View Full Version : Osteoarthritis Arthritis behind knee cap
12-07-2010, 05:42 AM
I was just diagnosed with OA behind my knee cap. My doctor said to try anti-inflammatories (which don't help, and I don't want to keep taking them), physical therapy to strengthen my quads and to lose weight (I need to lose maybe 20 lbs).
He mentioned resurfacing, but said it's no guarantee and wanted to try the above-mentioned things first.
He never mentioned the hyraluronic acid injections...two friends of mine had Synvisc done and it helped him a LOT. Unfortunately I didn't know about it to ask my doctor about it when I had the follow-up to review my MRI.
I'm thinking I'll go see the doctor my friend goes to and inquire about the injections.
Does anyone here know more about the injections or the smoothing of the joint?
12-07-2010, 10:31 AM
Synvisc and the other types of hyraluronic injections are usually given for OA of the knee joint and not just the knee cap so I wonder if they'd give it too. The theory behind the shots is that OA and the crumbling of the joint cartilage eventually causes the joint fluid to become thin and acidic. By replacing this fluid, it soothes the joint. But when only the kneecap is involved, is there enough damage to the entire joint to change out the fluid and will it help? That would be the question. Will you let me know what he says?
As for re-surfacing, my ortho said the same thing. It is available to do but is very questionable as to whether or not it will work. For some it does but for many, it speeds up the destruction of the cartilage. You don't know until after you do it.
But when it does get really bad, they can put a plastic cap over the back of the kneecap but that is very invasive and you have to keep replacing it as it comes loose. I had it done with my knee replacements and I'm pretty sure that the kneecap part has come loose. May end up with a full joint revision just because the kneecap piece came loose....bummer. I fell on my knee and that was all it took.
So you do have options but I can tell you that PT really helps with this. The stronger the quad muscles, the less stress is put on the kneecap so it stops hurting so much. I think I did them so much I did them in my sleep. But it kept me going far longer than the ortho thought I could. Predicted total knees at 43 and I made it to 47. Doesn't sound like much but in that time, they started making knees that lasted 10-15 years instead of 5. Now they last 30.
So do the PT and take ibuprofen as needed for pain. Did your doc mention any kind of knee brace? I should also mention that there are docs who specialize in kneecap problems and you could see one of them for a consult. Might have more ideas.
Eventually, you'll probably end up with a plastic cap but avoid it as long as possible. Once you start surgery, you never go back.
Jenny(14 knee surgeries and counting)
12-07-2010, 05:28 PM
Thanks for your reply. I also have some arthritis in the joint, which showed up on the x-ray the doctor took on my initial visit and he pointed it out to me. It looked like it was at the end of my femur bone. I think after the holidays I'll go to my friend's doctor and ask about the injections. I just don't understand why the doctor I saw never mentioned it when I asked him what could be done.
12-07-2010, 07:08 PM
I think the reason why has to do with money. The shots are expensive and most insurance companies won't pay for it until you have a certain amount of arthritis. They stage arthritis....1-4. I don't know what what stage you have to be in order for insurance to pay but I was 3-4....all bone to bone....but then again, they had just been invented when I had them.
Perhaps you aren't far enough along for insurance to pay for them.
12-08-2010, 06:07 AM
Yeah, I thought the same thing...it was an insurance/money issue. I also read that some insurance companies don't cover the shots at all because they're classified as a "device" and not a drug. Weird.