone seemed to know something about HGH-injection or regenexxs.

[irentat]

Carty,
You are going down the right path by looking at hormones to regenerate cartilage.  Yes I have documented proof of my own joints that the growth does occur and the pain does go away...permanently.  No artificial parts for me that can wear out!

Referencing corticosteriods as the other poster did, they did not tell you they shut down the healing process while they are in your joint.  this means even more degradation.  Also, why can you only give so many corticosteroid shots before they have to stop? 

On the other hand, GH and test shots into the joint have proven to regenerate and increase healing.  What you are referencing regarding the growth of cartilage, hands, feet, etc. is for people who are abusing at a bodybuilding level.  This is not even in the same realm as what is needed to get the cartilage rebuilding in a specific joint.  there are no issue with acromegaly when used as an IA injection intermittently.