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  • Very Confused, Synvisc one, TKR.

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    Old 02-04-2011, 08:15 AM   #1
    newpotato
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    Very Confused, Synvisc one, TKR.

    I have had severe pain in my left knee for about three months. Insurance finally kicked in, and it seems I have severe degeneration of the cartilage due to Osteoarthritis. I was running about 5k a day 3-5 times a week, and this seemed to have made it worse, to the point where I can walk maybe a minute before the pain gets to be too much, and I need to slow down. I can only walk by limping, period.
    I have cartilage missing in 2/3rds of my knee. I went to hospital for special surgery, they say a TKR is necessary, but we will try the synvisc one shot first.
    I've been reading about synvisc one, and have seen many many nightmare scenarios of extreme ongoing pain after the injection, and very few stories of it helping the initial knee pain.
    I don't know why the doc is suggesting this over the series of three shots, which also seem iffy, or even over Euflexxa, which seems like a better option.
    If the injection doesn't work, I'll need a TKR which terrifies me. I'm 45. I want to put it off for as long as possible, but can't live with the pain I'm in now, either. I tried to do some work yesterday standing and walking for about 2 hours, and am paying the price today, can barely move...
    I've read so much and it's all a jumble in my head...Did anyone get good response to the synvisc one? Euflexxa?
    I'm seeing an orthopedic surgeon, should I consult with a Rheumatologist?

     
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    Old 02-04-2011, 11:11 AM   #2
    jennybyc
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    Re: Very Confused, Synvisc one, TKR.

    Welcome to the "running is really bad for your knees club"! It kills knees despite what they say about how good it is for your heart. It is bad for your knees.

    I had the 3 Synvisc shots and it made my knee swell up so badly I had to have it drained and flushed out. My other knee I had Hyalgan and that worked well but was 5 shots. Haven't tried Euflexxa but hear good stuff about it.

    It can be helpful to do this prior to replacement as it calms down the inflammation but if you don't want Synvisc, then say so. The doc should support your decision. Tell him about what you've read. I've been to *** and they respect a patient who educates themselves. I think maybe he just wants to do 1 shot and then if that doesn't work, go right to surgery. But that will bring the inflammation down while you get ready for TKR.

    I had both of my knees replaced at 47. I had to wait as long as possible to get the knees with the longest shelf life and 12 years ago, that was 10-15 years. Now it is 30. So if you take care of that knee, it may last the rest of your life or at least you aren't looking at a revision for 25-30 years. I'm already looking at revisions(probably this year)and they can only do them 2-3 times max.

    So, you will be fine of you do it now. With knees, it all about the revisions...how many can you expect in your lifetime. For you at 45, you could do 2 and that should be no problem. When they only lasted 5 years, you were out of bone after 15 years(3 revisions). Even with my current knees, I am out of luck but the time I turn 77 so I was so glad they developed a better plastic/metal alloy that can last up to 30 years. I'm looking forward to getting a pair of those! Means I will keep my knees and never need to have them fused straight.

    *** is the best place to get new knees.....that's is where my doc went for her knees. They do a great job and with the new techniques and pre-op pain management, you don't have anywhere near the problems they had even 12 years ago.

    I'd skip the rheumy...they'll tell you that you need a new knee in all likelihood. They know when medication will no longer help and with 2/3rd's of the cartilage gone, they can't bring it back.

    I'd have the injection of whatever you want to try and then set up surgery. At least you'll be more comfortable until it gets replaced.

    Just my opinion.

    Jenny(14 knee surgeries and counting)

     
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    Old 02-05-2011, 04:17 AM   #3
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    Re: Very Confused, Synvisc one, TKR.

    Thank you for your thoughtful reply, Jennybyc.
    I did just what you suggested, I called the doc and spoke to the physicians assistant. She told me that the doc I see uses Synvisc all the time, and she has never once had a patient respond in the way I'd read about. She told me that she also assists another doc, and this other doc has had three patients respond like what I'd described to her all in the same week, and that she notified the manufacturer of the lot number of the batch that they had used.
    She then told me that most of those those reactions that I'd read about are probably from physicians who are not properly injecting the Synvisc.
    She did, however, offer to change the injection to Euflexxa or Orthovisc, if either of those would make me feel more comfortable, and that the sole reason that they were going with the Synvisc one was because it would be more convenient to me.
    It's worth it to me, I think, to make three trips instead of the one if the likelihood of a negative reaction is less.
    I just want to do it ASAP. It's been months since I have been able to function normally, and I really need to be able to leave my apt. regularly soon, instead of being essentially a shut in.
    I'm also hoping to put off the knee replacement for as long as possible. I'm really hoping the injections work.

