The OSTEOARTHRITIS DEPARTMENT => KNEE ARTHRITIS - Injections into the joint => Topic started by: KJ on August 12, 2002, 10:28:02 PM

Title: Synvisc and articular cartilage damage
Post by: KJ on August 12, 2002, 10:28:02 PM
I had my first Synvisc injection today. I had a normal knee until 18 months ago when I had a skiing injury with knee dislocation causing ACL/PCL/MCL and partial PLC rupture. Since then I have had PCL and ACL reconstructions but still have instability and degenerating articular cartilage.

My OS suggested that Synvisc might be worth a try for my current flare up. I actually got the injections on the NHS and it was done in 2 minutes today.

It might be a placebo effect but this afternoon there is a noticeable difference. Over the last week I have almost been unable to weight bear by the afternoon ( I have reverted to using one crutch when walking) Within an hour of the injection (which only hurt as the fluid went into the knee joint) my I did not have the same "splintering" medial pain on walking that I had before the injection. No local irritation so far.
So.........good news so far, I'll wait and see how it goes over the next week before the next injection.

(The OS did comment that my knee was "breaking up" which didn't sound quite so reassuring!!)
Title: Re: Synvisc and articular cartilage damage
Post by: The KNEEguru on August 13, 2002, 04:06:34 AM
It seems that the response to Synvisc varies a lot from person to person - from "great!!" to "no difference!!". But I do not hear much in the way of bad responses. Any experience out there of a really negative response to Synvisc?
Title: Re: Synvisc and articular cartilage damage
Post by: Tabu on August 14, 2002, 10:26:59 AM
My mother had synvisc injections done to both her knees and one knee that has nothing(bone eating bone)it didn't help but the other one she had no pain for about 2 years. the pain has come back recently.
She will not go in for the knee replacement that her Drs want her to do. She is afraid that it would hurt worse and that she won't wake up. But she is taking painkillers now to sleep-how can a knee replacement hurt worse?  She is 75 this year.
Title: synvisc + 2 days
Post by: KJ on August 14, 2002, 10:10:39 PM
My initial optimism has been revised after 2 horrible days. It is no worse than pre-injection but back to where it was in this current flare up. i.e. difficult to weight bear by lunchtime if I have been on my feet.
Depressed :'(
Title: Re: Synvisc and articular cartilage damage
Post by: Maggie on August 14, 2002, 11:17:50 PM
I had Synvisc injections about four months ago. After the first injection I, like you had an immediate response that only lasted a couple of days. After the second I again had a positive response. After the third I felt great for about a week and then it started swelling up, I called my OS he told me to start the ibuprofen at maximum dosage again and ice it and keep it up, which I did it was no better by Monday so he had me come in. They had to drain it and give me a cortisone injection. It did have good effects after that for about a month and a half, and now the pain is back and getting worse by the day. I will not have the Synvisc again. I was not that pleased. However everyone responds differently I'm sure there are many factors that determine how helpful they are. Thanks Maggie
Title: Re: Synvisc and articular cartilage damage
Post by: mark on August 22, 2002, 07:36:08 AM
I had the injections about three months ago, as far as I can tell they were a waste of my time and money, I never did feel any better, in fact my knee hurt worse after the injections, did any of you get a local before the actually shot because I did not and it was VERY painful. :o
Title: Local anaesthetic and intra-articular injection
Post by: KJ on August 22, 2002, 05:09:41 PM
There is very little point in giving a local for the Synvisc injection. The needle to inject the local is roughly the same size as the needle for the Synvisc.
It's the volume of fluid in the inflamed joint that hurts.

I have had 2 now, the second time I didn't even get a temporary effect, but I'll complete the course
Title: Re: Synvisc and articular cartilage damage
Post by: Karenk on August 23, 2002, 11:34:15 PM
I had Hyalgen injections (same theory) all 3 were painful injections - but later that day it was unbearable. It took a week for the first two to stop hurting and a full 2 weeks after the 3rd. I'm no sissy, but I wouldn't go there again. I had almost 2 wks of relief from all the pain but it's creeping back in and my knee is swelling some. I guess surgery will be pushed up, I was hoping for at least 6 months of relief. My problem is what to do, a Unispacer or a partial replacement. I am open for views and opinions. Thanks, Karenk  ;D

Decision has been made - Going in for Unispacer on Sept. 26th. Hyalgen injections are giving me some relief-but the bottom line is I need to fix this knee. Unispacer is a good place to start - if it works, I could get 10 yrs. of relief and then still go ahead with a partial replacement, if need be. Karenk ;)
Title: Re: Synvisc and articular cartilage damage
Post by: a7yritch on September 02, 2002, 09:14:34 PM
I had synvisc injections last year.  I had absolutely no relief from them, as a matter of fact it made my knee worse!!!  I couldnt weight bear for 2 days after, and even then my knee was too tender to do too much.  

