Knee injections long term?

I played football and worked construction for 40 years so I earned worn out knees. To avoid surgery I had steroid injections and PT in 1998 that moderately helped but was warned that they erode the joint. Next I had the chicken juice injections called Synvisc in 2004. The doctor injected me 3 times over 15 month and with PT they helped some and allowed me to work and sleep. I retired in 2010 and stayed active and exercised. 2016 I investigated stem cell therapy and in 2017 I chose the Regenex Stem Cell Therapy and RAPS, a Pittsburgh group of doctors to treat me. The Stem Cell Therapy was not covered by my insurance provider so my cost was $7,000 per knee. Rt knee in September, Left knee in December. Some pain for 1 week then the knees were great. 2019 - I needed a plasma platelet injection in both knees - $2,000. 2021 - plasma platelet injections in both knees - $2,000. FYI, the platelet injections really hurt (8) for about 2 hours. Recently at 75 years old, I returned to RAPS and was told that the platelets would cost about $6,000 and probably would not be effective and I should consider the Stem Cell Therapy again which now would cost me about $25,000. I am interviewing doctors and am debating between replacement surgery, arthrosamid injections and platelet injections. I have found a very reputable surgeon who will provide platelet injections for $1,000 per knee, again not covered. This surgeon has 6 years experience with platelets, his procedure and results are good and he has not caused an infection but he cannot guarantee results. I must decide soon so wish me good luck and I hope I didn't bore you with my long story with an inconclusive ending. Keep moving but know your limits and take advice only from respected medical professionals.

Hi bhb,

Sorry for what you're going through. I was a long-distance runner, completed 20 plus marathons, but osteoarthritis did me in at 48 and my last marathon was 1999. I have had both knees scoped twice each, and never really got much from those procedures. I've also tried cortisone shots, with mixed results. Best case is some pain relief for two months. I have no experience with gel injections.

At age 67 I had both knees replaced, 4 months apart. At my surgeon's suggestion, I worked with a trainer for six months prior to the surgeries to get the muscles around my knee as strong as possible, given my limitations. I did research and found a great surgeon who did his residency at Cleveland Clinic. Finally, the surgeon used the Stryker/Mako surgical assistant. Finally, and most important, I did all of the rehab exercises 3x/day for 6 weeks and saw a PT 2x/week. I worked very hard on my recovery/rehab.

My knees have never felt better, and I'm 70 now. I can't run or do impact sports, but I've taken up spinning and love it. I still work with the same trainer and we are able to push leg exercises much further with the new knees. I go to the gym every day and feel great.

Anyway I know you're looking for an answer on gel or other injections. In my experience, once degeneration of cartilage begins, the process can't be reversed. I'm not trying to sell you on knee replacement now. Put that off for al long as possible. Once your knees get so bad that you have trouble sleeping or climbing any stairs, then it may be time. Whenever that happens, do your research and find a surgeon in his/her mid 30s to mid 40s, with a solid pedigree (med school and/or residency).

I wish you all the best!

Joe

Hello, heyjoe415

Yours was one one of clearest, most detailed chronicles of life with deteriorating knees I've read so far. It echoes in so many ways my own experience. I, too, was a long-distance runner (not as many marathons as you!). My running days came to an about 20 years ago when I had my right knee replaced. I'd been doing fairly well ever since, until about a year ago when my left knee began to give me achy moments. I thought, 'Uh-oh, time for TKR #2.'

But my orthopedist, studying my X-ray, said, 'Well, Ray, your knee is bad, but I'd advise we take a more conservative approach, at least for as long as we can.' We started shots, first steroid, then gel, and I've been doing pretty well ever since. Shots work, but, as I've been told, not for everyone. I guess I'm one of the lucky ones for whom shots do work.

Off the topic. heyjoe415, do you miss runningas much as I do? After all these years, and now withPN to boot, I still get nostalic when I see someone ticking off the miles on one of our local trails as I lumber by in my Jeep. ::sigh:: 🙂

Best wishes,
Ray (@ray666)

Also a trail distance and Ultra runner for a couple of decades with RA and Osteoarthritis and had good fortune with injections for which I am so thankful for! I followed the path you outlined pretty much. Steroids then gel (Duralane) My first gel lasted a year with lots of running miles and I just received my 2nd and now I'm building my miles again. My insurance won't cover gel injections because they deem it not medically necessary so I had to pay out of pocket. For me and my life tho, I feel it was necessary and less expensive than replacement surgery, so I dont understand insurance All the best for you!

Re: decision for tkr
Thanks to this forum, I was able to make the decision to do the tkr on mid Dec 2024. My gratitude to all the contributors who shared their honest opinions.
Prior to the surgery, I was on cortisone shots, then gel. Improved but the period between shots got shorter.
I started limping after walking for about 10 mins . Pain got worse. Did my research and started preparing for the inevitable. Did all the pre exercises (internet) and continued to exercise at the gym.
Tkr recovery is excruciating. With perseverance and doing the post work will be worth it. It is a scary surgery . My surgeon used the robot assisted technology. I’m now 10 weeks in recovery. After six years of no stairs (up nor down) I can do so. I can do at least two miles of walking in the am. My quality of life has improved so much. So, do the work that is needed, pre and post surgery. I am 73 years old , doing great.
Yes, you can .
All the best.

I'm happy to hear you've extended your running days, in spite of having OA. Enjoy it for as long as you can!

That's the plan! 🙂

Hi Ray, and thank you for your kind words.

The fact that your surgeon isn't rushing into the second replacement means you've found a good Dr. My rule of thumb, well in retrospect, is to wait until daily activities become disrupted by the pain - sleeping or climbing a flight of stairs for example, and it can't be fixed with cortisone or another remedy. Then bone is likely rubbing on bone, and a replacement is, for now, the best way to go.

As for running, yes I do miss it quite a lot. Ironically, with the new knees, I'm able to do a HIIT/spin session 5x/week and that feels absolutely great. My knees have never felt better.

What I miss most about running are the people. During the winter, we'd have a weekly Sunday 10 mile run from a friend's home. We'd train together for races and marathons, we'd run these events together. I don't get that from spinning, although I have made some new friends at classes. I did manage to reach my #1 goal of running a few marathons under three hours. So mostly I'm grateful I had the experiences and friends that I did.

Thanks again Ray, and all the best to you.

Joe

Hello, Joe

I, too, took it as a positive sign when the surgeon suggested I give injections a try. He'd cautioned that they might not work. Fortunately––at least, thus far––they did, and have.

It's the same for me. While it's true I miss the running, I also miss the people –– my running buds. I miss the buzz surrounding an upcoming event, then teaming up with one or more friends and making plans to train together. Then the whole going together and the good-fellowship talk after: How ya do? Coulda done better. How 'bout you? Cramped at 16. Sorry to hear that. See ya Monday? Go for an easy one? I'll be there. Etc. Etc. Etc. I miss the comradery.

Cheers!
Ray