Question
I had a severe left knee injury at age 17 that resulted in cartilage removal from the inside of the joint (instep side) and removal of the ACL ( torn completely). Now 31 years later – of bone on bone wear – I have started having fluid build up and pain. Clinic I am at attempted cortizone which resulted in 3-4 weeks of relief before symptoms returned. Now I am two days away from a 3rd Synvisc shot ( 3/3). At each treatment, the knee is drained ( 140 cc, then 40 cc). I have received no relief from the Synvisc. Fluid builds up within hours, the joint mobility is limited and unstable. I can hobble around some and I am able to oeprate with 1 crutch at times. Is this result understood with Synvisc? Is Synvisc only intended to be used on patients with cartilage in their joints? My physician doesn’t seem to have an answer.
Answer
Synvisc and related preparations are probably less effective once the cartilage is gone and there is bone on bone. Joint replacement at that point is probably the only solution.
