Discussion: Viscosupplementation - Hyaluronic Acid injections?

Has anyone had these? With any success? I have major degeneration in my patella and meniscus, and a bone bruise as a result. This treatment has been suggested and I would love to know if anyone has any info and/or has actually had any luck with it.

Is this the same as Synvisc?

If so it didn't work for me. I too have a bone bruise (lesion on the femoral condyl) that I'm not sure can be improved by Synvisc. If it isn't the same I'm very curious if they will help because I'm very seriously considering partial knee replacement.

I had the Synvisc treatments many years ago. (I believe it is the same thing.) I found that it "loosened" up my knee joints but it did not do anything long term to alleviate the underlying problem (no lateral meniscus and deteriorated medial meniscus).

Looking at the Synvisc site it appears that they have the same base..... Synvisc mentions hyaluronans.

The reason synvisc was suggested to me was purely a 'pain management' situation. The goal being that if pain was reduced I could do a better job at strengthening the muscles to support the knee. But it appears that the lesion or bone bruise is in a position that will still hurt even if the muscles are stronger. I currently have two tears on the medial meniscus in my so-called good knee (injured at the US Classic Champs). I have hardly any pain from that. But this lesion is v. painful.

A micro fracture didn't work for me but there is talk of taking cartilage from part of the knee and moving it to the worn out spot. Dunno if it will work or not.

I just finished a series of 3 Synvisc shots. They didn't seem to do anything. I'm in PT now, after my micro fracture, which I hope will be successful but I have my doubts.

Good luck, Kristin!

I've had the series of 5 shots with the hyaluronic acid several times and the 5 shot series is supposed to be 20-30% more effective. It has helped with the more severe pain and I've usually gone back in when that starts to get bad. It hasn't let me get back to running. I have an appt. coming up, so I'll see what they suggest this time.
The Donjoy custom braces have helped a little more and have at least let me orienteer at a walk. The time between knee appt. has also been longer. I had to ask about the brace, they never suggested it.
I hope you find something that works.
My PT said it is a whole lot easier to recover from the partial knee replacement than the full one.

Without wanting to be unsupportive: what should the rest of us do to make sure never to get into the position of needing any of this? Or was it just bad luck?

Avoid traumatic injury. Don't get older. ;-) And be sure your DNA is up to par (i.e., no arthritis in your family tree). Probably helps to avoid Lyme ticks, too.

Feet, I'd say I got into this partly out of not having a strong core, especially hips and glutes . But most of my pain is also from some bad luck with a traumatic injury to the knee in an orienteering race by jumping off a small (crossable) cliff and then landing awkwardly.

So to answer your question...cross training including a good dose of core.

Besides the above, anyone can think of their "normal" wear and tear, and try to think about what things could be possibly done differently or that could be changed that would reduce normal wear and tear.

As an example only, if someone wants to run and the only place to do so is on asphalt, then so be it. But if they could choose to run on an available softer surface, perhaps a dirt trail that parallels the asphalted running route, then why not?

I'd say keep the muscles around your knee strong. My kneecap never tracked correctly because the inside quad muscle was weak. That is probably not a problem for most people, but I've talked to other women with bad knees that had the same thing.

My doctor recommended that I strengthen those muscles too, as the other muscles are strong. Adductor machines at the gym, or probably simply squeezing a ball between your knees, will help.

The VMO muscle is so important and it is usually the first muscle to 'waste' during any layoff or other injury. Keep it strong.

The troubles in both of my knees began with traumatic injuries experienced while orienteering. And probably also made possible by weak leg muscles not holding things properly in place.

So, don't have traumatic injuries!

Thanks all of you, it helps. Both the information and knowing that I am in such esteemed company!

My diagnosis is "Chondromalacia, medial joint cartilage thinning, bruising subchondral, MM degeneration, chondromalacia patella."

PT, Vitamin D, icing, and acupuncture were all recommended. Not sure about the final one. The viscosupplementation picture I was given sounds like Gail's story - to help treat, but not a cure, and lasting approximately 6 months. If I try it, I will definitely ask about the 5 versus 3 injections.

In answer to Feet:
1) Stay off pavement (original problems here began for me in 1991)
2) Watch muscle strength, like the others, I had weak inner quad contributing to the original degeneration. (Along with a lot of training and too much pavement.)
3) Don't have traumatic injuries (don't downhill ski), falling skiing caused the most recent and worst flare up

and finally, the BIG ADVICE

4) DON'T KEEP TRAINING AND RACING WHEN YOU ARE IN PAIN!

Really if I had had just the first 3 problems, but had followed advice #4, I probably would not be in this situation now.

#4 sucks

Thanks for the responses to my question. I was curious whether there was going to be a common factor. 3 is hard to avoid if you are unlucky and don't live in a bubble (and even then), but it's interesting to see that 2 and 4 are common to almost everyone who posted. Makes getting to the gym more often to fix 2 easier to get motivated for (particularly when I know I have been letting chondromalacia patella ride for more than a decade now...)

I don't have access to full text but this review on treatments of tendinopathy says that "by comparison with placebo, reductions in pain were reported after injections of sodium hyaluronate (short [3·91, 3·54—4·28, p<0·0001]."