I am 50 years old and have recently been diagnosed with severe osteoarthritis of my right knee as well as a serious tear of the meniscus. Due to the severe osteoarthritis, my surgeon does not recommend surgery to repair the tear as there is too much scar tissue and he fears it may cause more damage or place me in more pain than I am currently in.
My surgeon recommended a coritzone injection followed by a Synvisc injection. I am looking at a total knee replacement down the road.
My concern is how painful are the injections and what can I expect to feel afterwards? Does the cortizone help and what about the Synvisc?
I am scared of a painful injection, but can't seem to function like this. What OTC pain meds can help?
It's true, meniscus repair doesn't help much when there is a lot of arthritis.
Synvisc may help you a lot. About 85-90% of people are fine afterwards, about 10% have significant pain lasting a couple days after the shot. Don't expect to be on your feet all day at work right afterwards (That was my mistake!)
Assuming it works, you will see a decrease in pain and improvement in function for half a year to a year. You almost certainly will have a replacement eventually, but because you are relatively young, you don't want to do it any earlier than you have to. If the injections will buy time, go for it.
Of course, if the injections do not help, and the pain is so bad you can't exercise and have trouble just getting around, schedule the replacement as soon as possible.
I also have Severe OA and have tried all sorts of anti inflamatories-- with no success. I am unable to do the synvisc injections no to bird allergies, however I have had the alternative which is Supartz. The down side to this one is it is a series of 5 injections over 5 weeks. I am wrapping up the second series I have had. The shots are a little uncomfortable, but not unbearable if the knee is not very agravated to start with. I feel the benefits of 6 months with relatively little problems worth the cost.
At only 46, I am definitely not ready to undergo a joint replacement but know it will be necessary eventually. Keep a possitive attitude and take care of yourself. These are as important as anything a doctor can do for you. good luck
It's true, meniscus repair doesn't help much when there is a lot of arthritis.
Synvisc may help you a lot. About 85-90% of people are fine afterwards, about 10% have significant pain lasting a couple days after the shot. Don't expect to be on your feet all day at work right afterwards (That was my mistake!)
Assuming it works, you will see a decrease in pain and improvement in function for half a year to a year. You almost certainly will have a replacement eventually, but because you are relatively young, you don't want to do it any earlier than you have to. If the injections will buy time, go for it.
Of course, if the injections do not help, and the pain is so bad you can't exercise and have trouble just getting around, schedule the replacement as soon as possible.
Dear Janewhite1,
Thanks so much for your reply. It has helped me to know others have had the same or similiar issues. I just can't believe so many relatively young people have knee problems. This diagnosis has been very depressing for me. The first thing my ortho wants to do is a cortizone. Is the injection painful and also, is the Synvisc injection painful?
I also have Severe OA and have tried all sorts of anti inflamatories-- with no success. I am unable to do the synvisc injections no to bird allergies, however I have had the alternative which is Supartz. The down side to this one is it is a series of 5 injections over 5 weeks. I am wrapping up the second series I have had. The shots are a little uncomfortable, but not unbearable if the knee is not very agravated to start with. I feel the benefits of 6 months with relatively little problems worth the cost.
At only 46, I am definitely not ready to undergo a joint replacement but know it will be necessary eventually. Keep a possitive attitude and take care of yourself. These are as important as anything a doctor can do for you. good luck
Dear bathnz83,
Thanks for the reply and information. I appreciate it.
I am scared to death of getting injections for fear of the pain. Unfortunately, I may not have any choice. I am sick about this injury as I caused it myself at the gym. I know the osteo has always been there, but my knee did not cause me any problems until the injury.
I am thinking of a second opinion to see if another docter will do the meniscus repair. ??
I have not had cortisone in my knee. The synvisc or (supartz which I get are uncomfortable) Typicallly not horribly painful. I do have a very high tollerance for pain though. I have also made it through ACL surgergy and had most of the meniscus removed at that time. I was told at age 35 that I would probably need a TKR(total Knee Replacement)-- That was a lot to take on mentally. Always remember that it could be far worse and make the best of every moment-- even if it is difficult to smile!!!
I have a very difficult job on my feet 8 to 12 hours a day walking from 5 to 10 miles a day. I also have the complication of plantar fibrmas-- which are tumors on my feet. My brother has lost both legs to diabetes and told me he would trade me. That kind of put things in perspective. Keep your chin up-- smile and laugh life is far too short for anything else.
