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Author Topic: MONOVISC- the day after.  (Read 13912 times)

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Offline SarahMontana

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MONOVISC- the day after.
« on: February 28, 2015, 03:57:25 PM »
Yesterday, I received 4ml Monovisc in my right knee for stage 3 Chondromalacia. If anyone else has to go through this, make sure you ASK FOR THE NUMBING STUFF before hand. This will help with the initial shock of the needle in your joint. That being said, make sure you think happy thoughts. This injection takes time, and you will start to feel pretty intense pressure in the knee. Once finished, be prepared. My doctor grabbed my ankle and started cranking on my knee. Bending it from 90* to 180* quickly and multiple times. (This is going to hurt. A LOT). Then all will be done and you can leave. However, for me, I stood up and, like always, put most of my body weight on my good leg. As soon as I took my first step and put weight on my right leg, I immediately burst into tears. The pain was SO intense and SO sharp, it was worse than the initial injury I sustained. (Large plywood fell on me, stood back on knee and twisted pushing down with weight- ouch!) My doctor seemed genuinely shocked that I was in such pain, and I was wheeled out to the car in a wheelchair. Since that time, I have been unable to completely extend my leg straight, bend my knee fully or put ANY weight on it. I am back to crutches. When I extend my leg, the site of injection is swollen and sore and the source of all the current pain. I am certainly hoping this subsides, because it is awful.
I know MONOVISC is still new on the market, and have been unable to find any ones reviews of receiving the shot thus far, which is why I chose to share my experience. I shall keep you updated, but so far, I am MISERABLE. And I have 2 flights of stairs in my home which I have to go up and down on my butt. Oi....

Offline vickster

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Re: MONOVISC- the day after.
« Reply #1 on: February 28, 2015, 08:09:31 PM »
I've not had monoviac but I've had the ostenil  single jab before which is fairly viscous stuff. No local anaesthetic from what I can remember, but I really don't have any issue with needles typically. I remember a full feeling afterwards for a few days, a little sore, but nothing untoward

You should use painkillers and ice to help with soreness and swelling.

Hope it all works for you. Hyaluronic acid usually takes a few weeks to have an effect, with full effect by week 6 or so, so you'll need to be patient for it to kick in :)
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline MDAL

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Re: MONOVISC- the day after.
« Reply #2 on: March 01, 2015, 10:29:38 AM »
Sarah:

Never had that specific brand of HA, but in the last 14 months I have had 26 intra-articular injections to my knee (HA, stem cells and PRP), with more coming soon.

So speaking from experience:

1) If your joint is has inflammation it will hurt. Inflammation causes the nervous system in the joint to be totally hysterical. If the joint does not have inflammation it tends to be quite comfortable. Had some shots where I just feel a pinch and then could be reading the newspaper while the doctor finished, had others that I was a big man almost crying like a baby...

2) Size of needle makes a huge difference in pain. Quite often doctors use the biggest needle they can find and I often ask that needle to be replaced by a small one. I was under the wrong idea that HA needs big needles so the fluid can pass and that is what doctors use, but that is a wrong concept. My doctor replaced it for a tiny one and I was surprised to see that it passed just fine... And trust me, I had all sorts of needle sizes and the pain is proportional to it. Most often big needles are totally unnecessary even for HA.

3) Pain is proportional to how tense your muscles and tendons are. Don't know how you had it, if supra patella or lateral side, but your position should be one where you don't have your muscles/tendons active. Laying down with your knee at 30+ degrees (often used) is one that guarantees your tissues to be under tension.
 
4) Doctor hands count. If the needle is stable and firm pain is less. If your doctor is messing around, changing hands and moving around while the needle is in, it will hurt like hell. It's the actual motion that hurts the most, not the fact that the needle is there. So if your doctor can't keep it steady, get another one next time.
« Last Edit: March 01, 2015, 10:33:30 AM by MDAL »

Offline Athaclena42

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Re: MONOVISC- the day after.
« Reply #3 on: March 04, 2015, 06:58:16 AM »
I just had my first Monovisc injection this afternoon to treat my grade 4 chondromalacia.  About a month ago, I went into my ortho's office, and he explained my condition and offered me a cortisone shot to tide me over until he cold get insurance auth to get me the Monovisc.  Since the cortisone shot, I have had no pain or discomfort, and prior to that, I was gimping up and down the stairs and could not use that leg to climb or go down a step.  I could step with only my right leg.  So today I sat on the exam table.  He shot some numbing stuff in my knee and used ultrasound guidance to inject the Monovisc immediately after.  I watched the stuff go into my knee on the ultrasound screen, and there was definitely some discomfort and pressure while he was pushing it.  He warned me not to go crazy with activity for the next few days, and to ice it if I had any pain or swelling.  He did specify to not kneel or squat.  When I stood up to go home, there was definitely a little bit of pain, but nothing extreme, and my knee definitely felt weird.  By the time I got home, my knee felt almost normal, and 12 hours later, it feels perfect.  I have no idea how it's going to work for me or what the timeline will be, but so far, so good.  I'm sorry to hear about your experience and the pain you're in.  My doctor was very gentle and did not manipulate the joint after the injection at all.  He said the HA would disperse through the joint over time and get where it needs to go. 

Offline SarahMontana

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Re: MONOVISC- the day after.
« Reply #4 on: March 09, 2015, 07:03:02 PM »
So here I am, a week and a half later and I have had 0 change in symptoms. I still cannot fully straigten or bend, or put weight on my knee. I went back to my Ortho on Friday and all he could say was 'RSD', which sounds like a load of crap to me. He even mushed my kneecap around and moved my knee while I was in TEARS and just said to go to therapy 6 days a week. It has been 3 months since my date of injury, and I still think I am being misdiagnosed and want to see a different dr. But, workers comp has denied my proposal yet again......

Offline vickster

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Re: MONOVISC- the day after.
« Reply #5 on: March 09, 2015, 07:30:43 PM »
Could you pay out of pocket to see someone else?

 Did you have surgery already? Another scan? The locking you describe can be due to a meniscus tear trapped in the joint?  The HA jabs do take 4-6 weeks to work so perhaps give it more time if funding an issue. If the insurance is paying for physio could you not ask them to fund a consultation with another specialist instead? Can the PT refer you?

I don't really know how the US system works.
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up















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