     
    Old 02-05-2011, 04:55 AM   #4
    glennxyz
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    Re: Very Confused, Synvisc one, TKR.

    Before my TKR they injected orthovisc (another brand), 1 shot each week for 3 weeks. I found that it barely made any difference. I had no reaction to the shot other than the pain when it was being administered :-) Visco supplementation is standard practice and the last phase before TKR. I am 55, TKR Oct 2010, doing great now, can do anything I need to do in life, went skiing 3 weeks ago, been bowling since the 6th week no problems but I am not a runner. I had it done at ***, Dr. Steven Haas. The hospital is amazing. After 3 days went home and never used a cane or walker ever. The outpatient PT has been great. I was very worried going into this since I felt I was too young as well but glad its over with now.

    Best of luck,
    Glenn

     
    Old 03-29-2011, 02:29 AM   #5
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    Re: Very Confused, Synvisc one, TKR.

    Hi Very Confused...

    I have mild oesteoarthritis in both knees and had an arthroscopy to tidy up some cartilage damage about a year back. The guy that did it was one of the best in the UK.

    Still had pain post-op and he recommended SynVisc One. He said it works to some extent (a max of 9-months) for about 55% of his patients.

    I had it done (by him) in November and have had maybe a 20% improvement in pain relief. I had absolutely no side effects with the jab (and I mean zilch). This I attribute to having it done by a top guy - he said some have allergic reactions (strangely poultry related). He said many patients see him regularly to have a repeat jab.

    Although its not been a major improvement for me I would definitely recommend it for someone in your position. You may find given the severity of your condition that it gives much more relief.

    I would delay the TKR for as long as possible - technology is improving all the time - if the Synvisc does the job for you - you may find there are some less drastic procedures in the pipeline.

    Best of luck to you!

     
    Old 03-29-2011, 05:19 PM   #6
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    Re: Very Confused, Synvisc one, TKR.

    Synvisc was first available in 3 shots. They released a new version Synvisc One which only requires one shot. I had Supartz in a series of 5 injections. Each shot cost $50 for the prescription co-pay and $40 for the doc to administer it. It didn't hurt but I don't think it helped.
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    Old 08-22-2011, 06:48 PM   #7
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    Re: Very Confused, Synvisc one, TKR.

    I'm new to the site, 8/22/2011 I had the synvisc injection today. This is the second time around for the injections, I had the first time in 7/2010, when I got it after 3 hrs later, I was in pain , I wanted to cry, I call the dr. and put ice pack on it , and now , I was better. The dr. said today that I'm getting to the stage of needing TKR, I'm to hold out as long as I can , the pain is no joke. I had the scrope done 3/2010, pain everyday. Going to lay down and use the ice pack.

     
    Old 09-08-2011, 06:42 PM   #8
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    Re: Very Confused, Synvisc one, TKR.

    Hi, folks -

    First time here, but I felt the need to share my experience. I'm a 46-year old female, used to be very athletic in my school years. After a few sports that challenged my knees (BMX bike racing/wrecking, catcher in softball, football and the duckwalk exercise), I did enough slow damage to experience consistent pain. In my senior year of high school, knee surgeries began. Arthroscopy, tibial advance, etc. At the age of 24, my surgeon and I were out of ideas and I was experiencing frequent pain and instability. He made a deal with me - he'd replace the knee if I would quit playing sports. Impact sports would wear the replacement down in half of it's normal life. I agreed, and it was the BEST DECISION I EVER MADE. The recovery was tough, but absolutely worth it. I enjoyed a number of years with virtually no pain. As I hit the 14th year after the replacement, I started to get some discomfort, and it was time to replace the patella. That procedure was seemingly routine, the recovery was quick.

    My suggestion to anyone who is reading this, who is suffering on a daily basis with knee pain and has already explored other avenues, is to NOT put off a replacement because you think you're too young. Have a serious talk with your orthopedic surgeon. I was 24 and was determined to not suffer, and it has made my last 22 years much more enjoyable, and with a much better quality of life!

    Last edited by Hunch; 09-08-2011 at 06:50 PM. Reason: finish sentence

     
    Old 09-29-2011, 07:40 AM   #9
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    Re: Very Confused, Synvisc one, TKR.