I would definitely get a second opinion if you are even thinking that line. You must feel 100% comfortable with this type of Dr. It is important to have a great report with them. Don't worry to much about injection pain it really isn't much and there are ways they can minimize the pain at the time of the injection. Trust me the shots are nothing compared to surgery.
Thanks for the information. I too have a brother with diabetes and lost my parents through significant illness and suffering. I think of what they went through, all the pain and suffering. That is what gets me through the disappointments, etc... in my life.
I appreciate your candor and will keep you posted on what I decide to do.
Just had right knee arthroscopy 5 days ago and am sharing my story so far.
Have had knee pain for 10 months initially treated as moderate OA and went to physical therapy. But the pain in my inner knee was knife like, catching and never went away for more than a day or two.
So I finally had MRI which showed degenerative tear in the medial meniscus, moderate OA in the medial compartment and extrusion of the medial meniscus into the joint space.
First doc said not a prob, have arthroscopy and high probability of success.
But my reading of these probs indicated arthroscopy not great when OA present. So waited 3 months to get second opinion.
Second doc was great; took time to explain and gave me a 6/10 chance of arthroscopy helping and said on the balance of probabilities it was worth a shot. He also diagnosed a stress fracture in my knee and predicted my knee probably won't last another 10 but was hopeful the arthroscopy would give me some time.
So I agonised over it and finally booked in for partial meniscectomy; remove loose bodies on March 30 and I am so far happy with the result. I was given compression stockings for my legs and wore one on my good leg for the op. Post op I have been on crutches and after two days removed bandages to see two neat little incisions. Since then I have had bandaids on them and wearing stocking. Using ice twice a day and swelling has reduced. Pain is minimal despite taking no painkillers for the last 2 days! I feel I can walk without the crutches but am following doctors advice to use crutches for 2 weeks to help stress fracture heal.
So while it is early days I am hopeful this op has helped me. I almost cancelled after researching (both medical and patient feedback) but am glad I didn't. I realise the op can aggravate the OA but my surgeon said the floating bits can do damage too so its a catch 22. He also said he would remove as little of the meniscus as possible given its vital role but I have not had my post op checkup I do not know exactly what he did although he did give me a dvd and some pictures.
I will update my status if things change as I know I found reading boards helpful.
Good luck everyone!
The Following 2 Users Say Thank You to msgoldenhair For This Useful Post: janewhite1 (04-03-2012), mgkg (04-03-2012)
I am so happy to read your post and hear that you are doing well. I am going to seek a second opinion and see if surgery is possible. For now, medication to control pain and swelling.
Best of luck with your recovery and please, please post how you are doing.
The following user gives a hug of support to Lucas634: msgoldenhair (04-08-2012)
I have had the syneviscs injections to me the shot is very painful. It is thick gel so it takes awhile to get it all in. It is sore that night and for a few days. I have only had 2 injections the last one in December, went just like the first one except that my leg swelled so bad 3 days afterwards. By the 5 day I could not walk, went tothe os and he had 2 drain it. Also certainly. Never again syenvisc injections for me. So now I am scheduled for for in may 29. Almost bone in bone. Just telling you my experience. It could be totally different for you
The following user gives a hug of support to nana b: msgoldenhair (04-08-2012)
Dear Nana b. Thanks for the info and reply.
I am uncertain about the injections for a couple of reasons. My good friend had 3 and they didn't help for that long of a period. Also, my insurance plan doesn't cover the cost so it's $450 per injection out of pocket for "possible" help with the pain. My friend, who by the way is a doctor, said to have my ortho prescribe naproxen for 6 weeks, 500 mg 2xs per day to help with the pain and swelling. This should help and then see where I am. By then I hope to have a second opinion doctor lined up.
Good luck with your knee.
Now Day 10 since I had the arthroscopy and happy to report that so far recovery is going well. There is some swelling in my knee but reducing each day; pain from the incisions is nil although I have noticed a twinge in the inner medial area which was causing me a lot of pain pre op. I am hoping that is the process of healing and not residual pain (remember my doc only gave me 6/10 chance that the procedure would help).
I am doing three simple physical therapy exercises as prescribed by the doc, wriggling my toes alot and have been elevating my legs 2/3 times a day where I swing them up high against the bedhead.
I have tried to walk without crutches and can do without pain so another positive sign.
So good at this stage but I am cautious and know I won't really know until I start walking regularly and see whether the pain returns...because I am resting and limited weight bearing I know its early days. One good sign is though my leg was very painful at night before the op and so far that is almost non existent.
I wish all well and hope that some day they can find a cure for osteoarthritis.
