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Synvisc for the Ankle?

Hello everyone,

              I just joined this forum a few days ago. I was researching Synvisc for my husband, whose doctor is recommending the injections for his ankle. The doctor was very frank with him, telling him that it is not yet FDA approved for ankles, but it is a permitted "off label" use. Apparently it has been approved in Europe, and the doc feels it is imminent in the U.S.

               My husband, Gerry, broke his ankle in a motorcycle accident when hew was 21. He is now 56, works a physical job where he is on his feet most of the day, and has been in pain for the past 10 years. He has been in SEVERE pain for the last two years, and EXCRUTIATING pain for the last six months.

               He's been taking the glucosamine since it first came out, he elevates and ices it every evening, has had a chiropractor give him some kind of "electro" therapy.  He finally agreed to see an orthopedist who took X-rays (the chiro never did) and showed Gerry that there is simply no cartilage left in there; the pain is from bone on bone.

                The doc gave him a cortisone injection that day, which took a few days to kick in, and that has provided some relief. The doctor suggested ankle replacement surgery, but the recovery time is too long right now. Besides the fact that we don't have health insurance and would be paying 100% ourselves, he would not be able to get 2 to 3 months off from work.

                 The doctor then suggested the Synvisc.  So my question is, has anyone here tried it? What has your experience been?

                  Sorry if this so long.  I look forward to hearing from someone.   Thank You!

                  Chris

29 Responses
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Avatar universal
This is my first post and am new to forums...
I jad my first injection 2 days ago..the pain has been as bad as before the injection i have been assured short term...i can already notice more mobility..if he has the shots lay low and the side effects will not be as severe as mine
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Avatar universal
All of you should try acupuncture.  It helped me when I started in 2000 after breaking my ankle badly in 1998 and later have OA diagnosed. Now,  I also want to find a doc that will do the Synvisc in the joint.  I have not asked about it since I first read about it but saw it was only approved by FDA for knees.  Hyaluronic injections work in horses - have been used for years to "lube" their joints.  It is not a pain killer per se, but if the joint has some cushioning between the bones, pain is reduced.
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Avatar universal
All of you should try acupuncture.  It helped me when I started in 2000 after breaking my ankle badly in 1998 and later have OA diagnosed. Now,  I also want to find a doc that will do the Synvisc in the joint.  I have not asked about it since I first read about it but saw it was only approved by FDA for knees.  Hyaluronic injections work in horses - have been used for years to "lube" their joints.  It is not a pain killer per se, but if the joint has some cushioning between the bones, pain is reduced.
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Avatar universal
I have just discovered your item about your husband and the stem cell treatment.
My son has no cartilage in his ankle after an accident and suffers greatly..

Could you tell me    how your husband has gotten along in this treatment?

It sounds as if it could be a miracle.

Phyllis
Canada
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Good answer! Thanks.
Mary
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Who performed the injections.  I cannot fnd a doctor who will do this
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Hello ,

Thanks for the  information. I just had my first injection today and hope that this works. I have had two surgeries and fusion is the next course of action if this does not work. The synvisc was reccomeneded by one of my doctors.

TonyLee
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After having the fusion, synvisc wont work for you. Synvisc is a joint lubrication and once you have you ankle fused and the joint is no longer moving there is nothing to lubricate.
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6/7/11

Just had my 1st injection today.  I broke my ankle 25 yrs ago (now 55)  in three places, have two screws still in place; and also, like most others have not cartilage, just bone on bone.  I do hope this injection works I am tried of wearing all those awful braces and taking Aleve daily.  What I have read so far it seems that its about 50/50 chance it will work.  I will keep ya'll up to date.

