KNEE ARTHRITIS - Injections into the joint :

Synvisc shots next week...opinions? - - Posted by cjd72 (cjd72), 31 December 2004

I went into see my GP week or so before X-mas due to knee pain in my left knee (been having pain in both knees for years, just finally got bad enough to get me into the Doc)... The Doc suggested getting X-rays of the left knee, as I was getting the X-rays I asked the tech to take X-rays of the right knee for comparison. Long story short, it turns out I have a nasty case of tri-compartmental OA in both knees, and he estimated I'd be lucky to make it to 40 before I needed TKR on both knees...I'm 32 now.

I still appear have complete cartilage coverage across both knees but not much spacing. The Doc gave me a few options for knee injections, one was Synvisc. I was/am more interested in something that was a little more long term than Cortizone, or the like, and he said Synvisc would be my best bet...

My questions are: Who should administer Synvisc? Is it ok for a GP to do? ...I'm supposed to have my first series done on Friday 1/17/05. Should I have a OS look at it first?

He says he has done it many times in the past, I didn't ask the number, but as I read in here it looks like many of the people posting say that a OS has done theirs.

Any suggestions would be appreciated.  

Thank you,
Chris
Posted by Parrothead (Parrothead), 4 January 2005

I would strongly advise you to see an OS.
I've read lots of stories on these boards about people having problems with pain and swelling. My OS said this happens when it is injected incorrectly, into the soft tissue and not into the joint, usually by a GP.

This isn't a knock on GPs, it's just a simple fact that the highest success rates correlate with the number of procedures done. Your GP probably injects synvisc a few times a year, an OS does it a few times a day.

He also told me that he can tell it's going into the joint because it's going in easily. If it's going into soft tissue, it will not go easily.

But do try it. I just had my 3rd shot shot 4 days ago and I'm already nearly pain free.  I'm trying not to get my hopes up too much, but I'm really happy with the results so far.

I have no cartiledge, bone-on-bone and the only really solution is a TKR, but my doctor strongly advises against it before age 50 (I'm 41).
Posted by cjd72 (cjd72), 4 January 2005

Thanks. He'll be doing some injections on my lower back for pain that day as well, so I'll have a little heart to heart on whether I would be better off seeing an OS.  

Let me know how you are doing with the Synvisc...I agree there have been a lot of fightening storys on this sight regarding Synvisc injections. ...but then again bad news always travels further, faster and louder than good news.  

Thanks,
Chris
Posted by rozzzie (rozzzie), 4 January 2005

Synvisc works realy well for some people, but not all.  I had it in my rt first realy good help, left not as much.  Second set in rt not too much help.  There suposed to give you about 6 months, but there's not much out there on second and third rounds of ingections.   I have had sateriod shots and they worked quite well, but did not give me the same lenght of releaf, but I found they are more likely to keep working injection after injection.

Make sure your insurance will cover Synvisc otherwise your looking at 200+a shot for the meds only!

Good luck, see an OS an let him do it.  

Hugs
Rozzzie
Posted by cjd72 (cjd72), 4 January 2005

No worries on the insurance...I'm covered.

I trust my Doc, and I know he does a lot of work on the orthopedic side of the medical profession, but I was starting to question who should do the injections after finding this website.

I'll post whatever happens on here...good, bad, or otherwise.  


Chris

Posted by Parrothead (Parrothead), 5 January 2005

one other thing...

There are also a lot of stories on the boards about the shots being painful.  I did not find this to be the case at all.  I felt a prick when the needle broke the skin, then just a sensation of pressure in my knee.

My doctor doesn't use lidocaine or freezing spray, he finds it unnecessary.

Since the needle doesn't go through very much flesh, I wouldn't expect it to be very painful.  I would once again wonder if the people who experience such pain are having the synvisc injected incorrectly, into soft tissue instead of into the joint. Forcing the gel into soft tissue seems like it would be painful.

My doc also studies my x-ray right before he does the injection, so he knows exactly where he's going.
Posted by nicole (nicole), 6 January 2005

I just want to say thanks for all these posts.  I am scheduled for my first Synvisc injection on 1/10 and have been a little nervous from reading previous posts.  I am also 32 and OS says he could easily justify replacement based on my X-rays right now.  But I am not anywhere near the pain threshold for needing that yet, thank god and cox2 inhibitors.
Anyway, I have been very concerned by what seems to be mostly negative results from Synvisc because I am counting on this to reduce the pain/swelling enough to get through another football (American) season before I have to "retire".
So, like I said, thanks for the posts I'll let you all know how my injections work out.  BTW, my OS is doing the injections and I wouldn't have it any other way
Posted by cjd72 (cjd72), 7 January 2005

I guess I need to correct myself, I'm due to go in on 1/7 @ 2PM...tomorrow, not on 1/17.

Thanks everybody, for your help. I'll have a little chat with my Doc and see what he says about refering me to an OS.

Good luck with your shots Nicole!

Chris

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