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Bone-on-Bone Arthritis - Synvisc injections

inchwormiinchworm Posts: 719
edited 06/11/2012 - 7:42 AM in Arthritis, Osteoarthritis
Well, I couldn't be content just with back and neck pain, I had to get my knee into the picture, lol. Just got home from seeing an orthopedic knee specialist who did an xray and showed me the bone-on-bone arthritis in my right knee. It was injured about 15 years ago and have had 2 arthroscopies in ensuing years but was doing fine until about 3 weeks ago. Got up one morning and my knee was stiff, couldn't bend it past 90 degrees, etc, and it has been hurting and stiff ever since. Some days are better than others but it always hurts. I thought I just had a piece of cartilage floating around in there that could be removed and I'd be good as new--wrong! When I asked how bad the arthritis is, he said it doesn't get any worse. My only real option is a total knee replacement but I'm going to give anti-inflammatories and rooster comb injections a try first. They will give me 6 months to a year, if they work.

I know that Paulgla tried Synvisc before having both knees replace. Anybody else try the rooster comb injections? and how did they work for you? I am 62 y/o and apparently that is a good age from several aspects to have a knee replacement but since I don't know where I'm going with my back I'm thinking I better put that surgery off. Have been having severe shinbone and foot pain in the same leg at nights and thought it was from my knee but he said no, that sounds more like neurogenic pain from my back. Ahhhh...the joys of aging! ;)

2009 Foraminotomy C6-72010 PLIF L4-S1Multi RFA's, cervical inj, lumbar injLaminectomy L3-4 and fusion w/internal fixation T10-L4 July 17Fusion C2-C5 yet to be scheduled


  • Well I'm probably just a couple of steps above you as far as arthritis in my knees. I've had CMP since I was a child, which cause uneven wear and tear on my cartilage, but until about 5 yrs ago the pain wasn't anything I couldn't tolerate. When I got real bad I went to on OS that said my knees were just a step away from being bone on bone, and to top it off I now have RA. I wasn't much of a candidate for surgery since at the time I was only 26 so I'd end up need the surgery again after a certain number of years. So first we tried the cortisone injections, which gave me a month of relief at a time. Then we went to Synvisc, and I had one injection on each knee. That was about 3 1/2 yrs ago and I have very little pain to this day. BUT my back problems during the past 2 yrs have restricted my activity so much that the knees weren't getting much of a workout until recently. But good news is that I'm still having very little pain. For me I think the key was that the synvisc gave me enough relief to allow me to spend time (before my back) doing some strengthening exercises that helped my issue (CMP). Not sure how much help m story is, but there you go lol
  • Hi--thanks for sharing your experience. I'm really happy that the Synvisc worked so well for you, even in a roundabout fashion. I don't know what CMP is but it sounds like a downhill slide for your joints and I'm sorry to hear that. :) You seem way too young to have a total knee done, for the reason you were given. My ortho told me he wouldn't do it on a 40 y/o because they typically last about 20 years and then you need a revision. For me, that will be 82 and who knows if I'll even live that long, lol. But if you do end up in severe pain, I imagine they would do the surgery and you would welcome it, even if you require a revision surgery in your 40's.

    I had the first injection today and was scheduled for one a week for the next 2 weeks but I had a long talk with my hubby and we've decided I will just go ahead with the total knee now. For me, it is the right thing to do and I'll explain why (for those who are in a dilemma about what do do with their worn out knees):

    --My b-on-b arthritis was caused because of surgical removal of a meniscus 11 years ago. (My ortho was careful to point out that the doctor who did the surgery did NOT cause my arthritis--the injury did).

    --At that first surgery I was 51 y/o and perhaps the surgeon should have told me that a total knee replacement was in my future, but he didn't and maybe that's just as well because it wouldn't have changed anything I did in the interim.

    --I'm choosing to have the knee replace now because my husband has a good job (and I have a job which will allow me to take the time for recovery) and in this economy who knows how long good jobs will be around. We have good insurance and with healthcare insurance up for political grabs nowadays, who knows how long we might have that (sorry for the political inuendo).

    --Anti-inflammatories and various injections are only stop-gap measures which may or may not give me another 6-12 months before surgery would be my only remaining option aside from living in increasing pain

    --I've lived for 11 years without pain and I'm thankful for that but those days are history and I'm not anxious to do more systematic destruction to my knee joint by waiting another year to have it replaced.

    --My lumbar spine issues are causing me increasing pain on the same side as the bad knee and my severe arthritis has caused that knee go buckle inward (knock knee) and it stands to reason that this is aggrevating my lumbar spine even more. Anything I can do to bring balance back to my legs and spine, it is bound to help my back issues. I can't even do my stretching exercises that help my stenosis because my the tendon in the back of my knee/thigh is contracting, making those exercises very painful.

    Okay, long enough post, lol. If one of the mods/auth want to modify the name of this topic, I'd prefer to remove the reference to Synvisc and just let this thread talk about the arthritis. It might bring more comment to the discussion. :tongue:" alt=":tongue:" height="20" />

    2009 Foraminotomy C6-72010 PLIF L4-S1Multi RFA's, cervical inj, lumbar injLaminectomy L3-4 and fusion w/internal fixation T10-L4 July 17Fusion C2-C5 yet to be scheduled
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  • Will do--thanks. :)

    2009 Foraminotomy C6-72010 PLIF L4-S1Multi RFA's, cervical inj, lumbar injLaminectomy L3-4 and fusion w/internal fixation T10-L4 July 17Fusion C2-C5 yet to be scheduled
  • Glad to hear you've made the decision...not that the decision for surgery is automatically a good thing, but as we all understand, sometimes it's the right choice for us. That's how it was for my lumbar surgery. I've put off the knee surgery partly because of my age...even though that might be a good thing because I'll heal faster (in theory) etc., but also because it's just not causing me enough pain for surgery to be a consideration.