    Quote:
    Originally Posted by newpotato View Post
    I have had severe pain in my left knee for about three months. Insurance finally kicked in, and it seems I have severe degeneration of the cartilage due to Osteoarthritis. I was running about 5k a day 3-5 times a week, and this seemed to have made it worse, to the point where I can walk maybe a minute before the pain gets to be too much, and I need to slow down. I can only walk by limping, period.
    I have cartilage missing in 2/3rds of my knee. I went to hospital for special surgery, they say a TKR is necessary, but we will try the synvisc one shot first.
    I've been reading about synvisc one, and have seen many many nightmare scenarios of extreme ongoing pain after the injection, and very few stories of it helping the initial knee pain.
    I don't know why the doc is suggesting this over the series of three shots, which also seem iffy, or even over Euflexxa, which seems like a better option.
    If the injection doesn't work, I'll need a TKR which terrifies me. I'm 45. I want to put it off for as long as possible, but can't live with the pain I'm in now, either. I tried to do some work yesterday standing and walking for about 2 hours, and am paying the price today, can barely move...
    I've read so much and it's all a jumble in my head...Did anyone get good response to the synvisc one? Euflexxa?
    I'm seeing an orthopedic surgeon, should I consult with a Rheumatologist?

     
    Old 01-22-2012, 10:14 AM   #10
    newpotatotwo
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    Re: Very Confused, Synvisc one, TKR.

    HI,
    Original Poster here (I couldn't find my old password). I just wanted to follow up and give my experiences to hopefully help inform others.
    I ended up getting the three injections of Euflexxa rather than the Synvisc one. The risk didn't seem worth it with the Synvisc One, and when I asked my ortho why she recommended it over the others she told me it was more as a conveneince for me to not have to return to her office three times.
    I am VERY happy with the results of the Euflexxa injections.

    FIRST SERIES OF INJECTIONS:
    I had them initially starting in mid February 2011. Going in to the office I could barely walk, even with crutches. The pain in my knee was too intense. I was at wits end from not sleeping because of the pain.
    The injections themselves were pain free. I don't know if it's because I was treating my knee with lidocaine patches and also voltairin gel, but I literally could not feel the injections. The ortho had her assistant spray some cold spray on the area as she was injecting and I felt that, but nothing else.
    The injections lasted maybe four -five seconds at most anyway.
    Immediately after the appointment, I went out to lunch at a cafe that the cab dropped us off in front of. I could tell already that the pain was lessening. During lunch, I looked down and saw that I had crossed my legs, something that I had been unable to do in months. I nearly cried.

    By the end of the third injection, I was walking more or less normally.
    I started going back to the gym a few weeks later, and could do the stair machine without any issue. I stupidly then began trying to running again. I reasoned that by landing on my forefoot rather than heel I would be able to run.
    I kind of punished myself, and made myself sorer than I normally would have been, sometimes even with some bad pain involved afterwards.
    I have since determined that I need to stick to a no-impact workout.
    SECOND SERIES:
    I Completed my second series of injections in December, the first having lasted well over the six months projected, and possibly longer, but because of the insurance deductible, wanted to get the second set within the same calendar year.
    I felt this set of injections more than the previous set, but I would still not describe them as painful, more like a strong discomfort. Something I could definitely survive as often as necessary.
    Within a few weeks of this last set, I have virtually no pain, except for after I have done some very heavy lifting or over exercised in some way. I am working on strengthening my supporting muscles, and that also seemed to have done wonders.
    I am a big fan of Euflexxa, and plan on continuing it's use for as long as it continues to work.

     
    Old 01-23-2012, 09:02 AM   #11
    newpotatotwo
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    Re: Very Confused, Synvisc one, TKR.

    Hi, Original poster here. I tried to post a follow up yesterday, but apparently Healthboards ate it.
    I ended up getting the series of three Euflexxa, and have been thrilled with the results.
    They were completely painless the first round. The orthos assistant sprayed some type of cold spray while the doc was injecting the knee and I literally did not feel a thing. It may have been because I was on lidocaine pads and voltarin gel at the time, but still, felt nothing.
    My results were pretty immediate. From not being able to walk farther than a couple of feet at a time using a crutch and still being in pain, to being able to walk normally with no pain (but still almost constant ache that was easily dealt with) right after the third injection. I also started running again barefoot style (but stopped because it was too aggravating to my knees) and dancing all night and wearing heels. The only big issue was going down stairs and carrying very heavy objects. These things would cause me pain.
    The injections lasted longer than six months, and I only rescheduled the second set so that they would be in the same calendar year so that I wouldn't have to pay a huge deductible.
    The second set I was able to feel more than the first. I wouldn't call it painful as much as producing discomfort. The injections only last a few seconds, though, and I could easily get them as often as necessary without apprehension.
    My knees are even better now, without even having the constant ache. I changed my workout to include more strength building in the supporting muscles, which I think is very important, and also taking some supplements. I have no idea if these are helping or not.
    I will continue to get the Euflexxa for as long as they keep working, and put off the TKR for as long as I can.

     
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