Hugs to all!
Last edited by msgoldenhair; 04-08-2012 at 10:11 PM.
Another update...off crutches 4 days ago at the 2 week post op mark...no pain in the pre op problem areas which is good; walked a bit and noticed slight pain front of knee below kneecap but disappeared with rest so overall good.
Saw doctor today and he was impressed by my progress and commented that for someone with arthritis in the knee it can take 3+ months to get back to the stage that I am already at...so you do have to be very careful if arthritis is present....he said about 20% of the meniscus had to be removed and the risk is a further tear down the track. He said swelling still present (not obvious to me) and suggested a trip to physio to massage the area to help reduce swelling.
So luck is on my side thankfully. Also helped that I was pretty diligent about doing the exercises which were painful at times but each day I pushed a bit harder and they did get easier.
msgoldenhair - Hope your progress continues - you certainly seem to be progressing well. I have also just had arthroscopy 8 days ago to remove more cartridge, my 2nd in rt knee. Most of the advice you have followed in your decision making certainly resonates with me. I have AO both knees grade iv and disc problems in my back, adding to my difficulties. I had a bi-lateral arthroscopy 2 yrs ago until which my AO was not fully diagnosed, and detached cartridge was removed. Due to the AO being more advanced than expected, recovery was v slow. It certainly seems to be true, recovery can take longer if AO present. Have also had steroid injections, found not too painful as over quickly, but little benefit with the pain, only the stiffness. Was told after 1st arthroscopy needed TKR x 2 but OS happy to play for time. Feeling like running out of options now, I'm only 42 and searching for any advice or treatment to delay what feels like the inevitable, although my knees seem to be breaking down, I don't quite feel ready to part with them yet and go ahead with TKR. Just wondering if my situation relates to any else's whom is glad went ahead with TKR or has regrets.
The following user gives a hug of support to aqua12: msgoldenhair (04-24-2012)
First of all, you are not too young to have total knee replacement. Most orthopedic surgeons usually wait until a patient is at least 50. And, given the symptoms you describe, the cortisone shots would only give you relief for about six weeks, when they are supposed to last about six MONTHS. (They're not really that painful by the way.)
As for the Synvisc, since it does not have a proven long term effective track record, most insurance companies would rather pay for the proven success rate of the $50,000 total knee replacement surgery. I would not waste time with having the knee scoped because every time you get an arthroscopy, it leaves the knee with even less cartilage than before the procedure.
I have now had both my knees replaced (within a year of each other - the right one last April, 4/5/11, and the left one this past March 23rd.) I am still rehabbing the left one but am so glad I got both done and over with! (My surgeon is one of the top Orthopedic surgeons for joint replacement in the COUNTRY, and did a fantastic job on both my surgeries. Plus he has a great bedside manner.) If your current surgeon is reluctant to do a replacement at this time, I would seek a second opinion right away. This guy may not have the skills or extensive experience with knee replacement surgery. You need to find someone who does a MINIMUM of 200 knee replacement surgeries per year and has at least ten years of experience doing them. Call your nearest University Medical Center and ask them for a referral to an Orthopedic surgeon with this amount of experience.
It sounds like you have the same degree of degenerative osteoarthritis in your knee that I did in both of mine, and it's only going to get worse. Why not get the replacement surgery now and be able to get back to doing the activities you love without pain, once you finish physical therapy rehab? Trust me, you WON'T BE SORRY!!!!
Any further questions, don't hesitate to ask me.
Good luck.
******* (Carol)
The Following User Says Thank You to ldy12 For This Useful Post: msgoldenhair (04-24-2012)
Your situation sounds so much worse than mine and I just want to say I am thinking of you. And at 42 you are so young!
Also I happened to meet a 72 year old lady on the weekend just gone who had a knee replaced 6 years ago after years of pain and a terrible arthroscopy. She said having her knee replaced was the best thing she ever did and so much easier than her arthroscopy (I know...sounds hard to believe!). Talking to her made me feel so much better about the future even if it does include a TKR. Like me she did her research and her doctor has rooms at the same hospital as mine (in fact 2 rooms away!). We both live in Sydney and have access to very good doctors. My doctor who did the scope does not do replacements so her doctor may well become my doctor down the track.
I wish you all the best in your quest to get your situation resolved as soon as possible.
msg
The Following User Says Thank You to msgoldenhair For This Useful Post: aqua12 (05-02-2012)
Re: osteoarthritis and torn meniscus of the knee 
Re: osteoarthritis and torn meniscus of the knee 
