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Knee injections long term?

Posted by bhb30602 @bhb30602, 4 days ago

Hello Everyone,
I'm returning to my exercise routine after an 8 month bout with gout and tendonitis and walked 2.5 miles last week and twice this week. Yesterday after my walk, I began experiencing pain again in my R knee. I'm hoping it subsides after a few days of taking it easy but would appreciate some perspective given my recent treatment:
4-6 weeks ago, I was given a steroid injection in my R knee (worn cartilage/arthritis) and it was successful in providing pain relief until now. My Dr told me we cold repeat the steroid injections but at some point, the gel injections that might be necessary. I wanted to learn more about the gel injections so I met with (another) Dr who specializes in knee injections/replacement to learn more and was told that I should stay with steroid injections as long as they work, then move to the gel. He indicated I could have more steroid injections (due to cost and what insurance would pay for) and only have the gel injections about once every 6 months. Ultimately, he seemed to indicate that total knee replacement was probable. I've read some of the posts on this site about knee replacements and the pain they cause and really want to avoid knee replacements if possible.
Has anyone had long-term relief from knee pain with injections (either steroid or the gel), or some other treatment to avoid knee replacement?
Thanks in advance for any info you can provide.

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klch | @klch | 2 days ago
In reply to @blairt "I played football and worked construction for 40 years so I earned worn out knees. To..." + (show)
@blairt

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.

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appreciate you sharing your thoughts. I had always believed that stem cell therapy provided a permanent fix. In my own experience, I had a total left knee replacement eight years ago, but it has caused me persistent pain. As I am slightly bow-legged, the surgery involved straightening my leg. Nonetheless, my right leg still has its natural bow, causing an imbalance in my gait and resulting in back and hip pain.

REPLY
cbphoenix71 | @cbphoenix71 | 1 day ago
In reply to @heyjoe415 "Hi bhb, Sorry for what you're going through. I was a long-distance runner, completed 20 plus..." + (show)
@heyjoe415

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

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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.

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1 reply
heyjoe415 | @heyjoe415 | 1 day ago
In reply to @ray666 "Hello, heyjoe415 Yours was one one of clearest, most detailed chronicles of life with deteriorating knees..." + (show)
@ray666

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)

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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

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heyjoe415 | @heyjoe415 | 1 day ago
In reply to @lorraine4 "Also a trail distance and Ultra runner for a couple of decades with RA and Osteoarthritis..." + (show)
@lorraine4

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!

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

REPLY
1 reply
heyjoe415 | @heyjoe415 | 1 day ago
In reply to @cbphoenix71 "Re: decision for tkr Thanks to this forum, I was able to make the decision to..." + (show)
@cbphoenix71

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.

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Hi cbphoenix71,

Thanks for sharing your experience. I had both knees replaced in 2022 when I was 67. Best thing I've ever done for my body and my quality of life.

Sounds like you did the all important pre-op work to strengthen muscles around your knee, and then followed all the post-op rehab advice.

I'm still surprised that a number of people our age (I'm 70 now) are so afraid of TKR surgery. Yes you have to do your homework and find a good surgeon. I also recommend a Dr who uses a robotic surgical assistant. It is a traumatic procedure, the incision is around 10" long.

And recovery is, at least for the first two weeks, painful. But every day the pain was a little less, so look at recovery that way, as a process.

At the end is a lot of relief. Good for you cbphoenix71. Congratulations and thanks for sharing your experience.

Joe

REPLY
lorraine4 | @lorraine4 | 1 day ago
In reply to @heyjoe415 "I'm happy to hear you've extended your running days, in spite of having OA. Enjoy it..." + (show)
@heyjoe415

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

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That's the plan! 🙂

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1 reply
heyjoe415 | @heyjoe415 | 22 hours ago
In reply to @lorraine4 "That's the plan! :)" + (show)
@lorraine4

That's the plan! 🙂

Jump to this post

It's just a terrific story and I'm happy for you.

I have a friend who needs a TKR. She's 70 and her insurance company won't pay for gel injections either. I don't get that. Cortisone shots are (almost) always covered, and it sounds like the gel shots work better.

Although in her case, she really should get the TKR. She has some familiar excuses but at the heart of it, I think she's just afraid of the surgery. Understandable, so was I. But after doing some research and talking to people who had successful and unsuccessful outcomes, I learned what to do to 1) prepare for the surgery and 2) recover from the surgery. Not easy, but it allayed my fears and worked great.

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