A recent study evaluated joint lubricants, called viscosupplements, commonly sold under names including Synvisc, Orthovisc, Euflexxa, or Supartz. These lubricating injections have been used for more than the past decade for the treatment of osteoarthritis of the knee. While no one thought they would cure arthritis, they have been thought to be an effective treatment to help control the symptoms of mild to moderate arthritis. These medications have been thought to be helpful in delaying the need for knee replacement surgery.
A recent analysis combined the results of many studies that have been performed to investigate the effect of these medications. This so-called "meta-analysis" takes into account many factors to evaluate how well performed these studies were, and the results they found. Overall, the studies show that the viscosupplementation injections offer no significant benefit. The cost of the injections is not justified by the lack of benefit. Furthermore, some studies showed that the injections may make patients worse, because of possible side-effects of the injection.
I use viscosupplementation injections in my own practice, and I have patients who feel as though they are an important part of the management of their arthritis. This study will force me to look carefully at the benefit of the injections, and while for the time being I may continue to offer the injections, it will change the conversation I have with my patients when I inform them of the possible risks and benefits of viscosupplementation.
Should these injections not be offered? Should Medicare and insurance companies stop paying for the use of these injections? Share your comments below!
Source: "Knee Injections for Arthritis? Save Your Money, Study Says"
My orthopedist insisted about 4 years ago that I get them for my knees. I was very leery. The first injection wasnt bad, but I didnt notice any difference in my pain. When I went back for the second and told him he said that it might take until the second injection. Had the second and it hurt like heck! The third I jumped outta the chair the injection was so painful! Worse than my usual cortisone injections. He got upset with me when I told him it wasnt working and came back into his office with my leg locked about two weeks later. So much pain if I even thought about moving my leg! I will never again get those things and always tell people about my incident, because everyone thought the injections thought they were the next best thing to inventing electricity. 4 years later and much pain, I still have my knees. I’m only 52, but I will wait for replacements for a bit.
I have had a series of the these injection yearly, for the last 5 years. I had a severe reaction to synvisc the second round and switched to Euflexa. I find the injections help reduce my pain and allow me to function at a more normal level. In my “bubble world” I am hoping that they delay the need for knee replacements until they have developed a viable stem cell approach to cartilage regeneration!
I was diagnosed as bone on bone medial both knees 7 years ago and I have had a total of 48 injections–24 each knee–I began the first series of 5–which I had 3 times with hyalgan and then all the remaining series were 3–mostly synvisc-but my last 12 were Euflexxa-and I have found that they are very effective for me–I count the days until my next series–I have found Euflexxa to be more effective. I can still play 10 hours of basketball a week and walk 20 miles. Just last year I thought maybe I didn’t need the injections–or that they weren’t effective–so i lapsed to 9 months instead of going at 6 months–major mistake–I eneded up at 9 months walking with a cane!!!!! My next app’t is just 2 months away–can’t wait. When I first got my initla injections 6 years ago–I could barely move and thought then a knee replacement would be coming soon at age 55-but these injections greatly improved my condition.
For the past 14 years I have been treating osteoarthritis of the knee with
intra-articular growth hormone (IAGH) injections. In a study of 66 knees soon to be published, 87% improved greatly and did not need total knee arthroplasty. Treatment of ankles results in 95% improvement of these patients who no longer need arthrodesis or total ankles. A study was recently completed adding HGH injections to microfracture of the knee in rabbits and the HGH injected knees grew real articular cartilage, not fibrocartilage that always results from microfracture. Read “Morphoangiogenesis-a unique action of growth hormone, Microvascular Res. 63:295-303, 2002. Allan R. Dunn, M.D. iaghdunn@aol.com. IAGH.COM
In my second post here –I will also mention that I never had anything near ” severe pain” from any injections of my knees with Euflexxa or Synvisc-however 46 mine were given by the ortho’s PA who was very experienced with giving them –he was skilled, concerned and courteous–of the 48 injections I got I experienced minor pain maybe 8 times–all were given on the top lateral outside –(put a clock face on your knees)about 4 o clock when looking down at my right knee and 8 o clock looking at my left knee–although I have spoken to some who got them under the knee–the noon position looking down–and I have had some say they were painful–neither have I experienced any infections or allergic reactions–the process certainly has been worth the minor few seconds of pain of the injections–and unfortunately I will have a new person doing mine in 2 months as my ortho’s PA has left the practice and is now longer available to me :>( stay tuned!!
I have had a total of 6 knee surgeries in my life, 5 in the past 2 years. 2 of those 5 were to remove retro-buttons that became dislodged from a hamstring graft to replace my left ACL. The rogue retro-buttons in my joint tore up my medial cartilage.
I was told I am too young for knee replacement at the age of 40. As a mother of 4, leading a healthy, active lifestyle is important to me. The pain I was experiencing prevented me from doing everyday tasks, and affected my ability to rehab effectively from my Right ACL surgery.
Having the Euflexxa shots felt like a miracle to me, and I didn’t experience any side-effects. I could exercise without pain. I was able to progress with the extended rehab in physical therapy, and focus on strength building in both legs. I plan to schedule my next series of injections in September, and am grateful that the injections are available to me.
In sport my miniscue is torn and after some time i had mild brusing in tibial plateau. adoctor inject hgh+collajen in my knee cartilage and around knee it has massive pain
I had the Synvisc injections 2 weeks ago. I am in more pain and discomfort than I was before the shots. Now I understand here that these shots are given once a week for three weeks. When I arrived at my Doctors Office, she explained how my insurance approved to cover for the expense but i have to have the injections on both knees in one visit. Which meant, three weeks of solution is in each injection for each knee. I agreed, and it had to be the most painful procedure I have experienced. My doctor did mention that I will not feel the difference for at least 4 to 5 weeks. I am entering my third week this Monday, November 5th. My question to everyone? Will I have a chance of feeling relief? Anyone else experience what I have? And any advice? Because I remain in pain.
I had the euflexxa injection six weeks ago and had some relief from pain for about 2 weeks and now the pain is back.
The first injection went well, but the second and third were very painful because there was inflammation in the area.
I had the Euflexxa shots (3 of them, a standard treatment) and it is awesome! Had very very litte or NO PAIN for 12 months! I would recommend it. By the way, I can run a 12:56 2-mile at age 43.
I had the 1 Treatment of syn-visc 6 mts ago, since we are trying to hold off on total knee replacement. minimal discomfort in both Kness when shots
were given. Some discomfort after, butNo pain for 6 mts. I just had another 1 shot in each knee on Thursday. The pain was excrucing, it is still,it’s Sunday and I amusing a walker. I have been taking anti- inflammatory every 5 hrs. For pain and movement. Never again……u
I had the 3 shot series of Euflexxa injected into my right knee in March / April of 2011, and it was extremely therapeutic, with NO side effects. At that time I was experiencing such pain in my knees, I was one step away from being wheelchair bound. The shots to my right knee alleviated all pain. I am extremely grateful to my rheumatologist for suggesting this treatment.
I had the synvic shots and the first shot very painful the second shot was just as painful. but after a couple of weeks the pain stoped they last about six months. they work well,with no sideaffects. but so dam painful afterwards.