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Author Topic: Knee Arthrosis: Options & Recommendations - Please ?  (Read 3177 times)

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Offline Samer

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Knee Arthrosis: Options & Recommendations - Please ?
« on: May 21, 2015, 03:59:27 PM »
Hello !

I was diagnosed with moderate Knee Arthrosis in my two knees. I truly feel very sad and depressed about because I am in my late twenties with a very average weight, and never practiced any extreme sports nor injured.

All of a sudden, I am in an awful pain, it is difficult to kneel, get on the floor with my little child, climb the stairs, and do some of the physical activities I enjoy and need.

I have done some research and it seems there's no cure, I don't know if these medications do anything, the data are quite iffy.

I am trying to do some exercises to strengthen the knee muscles/joints.

My questions to you are:


1) How soon or late should I start the injections into the joints? Are there any benefits/values of starting sooner? Should I delay that? Any medical scientific recommendations?


2) Here in Europe, There are many types of knee injections such as: Synvisc-One, Ostenil Plus, Durolane, and others. Which one of these viscosupplement formulas is the BEST? I would prefer one-single injection and the cost is not a problem, But, Based on your knowledge and experiences. Could you please tell me which one is the best ?


3) Are there any advice to share with me - Please ?


I would sincerely appreciate any inputs !

Offline Vickster

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Re: Knee Arthrosis: Options & Recommendations - Please ?
« Reply #1 on: May 21, 2015, 05:12:55 PM »
I assume you mean osteoarthritis when you say arthrosis? 

You need to understand the causes of the damage - is is systemic (get some blood tests) or down to your muscles or the alignment of your bones.  Given your age, you want to try to see if there is a long term solution to stop it getting worse - there is no cure per se but you can help the situation potentially :)  The injections last a 18 months or so if lucky, sometimes rather less and for around half of patients unfortunately there is no real response

Regarding the injections, you would be best to get the advice from a knee specialist.  Indeed, if possible get several opinions if you have the funds or the healthcare system in your country (?) funds it

Personally in my left knee I've had Durolane (given during key hole surgery in Dec 2010)

Ostenil - 3 injections in May 2012 I think
And the Ostenil Plus - 1 injection in Dec 2013

The Durolane was a different surgeon.  I think it depends on the preference of the surgeon and possibly the hospital pharmacy (at least in the UK) as to which is used.

I can't say any was better or worse for me, they all seemed to help, none was especially painful, and I had no adverse effects from any.  Of course better one injection than 3 - my surgeon didn't like the initial form of the Ostenil Plus - he said it was extremely thick and painful, the new form much better (I don't recall any pain specifically, you need a good surgeon who can hit the joint space easily, you need to be relaxed too)

One thing you do need to be aware of is some are derived from poultry rather than being synthetic, if you have any sort of allergy to eggs, make sure you get a synthetic one.  Also, heed the specialists advice about rest, elevation and icing after the injections to ensure a swift recovery.  Be aware that there is always a risk of infection with any injection, but the specialist should tell you about all that.

This is a good place to get some useful information on arthritis  http://www.kneeguru.co.uk/KNEEnotes/primers/joint-cartilage-and-arthritis-primer

Keep up the physio

Good luck :)
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 Samer

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Re: Knee Arthrosis: Options & Recommendations - Please ?
« Reply #2 on: May 22, 2015, 10:10:09 AM »
Thanks Vickster for your response, I appreciate it, and I have a few questions for you, which are as follows:

1) You wrote "see if there is a long term solution to stop it getting worse"?
Could you elaborate? What other solutions you could think of? Can you give me suggestions please?

2) How soon or late should I start the injections into the joints? Considering my moderate situation - Are there any benefits/values of starting sooner? Should I delay that? Any medical scientific recommendations?


Offline Vickster

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Re: Knee Arthrosis: Options & Recommendations - Please ?
« Reply #3 on: May 22, 2015, 01:04:30 PM »
For a medical opinion, you need to talk to a knee specialist. Everyone on here pretty much is a patient.

The injections are indicated for mild to moderate arthritis so again talk to the specialist as to when you should start the jabs. Has the moderate damage been diagnosed on MRI? What grade is it? From my experience the injections are worth trying but don't expect miracles

In terms of the getting worse, as I said you need to understand why this is happening given your age? If it's because the bones are badly aligned and are rubbing and wearing, there are surgeries to address this which might slow the process. Big surgeries though

What country are you in? Do you have a good specialist advising you?
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 thegirlracer

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Re: Knee Arthrosis: Options & Recommendations - Please ?
« Reply #4 on: May 29, 2015, 06:38:57 PM »
Depending on your source of pain and what the damage an MRI shows, you may need more than 1 injection. What you need to sit with is that Synvisc injections are only a temporary fix, like taking an NSAID, or using ice.

I had 3 full knee fractures and cartilage damage. I had 3 Synvisc-One injections (one full syringe for each injection): one on each side and one slightly above the knee. This was one injection a week.

Right after the injections, and for about 2 months after, I had great relief. Significantly less pain. The joint felt well "cushioned." I did lose some flexibility in the joint because of them though. I only noticed this when bending it very very far.

They were fantastic for 2 months, and then they quickly metabolized in my body and it was like I never had them at all. I am 34, have a fast metabolism, and am very active, so this could be why. I think for people that are more sedentary and older, they last longer.

Even after my Synvisc-One injections, I am still needing additional surgery. They are great for very temporary relief. I am just disappointed that they didn't last longer for me.
« Last Edit: May 29, 2015, 06:42:17 PM by thegirlracer »















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