Cortisone v. Synvisc?

[River525]

I just had both of my knees injected with cortisone today and they actually feel better but I know it won't last forever.

My question is does the Synvisc last longer and is it safer?  Does the Synvisc relieve the pain also just like the cortisone?

I have had seven knee surgeries thus far and am not wanting to go through the rehab, etc. so I am really looking for info on the reason why a doctor would do cortisone and not start the Synvisc injections.

[Chester]

Hopefully someone else on the board will tell me if I'm wrong, but I am under the impression that cortisone and Synvisc are actually trying to accomplish two different things.  Cortisone is injected to relieve inflamation in the joint, where Synvisc is actually like injecting grease into the joint to cushion the bones and such.  It's not really grease, but a substance that flows in the joint and acts like a temporary meniscus or barrier.

Cortisone only lasts for a while unless the reason for the inflamation goes away, but Synovisc lasts a few months or more until it is absorbed.  Then you have another round of injections.  I understand that Synovisc doesn't work for everyone.  Pro athletes have cortisone injections to get them back into the game temporarily.

That's my explaination, or at least what my OS told me.

[Mitidai]

I had my second synvisc shot today.  I've had two knee scopes, a chondroplasty, on crutches for six weeks,two rounds of physical therapy and heading into my third round of physical therapy starting Friday.  I've had two cortizone shots and they only lasted for two weeks and the second one made me get red and puffy.  My question is why do the doctors wait so long to try synvisc.  This is the last ditch effort before tkr.  Since I'm 49 he's trying to hold me off.  Still having pain in my knee but since the synvisc shot it's less stiff.  My other knee is starting to shows signs of patella arthritis.  It gets pretty depressing but I try to stay positive.  Anyway, why do they hold off on the synvisc when it's supposed to help so much?

JAN

[River525]

I have no idea on why the hold of on the SYnvisc injections.  I know my OS told me that it takes about 30 days for approval from insurance company; so maybe that's why it takes so long for them to use it.  Don't you love being held hostage by your insurance company?  But then in the same breath thank God for insurance.

I'm 40 and my OS won't even discuss any further surgeries with me which is great b/c I don't want anymore but in the same breath I am willing to do ANYTHING for pain free knees.

The cortisone is helping a lot this time but how many times can you get those before they don't work?

[Chester]

One of the problems with cortisone is that it can damage tendons in the area of the injection if used too many times.  I'm not sure what too many is, but my OS said that two is usually the limit that he would do for a particular problem.

I have heard that getting approval for Synovisc does take a little while because of the fact that it doesn't work for everyone.  Don't expect it to be a miracle cure for all that is wrong with your knee, even Synovisc needs to be redone occasionally to keep working.

[rickslick]

I'm pretty sure they wait to do the Synvisc injections for cost reasons. I just had the 1st of 3 today and the total cost is going to be $728 for the 3 injections. I'm almost certain cortisone is cheaper.
From reading many posts in this board there appears to be a regular accepted progression of treatment for the standard patient with OA type symptons and Synvisc seems to be after other treatments are tried.....Rick

[Janet]

I've tried the cortisone. It worked great, but only for three weeks. In fact, we tried it specifically to get me through a vacation. My next step is Synvisc. My doctor also wants to hold off as long as possible, and I'm not sure why. But he did say that he would put it in my chart that I could call at any time to come in for it. They gave me all the procedure and diagnosis codes and I called my insurance to make sure it was covered. It is. I know I am going to ask for it at my next appointment in November, but am trying to hold off until then.

Yes, Synvisc and cortisone are different. Cortisone is a strong anti-inflammatory that can be used only sparingly. When you have irritation or arthritis in a joint, it causes the breakdown of the synovial fluid which lubricates and cushions the joint. Synvisc is like synthetic synovial fluid. I was told that it only works in about 40 percent of the people, and it works best on ealy arthritis. But the nice thing is it can be repeated every six months.

Janet