    I get the whole "knock-knee" thing as well, and have since I was a kid. CMP or Runner's knee...just a little info on it - Chondromalacia patellae (CMP) results from damage to the cartilage which covers the back of the patella knee cap. In overuse cases, the cause of the damage is usually repetitive rubbing of part of the cartilage against the underlying bone. In a healthy knee the movement of the kneecap across the knee is a gliding, smooth movement. In individuals with CMP, the knee cap rubs against the part of the joint behind it, resulting in inflammation, degeneration and pain. They can be for a number of reasons, but is usually due to the position of the patella itself. In my case too far to the outside which is typical, and also in my case it is congenital...my knees are just built wrong lol and being a woman doesn't help because of the way our hips are set and our center of gravity blah blah...of course my rheumatoid arthritis doesn't help any, but so far that is mild in my knees and only bad in my hips, feet and hands.

    So my first option for surgery is to go in and have the ligaments and such cut, re-align the kneecap, and put everything back together. But that only treats the cause not the damage. And considering I'm not in pain most times, I'll be keeping that option on the back-burner as long as possible!!

    Anyway enough of all my stuff...best of luck with the surgery! Hope it goes wonderfully and helps address all the related issues as well!
  • Thanks for explaining CMP. It sounds like a painful condition and I'm glad you're not suffering terribly with it yet. If and when you do decide to go for the reconstructive surgery, I hope it helps you!

    And as for your lumbar problems, it sounds like you've made an amazing recovery and are doing really well. We all need to hear of those success stories. :)

    2009 Foraminotomy C6-72010 PLIF L4-S1Multi RFA's, cervical inj, lumbar injLaminectomy L3-4 and fusion w/internal fixation T10-L4 July 17Fusion C2-C5 yet to be scheduled
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  • x-rays last week shows R knee deteriorated from medial to medial and patello-femoral. L knee gone from medial to medial, patello-femoral and lateral, all in one year!
    I had a high tibial osteotomy a few years back to try to slow the progression of arthritis as i'm only 40. That was an absolute disaster, my new ortho says it should never have been done.
    My new ortho has said when i'm ready he'll do knee replacements on both, I see him next week to say i'm ready.
    His reasoning for doing it now is because my children are so young i'm missing out on a lot with them because of my limitations and the limping is increasing my back pain. Also by the time I need revision, technology will be much more advanced and other options will be likely.
    So that's my story in a nut shell.
    I also have arthritis in both shoulders, L one's already had the tip of the clavicle removed, which was a fantastic success.
    Doc says I just have crappy cartilage (very technical term).
  • It was great reading your posts....

    I am having arthoscopic tomorrow and the exciting part it then my OS can get the much need pictures of the underside of my petella and such. My cartlidge is very thin and worn and I am bone on bone for the most part on the inside of my knees but the outside isn't bad. He's really pushing the the partial knee replacement (says it's much quicker recovery and has a 20 yr shelf life).... I on the the other hand want to try the synovial injections first. However we will come upp with a game plan once he gets the pictures during the procedure (menisucectomy?).

    I have spent the better part of the last 3 years having back surgery and recovering. I want to let my body recover some more before being laid up again for another serious surgery.

  • I'd definitely talk to your doc about giving the synvisc a chance first if at all possible. I've had 3 or 4 rounds of them (3 shots, each knee over 3 weeks) and I think it really made a difference for me. True the last round wasn't as amazing, but I'm going back to give it one more try before I give up on them.

    Good Luck with your 'scope and your doc chat, hope all turns out well!

  • How was your arthroscopic procedure last week?
    I hope that your surgeon got the pictures he needed.
    Have you agreed on treatment?

    I have been having trouble with my knees, especially since my lumbar fusion. I think it is because I am using them more as I try to protect my back.
    It sounds like this is quite common.
  • The procedure went well. He found a very long tear along the inside of the medial meniscus and trimmed. It had filleted open into the joint but hadn't damaged anything. He said the tissue was not what he expected- Not as bad as he thought. A huge wave of relief BTW.

    Altough the x-rays looked really bad on my inside knees. I am knocked kneed- I guess it is genetic (I never knew) I have very thin cartlidge but it is in tact. When The go- I will only need the partials as the outsides are perfectly good still.

    I am going to start PT next week and if in 4-6 week the knee caps keep grinding we will start the lubricants.

    He said my body is so out of shape from the multiple back/neck surgeries that I need to work with a very good PT person to strengthen slowly. To stop trying to catch up and running marathons is not a good idea :O) You are probably exactly right on that.

    Hopefully I can get 5-10 years out of my knees. He thinks I can make it till I am 50 plus if I really take care of myself. More work at being safe and push myself less..... I was telling my friend they day that I start hurting my knee. I was limping but it wasn'y terrible until the next day.... I don't know how to quit and I really need to learn my limits.

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