Jackson007
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Avatar universal
Well, I'm sorry to report that in my case, the synvisc did not help.  The ankle remains the same - the more I use it, the more it hurts.  I did walk 18 holes (very short course) the other day, but I certainly paid for it that night and the next couple days (painful to the touch).  The only thing that seems to work for me is Advil, but after taking it for 20 years the doctor thinks it may have elevated my blood pressure - so I try only use it when I really need it now.  I don't think I will ever opt for a fusion, since it's my right ankle and I think that'd ruin my golf game.  Just going with pain management, and hoping that something groundbreaking materializes in the future.  Good luck all.
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I just stumbled across this site.  I am 2 weeks into ankle distraction for severe osteo-arthritis.  It took me a year of research to find this technique and a doctor to perform it.  I'd like to share my experience and reseach with anyone facing possible fusion or ankle replacement.  I believe this is a great alternative for the right candidate.  You can search for my blog under ankle arthritis on blogspot for more info.
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Avatar universal
I had surgery at age 15 for a trimaleolar fracture in my right ankle (fractured major 3 ankle bones and had a screw inserted), and at 53 have severe osteoarthritis/degenerative joint disease (for about the past 2-3 years). I  had surgery again last year and had the 35 year old screw removed, but it didn't help relieve my pain. Have been to multiple docs including orthopedic surgeons, rheumatologist, PT, etc. get cortisone shots which help for about 2 months, on an NSAID daily, and just tried Synvisc-One two weeks ago for the first time in my ankle joint and tibia, and hoping that it works in another week or two. Still very sore 24x7 and sleep with an ice pack wrapped around my ankle. Will keep everyone informed and please let me know how Synvisc in your ankle works for you. Last hope. Thanks. Suzy40
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I had an ankle replacement about 2 years ago. I wish I had had it 12 years ago. I've had a total of 9 ankle surgeries [right ankle] at this point.  The fusion made it a lot better, but not perfect. I still have a fair amount of pain from severe arthritis.  And now I'm getting arthritis in my knee because of the increased pressure from walking oddly [a side effect of a fusion]. I'm going to talk to my doctor about synvisc or other possible injections. If there's something that can help I'm all for it.
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10 days after my 3rd injection, my ankle actually feels pretty good...  I have to admit though, I believe that it's more a result of staying off of it (out of the gym, etc) from the soreness post-injections than it is from the injections themselves.  Time will tell.  I'll try to remember to write back in a couple of weeks after I've resumed my normal activities for a reasonable amount of time.  
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My story is similar.  Broken ankle when a child but a couple of other bad sprains from sports injuries.   The ankle was always weak and sore when over used but not a problem.  One year ago I developed pain that stopped me from jogging.  I have different pain when I wear different kinds of shoes.  Bare foot is the best situation.  But ir is sore most of the time and hurts when walking depending on my shoes and some days are better than others.

First dr. gave me three different cortisone injections that gave relief for a few days.  I then saw another more specialized Dr who immediately said it was arthritis and that my options were fusion or replacement but that Synvisc could help delay the inevitable.  I had the Synvisc injections starting 3 months ago.  Had discomfort and swelling with the 3rd one that lasted a couple weeks.  I saw little help until the past 2 to 3 weeks I would say the sharp pain I occasionally get is less intense.  No silver bullet.

I have now seen another specialist from the best ortho group in Chicago and he pretty much confirms the diagnosis.  I was hoping he would see something else.  Although he does say I have issues with a number of joints in the foot that would make even a replacement risky for me.   I am not in great pain but it is uncomfortable walking and I cannot run any more.  He has prescribed a brace that he says should relieve the pain greatly when I am walking much.  It is not a problem to wear and you can with regular shoes.  I will see if *** helps.  Just got it today.

Can't believe there isn't a way to fix this problem without taking your ankle out.  You would think something to slip between the bones would be an easy process in the world of modern medicine.
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Avatar universal
Broke my right ankle back in '87 when I was 17 and had surgery to repair it.  I've always had some discomfort when I use the ankle excessively, but it's all been a lot worse in the past year.  The Ortho talked me into a round of Synvisc shots - three over the course of three weeks, which I just finished.  As people have pointed out, the injections are painful but bearable.  After, the soreness seems to subside over the next 48 hours.  At first, it's pretty bad - walking is unpleasant and avoided.  The next day is still painful, but amounts to not much more than a bit of a limp.  I'll try to remember to report back in a few weeks as to whether or not it was all worth it.
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Avatar universal
Thanks for all the helpful information and posting your original message years ago. I, like the rest here have the same issues with my ankle following a sever break, and then going to a law enforcement academy with it broken. I had my ankle scoped last year to clean out the joint to include removing some bone chips floating around. I'm worse off now following that surgery. I'm starting my first Synvisc series tomorrow all with hopes of postponing the ankle replacement. I’m 36, too young! Anyway, I’ll keep you all posted and will start researching the stem cell alternative.

Thanks again Chris for the update.

Andrew
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I have had synvisc therapy for 3 years, and it has worked miracles. I had a severe break in 2003 and had 1 year with no pain. I had the scope surgery in 2005 and in 2006 began the synvisc therapy. I have the injections once a year and they are wonderful. I have no cartilage, and am 32 years old. I am not ready to fuse my ankle, and that seems to be the next step. The synvisc needs to be FDA approved for the ankle, there are plenty of us with osteoarthritis that could use the help.
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My husband had 3 Synvisc injections,the first Sept. '08, the last on 4/09/09. The last shot put him over the edge; the ankle swelled up, just as it did after the first two, and it never went down. The Dr. just went in blindly, without flouroscope  (X-ray guidance).

   On July 13,2009 I saw a report on our local CBS news about a treatment using adult stem cells, a person's OWN cells, to treat conditions like everyone here has. Your body will actually make new cartilage.  Please check it out: www.regennex.com and also www.centenoschultzclinic.com . They are in Colorado. My husband started the procedure on 9/14/09, and his last re-injection of stem cells will be on 12/10/09. He has experienced relief already, and that will improve over time, as the cartilage grows.