I have taken all kinds of meds, and done everything I have been told to do, but still have no relief.  My new OS told me I'd just better get used to the pain, and learn to live with it.  Whereas, my previous OS told me I needed either a mini knee, or a tibial osteotomy.  Neither sounds good to me.  So for now, we added Lidocaine patches into my mix of meds.  I wear 1 over my knee for 12 hrs a day.  It isnt great, but it helps me get through the day.  I know its just a band-aid so to speak, but until something better comes along or I cant walk anymore, it'll have to do. :-/
Title: 3rd Synvisc, minor effects only
Post by: KJ on September 02, 2002, 10:02:12 PM
I've now had three injections. They were not particularly painful - just some discomfort with the first 2 when the "gloop" was injected, the 3rd was completely pain free.
After the first I had 6hrs dramatic relief, after the second - no difference at all, after the 3rd I have had an effect, it has taken the edge of the very inflamed feeling but it certainly hasn't been a magic solution.
As a doctor i think I would think twice about spending 280 pounds of NHS money on a treatment that has such minor benefits but as a patient I was very keen to give it a try.
Title: Re: Synvisc and articular cartilage damage
Post by: atrand on September 03, 2002, 11:59:22 AM
The major problem I see with the unispacer is the lack of time to measure results since it is so new.  My ortho doc says they have tried this concept before and it hasn’t worked, but this could be the one that does.  If you like, let’s keep in touch and compare notes on the wisdom of the unispacer vs partial or total knee replacement.  The best evidence will be feedback from folks who have had unispacer in for a while… Good luck, TR

I am a 54 year old male who had my medial cartilage removed surgically 30 years ago.  I am bone on bone in my right knee (my other :) knee is fine) and the pain, discomfort and dysfunctionality is increasing with time.  My lateral cartilage is fine, tho there is some question about the patella compartment.  Am I a likely candidate for the Unispacer?  If so, who are the closest competent practicioners doing this surgery? ?   ( I live near Lansing, MI ½ way between Detroit and Chicago).  I love hockey. (a gliding sport!) Can it be played after getting a unispacer?   I am consiering the unispacer vs partial or total knee replacement.  Thanks for input.
Title: Re: Synvisc and articular cartilage damage
Post by: The KNEEguru on September 03, 2002, 02:09:43 PM
Sulzer have a site which offers help with finding a unit doing the unispacer -

For those of you who do not know what a unispacer is, it is a sort of artificial meniscus which is popped into the joint space (medial side only) if the medial meniscus has been destroyed and the medial side collapsing.  It is new and only in the early stages of evaluation.
Title: Re: Synvisc and articular cartilage damage
Post by: bc on September 07, 2002, 08:16:25 AM
I recently had the second in a series of injections of Supartz.  Found it much more painful than the Synvisc last year.  The Synvisc was prior to arthroscopic surgery, so don't know if the knee is just worse since surgery last fall, or if the different type of solution is more painful.  

The Synvisc, though having immediate good results, did not last a year, which was rather disappointing to say the least.
Title: Re: Synvisc and articular cartilage damage
Post by: Stevejw on September 12, 2002, 07:42:11 PM
Met with my OS today and was advised that the series of surgical procedures and injuries over the years have left me with a rapidly deteriating knee. Lots of pain, especially in the evenings and now having to modify significantly my exercise activities and general life style to cope .

Looks like a knee replacemnt is quite close (within a year) and as final exercise to give me some more time (I'm 37) he is recommending Hyaluconic Acid injections (Synvisc, I think?).

Due to return next week for the "jabs" - would appreciate from undersatnding how this has benefitted others (or not) and how much time  in terms of pain relief it has given. Finally, does anyboody know whether these injections can be repeated regularly?


Steve ???
Title: Re: Synvisc and articular cartilage damage
Post by: JorJor on October 10, 2002, 11:43:48 PM
Sorry to hear many of you had negative or no reaction to Synvisc type products. Here is how they worked for me...

I've had 5 rounds of this type of drug and have benefited greatly from it. For me, they tend to wear off in about 6 months but I know others have lasted for 18 months, varies from person to person.  
The first few rounds were with Synvisc and now I am using a different drug called Halygen (sp?). I have found that the actual injections (3, one every week for 3 weeks) are less painful and with less reaction on the new drug. You may want to ask your DR about alternative drugs to Synvisc. There is also a new drug called Supartz out that I hear is a little stronger and it is a 5 injection series.  
I have had lots of success with these injections but don't recommend them to the needle phobic or pain intolerate. They can freeze the skin surface but you will still feel the needle once it hits the inter part of the knee joint.  That's ONE HUGE NEEDLE.   I don't want to scare you with my details but I have always appreciated when others told me exactly what to expect in situations like this.

Good luck either way!  
Title: Re: Synvisc and articular cartilage damage
Post by: enuff81020 on October 12, 2002, 06:09:28 AM
Hi !  I did the Synvisc thing in my left knee in Oct. 2000 and my right knee in Dec. 2000.   i had relief from them until i fractured my foot and began stressing out my knees accomodating that.

I felt some inmprovement after my second injection and my ortho was genuinely surprised.  She told me that typically, the benefits do not start until 3 weeks after the series...I'm wondering if those of us who got more immediate relief was getting it from the addition of fluid rather than the effect of the SynVisc itself.   I also have wondered if the amount of total deterioration in that knee plays a role on the effectiveness of the SynVisc.

I know that for a few weeks, I was able to put on my socks and shoes like everyone else and that was great.  Sylvia