synvisc 1 method of delivery and effectiveness

41 yo Diagnosed "moderate" p-f chondromalacia (cruciates-collateral ligaments/joint capsule intact-normal joint fluid).The areas of concern are patella facets (small full thickness defects) , deep lateral facet defect (mid pole) and full thickness defect centrally in femoral trochlear groove. Chondral thickness in med/lat compartments within normal. Ortho ordered synvisc-1..my first question is will I get a better result (I guess better accuracy) if the shot is administered via fluroscopy/radiologist? Secondly, have you treated "runners/triathletes post synvisc"...how are the results? Can they still compete? Still run? etc....Thanks in advance!

[Michael L Gross, MD]

Any competent orthopedist can perform an intra-articular knee injection without the need for flouroscopy. While some joints, such as the hip and occasionally the shoulder, require the added expense and inconvenience, the knee does not.  Several studies have been done to document this.
As far as my experience, I have had excellant success using synvisc therapy in runners and other weekend warriors (including myself).  However, it is not usually my first line, or only line of action for the problems you are describing.  I would also consider physical therapy,  patella bracing or McConnel taping for your knees, and/or orthotics for your shoes.

[grammyto1]

A related discussion, shot was started.