Hyaluronic gel into a multi issue knee

@beachy
I use a brace with good results.
Also the monovisc/orthovisc shots help me.
I use cortisone shots for "special" occasions, such as....the mom/groom dance at my son's wedding and maybe this year for an upcoming trip to Yellowstone. This will be so I can hike in every day to Trout Lake (an annual trip for us).
Cortisone shots: I find that there are two main impact periods for the cortisone shots..... a big impact and then a lesser impact. The big impact on the knee only lasts about a week, so I have learned to plan the shot to go with the "special" event. I then will notice a milder impact for weeks after.
I talked with a neighbor who has had 2 knee replacements. She said that she was able to forestall the second knee replacement for about 6 years using a combo of gel injections, cortisone and a brace. I am hoping for a similar result.
I do use a product called cartigenix hp....not to sure about it yet, but it seemed worth a try. It is supposed to reduce inflammation. AI thinks I can get the same effect cheaper, but I am using the cartigenix as of now. The xrays shown in the study seem to be from different aspects which lessens the impact of any change being shown....so ....still wondering.
https://www.drkarafitzgerald.com/2025/10/03/osteoarthritis-joint-relief/.
xrays and research:
https://dynamicchiropractic.com/sponsored/102733-calroy-health-2025-06

@kathleen1314 thank you so much for very helpful tips! I was unaware of the cartigenx. Also, have you read much about the Jiffy Knee Replacement which I believe is also called Nano knee? It's supposed to be less invasive, not cutting tendons, etc. Very few states have trained surgeons in this technique. I'm searching efficacy and reviews now.

Yes, I looked briefly at the Jiffy knee. Ha, that was not meant to be funny.
Frankly, I do not know as much about the knee surgeries as I would like. I have been talking with steveinArizona on the Mayo site and with copilot to evaluate and look for surgeons.
I would prefer to maintain as much of the knee as possible and Jiffy, I believe, tries to do that.
Many knee surgeons frequently just don't seem to care about how much of the knee they carve out, it seems. Hard statement, but I have talked with 6 of them so far.
I would like a surgeon that is first and foremost interested in me as a patient and in how I will react and live with the knee, before and after the surgery. I am having trouble getting that feeling.
I do think that looking at steve's comments and discussions might be useful for you. It was for me. Link to his member page:
https://connect.mayoclinic.org/member/00-748a9dd558e368ff336939/

@beachy
Are your sisters able to stay with you for two or three days? If so, that would probably be enough to get you through the TKR enough to handle living alone.

@steveinarizona They live in Maine and I live in New York State. Medicare will pay for in-pt rehab prob for about a week. I may be able to stay at a friend's after. She has handicap accommodations in her home. I cannot have this surgery and be stable before September. Meanwhile, I'm trying to buy some time with injections. Thank you for your response.

@kathleen1314
Jiffy Knee is a branded version of a subvastus procedure that has been around for many, many years. I have a friend who was scheduled for a Jiffy Knee here in Scottsdale. I was chatting with my magician (AKA surgeon) and mentioned that to him and asked him what he thought of Jiffy knees. He replied that their efficacy depended upon the skill and experience of the surgeon. I told him the name and he replied that he had not seen any problems from that surgeon -- a compliment (my guy spends about 20% of his time doing revisions of other surgeons' work).
Subvastus procedures go under the tendon and muscle causing less trauma and therefore a faster and usually less painful recovery. The downside is that the surgical window is small. Another minimally invasive method is the midvastus method. This goes under the tendon but through the muscle fibers. My surgeon uses this method and I discussed it with him. He said that a subvastus approach would be slightly less painful in recovery but the midvastus would give him a better field of work and if a revision were ever necessary, a better pathway.

My surgeon also does the extremely rare bicruciate retaining implant ("BCR"). in 99+% of TKRs the surgeon cuts and removes the ACL. In many cases the surgeon also cuts and removes the PCL. In a BCR the surgeon puts in an implant that protects and preserves the ACL and PCL. My magician has been doing these for a decade and it can be done only if the ligaments are strong. Mine are and I had a BCR and I therefore still have all of my ligaments.

Most modern TKRs take a little of the bones as the surgeon can. Some refer to it as resurfacing. A really good surgeon will take only the amount of bone that is necessary.

@kathleen1314 i am intrigued with Cartigenix. I am Blessed with microscopic colitis triggered by NSAIDs. Bad drug to be Banned from with RA and now knee issues. I’d Give my kingdom for some Ibuprofen 🙄

Let me known how it does on inflammation please.

@pb50 Due to blood thinners, I'm also unable to take ibuprofen, celebrix or meloxican. My dr recommended rx Hydroxychloroquine and Sulfasazline which are managing inflammation so far. Good luck and I'd also be interested in how Cartingenix works for you.

Thanks! I am already on an every 6 week infusion of remicade - an immunosuppressant for my RA. I tried hydroxychloroquine but it didn't sit well.
Surges in inflammation respond well to ibuprofen. Sometimes Prednisone but one needs to be really stingy with that - for multiple reasons.

So that leaves me with an opportunity to identify a new approach to manage surge inflammation.

My comment here does not specifically address your pain issue, but I thought I'd share what transpired with me regarding Hyarolonic gel injection after surgery for a meniscus tear. The meniscus, itself, rehab was going well, but a pain under my knee would not go away. The physician assistant wanted to give me these gel injections, but I had NO pain relating to joint movement. He also wanted to do this without using visual means. He pushed on my knee and showed me a location where he'd shove the needle. I got a 2nd opinion. The ortho doctor determined that my pain originated from my back. Been doing therapy and getting better and better. I have gone from a barely 2.0 pace walking on my treadmill to over 3.0 in about 6 weeks. I've learned not to work with a PA post-op. In the future, I'll meet with the he/she doctor who performed a surgery before a PA. The gel injections would have been no use and yes, can be very painful and they are not a permanent cure. I hope this general info will help someone.