     This isn't cheap, about $8,000.00 plus travel costs and it is not covered by insurance, which we don't have anyway. We already know that  this is the best money we will ever spend. If you have been buying Glucosamine and Chondroitin, save your money, it's useless. So is Synvisc, IMO.  And ankle fusion surgery? BARBARIC!! Just ask anyone with Charcot-Marie-Tooth disease. Dr.s used to do ankle fusions on them for foot-drop.  And don't even think about Total Ankle Replacement!!  Dr. Centeno has a very interesting, very sad article about a patient  who had that done, and then elected to just have her foot amputated, she was in such agony. So sad.

         The web sites I mentioned have a lot of information, and Dr. Centeno also has some videos on Youtube explaining the procedure.  These Dr.s are not quacks.

      Another component of their treatment is prolotherapy, which we'd never heard of and apparently is controversial. That needs to be done within in a week or so in advance  of the re-injection of the stem cells, and can be done locally, rather than in Colorado. You can learn about this at www.getprolo.com. Gerry has had this done twice so far. The purpose is to prepare the tendons and ligaments surrounding the ankle.

      Good luck and best wishes to everyone. It breaks my heart to read your stories. But don't give up hope.

       Chris
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Avatar universal
I just had my third synvisc injection in my lower ankle for pain.  Like MikeRoss, I was in an auto accident in 2001 that shattered my heel and severely damaged my ankle - after three surgeries leaving no cartilidge.   The injections are directed to my "lower" ankle joint - a lot trickier to get to without flouroscope except maybe by the best and most confident doctors.  Each injection is delivered from a different angle of the foot.  The first injection was like falling off a log... the second left me slightly more painful after, but subsided after a day or two.  The third one was 5 days ago and I'm still pretty sore and slightly swollen.  This is supposedly a "postponement" for ankle fusion - to which I am highly resistant.  I'll try to keep the group informed as to my progress.  Since I have a "performance" next week which will have me on my feet and very actively dancing around, it will be my ankle's first big test.
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Avatar universal
I just had my 2nd synvisc injection on my ankle yesturday and I am wondering if it is normal for it to be painful for a few days after, it seems that it is better today than it was yesterday.  I know the relief does not come for a month or so after the first one.  

I am 38 years old, broke my ankle almost 3 years ago and now am suffering from severe post tramatic arthritis of the ankle.  I am on my feet all the time as I am a bartender and have 2 young children.  I am wondering if synvisc has helped or not.  My surgeon says my other option at this point in time is fusion but feels I am too active to take this drastic of a step right now(he says if i was older I would have a new ankle tomorrow)
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I have just got back for the Dr and he sugessted this Synvisc for my ankle and I am now looking it up

I shattered my heal about 6 years ago and have had ankle pain since they said most of the cartlidge was gone and that was the reason for the pain he also sugested that I could get my ankle scoped but to try this first

we will see how it goes
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Avatar universal
Hello,

I am a long time, (4 or 5) years, Synvisc patient for my ankle injury in 2001. I am 46. It happened on a Motorcycle as you, Chris. My pain is 24/7, too.

Anyway, Synvisc is not a direct pain reliever, as pointed out by the Toothfairytracie, but, by keeping the joint lubricated with the Synvisc, it helps with bone on bone wear and daily stress to my ankle, which in turn, reduces the number of pain issues and level of the pain issues I must deal with.

Also, I find it takes about (4) weeks from the first injection to actually start having better mornings and using less ice packs at night.

I usually get my injections every 8 to 9 months, not quite twice a year. I also feel the Synvisc injections are sort of maintenance on my ankle. Sort of like a lube job on the ball joints of your car.

So, not only does it help with the comfort level, I feel, it sort of helps to lengthen the longevity of my fragile ankle before I eventually have to get an ankle replacement...

Tip: Here is an ice trick for the ankle, someone passed on to me. Instead of trying to wrap your foot with ice and ice packs,
1) put cold water in the bottom of a mop bucket, ankle deep,
2) then submerge your ankle in the water,
3) adding ice cubes to the water "to your tolerance level"
...it can be a bit hard to drop your foot into the water if you've already added the ice. Its very easy to go past cold with this procedure. But it can be very effective in not missing a single spot on your ankle or foot...

Good luck, I hope I helped Chris (even though I was almost a year late) or anyone else reading this...

Eddie
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Avatar universal
Hi,
Just had no 2 injection of SYNVISC. I had a lot of questions before the injection, as I had suffered with extreme discomfort since no 1, & was worried it has irritated the joint. You, as I have had to, put your hands, faith & trust in your surgeons hands. He has assured me that he did not expect anything from no 1, but I should start to get some relief from no 2 & no 3.
There is not a lot of info out there on SYNVISC in the UK, but there is in America. What I have learnt is it is only a lubricant & will NOT help with pain relief.
As I said before ask plenty of questions.
Hope I am helping.
Toothfairytracie x
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