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Questions about Synvisc One and knee replacement...
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Questions about Synvisc One and knee replacement...

I saw an orthopedic surgeon for the first time, about my right knee, today.  I have degenerative joints in both knees and no cartilage in my right knee at all.  I also found out I have bone spurs in my right knee, not too long ago, when I last saw my rhuematologist.  I went with the intention of inquiring about a knee replacement.  The surgeon is willing to do the surgery once I lose some more weight (I had weight loss surgery earlier this year), but he's going to try and get my insurance to cover a Synvisc One injection, first.  I am also going to go through physical therapy to rebuild my muscles.  I haven't walked without assistance in many years.  I've lived in my house for eight years and have only been upstairs and to the basement, twice.  It is too painful for me to walk stairs and I cannot stand for very long.  

I am scared to have the Synvisc, as I hate needles.  Also, whenever I have had cortizone injections in the past, my rheumatologist had removed a small amount of fluid from my knee so it wouldn't hurt so bad (it would hurt, as if I could feel the cortizone pushing fluid aside, trying to make room for it).  The orthopedic surgeon says he can inject the fluid into my knee as I'm sitting in a chair and would not have to remove any fluid.  I don't know about this.  I'm willing to try it, but I am very nervous.  I am very sensitive to pain as I have Fibromyalgia.  I stub my toe and I cry; I am that big of a baby!  I am glad that he is suggesting the one injection over the three, though, due to my anxiety about the injection.  I will most definitely be taking a Klonopin the day of getting it!  

I just wonder, wouldn't he need to use ultrasound to make sure he is putting the fluid into the right place?  My rheumatologist always uses ultrasound to make sure he gets the cortizone into the joint.  I am also scared of the side effects.  Would I be able to walk out of the clinic, after the injection, with a walker, or would I have to use a wheelchair?  I don't know how painful it would be immediately afterwards.  Everyone I've talked to sung praises about Synvisc, but never mentioned any pain.  I'm only going by what I've read and it sounds like a very painful process.  

Oh and also, if the injection were not to work for some reason, how long afterwards would I have to wait for a knee replacement?  I should've asked the surgeon, but I was too happy to find a doctor that actually was willing to replace my knee, if needed, that I didn't think of it until after I got home.  I had been discouraged, by many people, in the past because of my age (I am only 42 and went on disability when I was 31 due to my knees).

Thanks in advance!
351246_tn?1379685732
Hi!
Ideally yes, the injection should be given under ultrasound guidance. However, an experienced hand can feel the needle going into the joint space by feeling the loss of resistance to the needle tip. However, yes, you can ask your doctor regarding doing this under ultrasound. You can take an anti-anxiety pill before the procedure. Usually you will have to avoid strenuous activities. The exact effect of the Synvisc-One injection can only be judged after a month. If there is no effect, your doctor may repeat the injection or start preparing you for knee replacement depending on your condition and the feasibility and success of knee implant in your case. Please consult your doctor regarding this. Take care!

The medical advice given should not be considered a substitute for medical care provided by a doctor who can examine you. The advice may not be completely correct for you as the doctor cannot examine you and does not know your complete medical history. Hence this reply to your post should only be considered as a guiding line and you must consult your doctor at the earliest for your medical problem.
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