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Knee & Hip Problems Message Board

Knee & Hip Problems Board Index

[QUOTE=jerseyboy;4260263]Not sure on the brand name you mentioned, but I have had Synvisc injections, first the series of 3 then the new Synvisc One (which I prefer). In my case I had the series of 3, three times. Each time the benefit was about 6 months. I then had the 1 shot last June. On Janurary 17th I had my latest "Rageing Flairup" as my doctor called it. It was at that point that I made the decision to have TKR. I had the right knee done on 3-31-10 and will have the left done 7-7-10.

Generally though, the shots last six months.[/QUOTE]

Thanks for the information on your Synvisc injections.

Here's my story:

The Euflexxa injections that I'm receiving are a product of Ferring Pharma. This HA is not made from processed chicken or rooster combs, which eliminates the chance of an allergic response in people sensitive to poultry products. It is manufactured through bacterial fermentation - also known as bioengineering, which is an everyday manufacturing process. Rarely do people have a flair or any negative side affects.

I damaged my knee (hyper-extended with torn medial meniscus cartilage)about 30 years ago. On the suggestion from the doctor that originally examined me he recommended that I wait until arthroscopic surgery was commonplace. I waited far too long and didn't have surgery done for 17 years after I damaged it. By then I was bone-on-bone and had arthritis.

For 30 years (since I damaged it), my knee has not felt right. Even after having the arthroscopic surgery (13 years ago) my knee has never felt right. My range of motion was limited and I could not fully extend my leg, therefore (as the doctor described it) I could not "fire my quad muscle, which allows you to walk properly. Walking only five blocks caused my knee (leg) to really tighten up and my knee to swell up and get puffy. Medication helped, but was not doing much.

Recently my knee had been getting much worse where I couldn't walk more than five blocks before I was stiff-legged and in a lot of pain. So I went to see a new doctor about a month ago. He specializes in knees with particular focus in athletic injuries. He took x-rays of my knee and told me I was a candidate for TKR, but that I was too young (at 60 years-old) because I would likely need a 2nd TKR if I lived to be an average age...and a 2nd TKR is almost always troublesome to do and doesn't workout too well. So, he highly recommended that we do whatever was necessary to "buy some time" before I had to have a TKR.

When I was in the doctor's office my knee was pretty swollen and puffy, and obviously it had a good amount of effusion (fluid) surrounding the knee joint. However, instead of draining the fluid from my knee he wanted to see what the affects of a cortisone shot would do for my inflammation. Believe it or not - I have never had a cortisone shot in my knee before...even though I have been battling a bad knee and pain for 30 years. He said if the cortisone relieved my inflammation that I would be an excellent candidate for Euflexxa, which would provide the best lubricate for my knee joint. He said that my body was no longer producing ample lubricating fluid for my osteoarthritis knee joint - that the natural lubricating fluid was minimal, thin and ineffective, which causes pain, swelling and tenderness around the joint. He said my OA bone-on-bone knee joint was like a crusty old rusty door hinge with a little water on it instead of being slippery and smooth...and because it's a weight-bearing joint whenever it's used (e.g. simply walking around) that's what causes the constant inflammation and pain. He told me I would always have the OA, but that Euflexxa should give me tremendous lubrication and greatly reduce the inflammation and pain.

He gave me the cortisone shot (just below the patella), which did not hurt at all and within a few hours I could detect that my knee was feeling oddly different - like it wasn't as mushy with inflammation. By the next morning my knee was almost the same size as my good knee and my range of motion was greatly improved. No longer was my damaged knee so inflamed that it bowed out (bowed), and I could straighten (extend) my leg almost straight. On a scale of 0-10 my pain and discomfort was always no less than a 7 and easily reached a 10 after walking or doing something that aggravated it. My pain had dropped to a 3 on the scale. By the second day after the cortisone shot my pain was a remarkable 1 on the pain scale. My knee had never felt better in the past 30 years! (Why I had never received a cortisone shot before is beyond me...) Anyway, I called the doctor's office to let them know the results of the cortisone shot and to proceed with the insurance approval and ordering the three Euflexxa injections.

I was told that it would likely take a few weeks to get insurance approval and to receive the Euflexxa, as the Euflexxa must be ordered on a patient-by-patient basis. After a couple of weeks I received a phone call from the doctor's office that my insurance (BCBS) approved the Euflexxa and to be expecting a call from a pharmacy that would be shipping the drug to my doctor's office, which happened a few days later.

When I went in for my 1st Euflexxa injection last Friday it had been one month exactly since I received the cortisone shot and my knee was still feeling great, even though I was told the cortisone wears-off after about ten days. I guess (since the cortisone wears-off in ten days) my inflammation is returning , but I certainly can't tell it. I almost hated to have anything more done to my knee because it was feeling so good.

On Friday I received a simply shot to numb my knee and after waiting ten minutes or so for it to take affect my knee was then drained of only 5 cc of effusion (fluid) and I received my 1st Euflexxa injection. I was told they always drain the knee at the site of the Euflexxa injection as standard practice. Fluid was not aspirated from the joint area. I did not feel a thing other than a tiny sting from the shot that numbed my knee except for the nurse applying some pressure with her hand to help extract (drain) my knee. The entire draining and injection procedure (after the numbing) took all of 3-5 minutes...and that included the application of a strip Band-aide just like with any shot.

I thought I would have my knee joint drained and receive the Euflexxa injection in the joint area. However, that wasn't the case. With my leg in the straight (extended) position the numbing shot as well as the effusion aspiration and Euflexxa injection was performed on the outside (lateral) of my leg above my kneecap even though my cartilage damage is on the inside (medial) of my knee. (I've learned that there are four injection sites that can be used, but the location where they did mine is the least likely to cause any damage or pain.) A 1 1/4" long 25-gauge needle was used, which was angled downward and under the patella at about 35 degrees to first drain (aspirate effusion) the knee...and then the aspiration syringe was removed and the same needle was used to inject the Euflexxa. Fluid was not aspirated from the knee joint itself. (For the benefit of others reading this that may be anxious or afraid of the procedure or experiencing pain - I did not feel a thing. I left the doctor's office feeling just as good as when I arrived. I had a strip Band-aide on the outer part of my leg just above my kneecap covering a tiny little needle mark the size of a ball-point pen tip.)

I was told not to stand on my feet for long periods of time and not to do anything strenuous (lifting heavy weights, playing tennis, etc.) for two days. I assume it takes a couple of days for the Euflexxa to get into the joint area or through the tissue where it was injected - dunno.

It's now been two days (48 hours) since my knee was injected with Euflexxa. During the first 24 hours I sometimes felt a very tiny burning sensation on the inside (medial) of my knee where my knee is bone-on-bone. It's hardly worth mentioning because it was barely noticeable. I no longer detect that sensation and my knee continues to feel great.

I understand that most people receiving HA injections do not feel any benefits until after the 2nd or 3rd injection, and many don't feel benefits until 12 weeks. I don't know if benefits are felt any sooner with Euflexxa versus other HA type injections. Obviously I am still feeling the benefits of the cortisone shot I received one month ago.

I hope that the 2nd and 3rd Euflexxa injections will be as easy as the first was. (By the way, I was told that each injection [spaced one week apart] will be given in the same area.) I'm hopeful the Euflexxa will lubricate my knee joint and eliminate (or greatly reduce) any inflammation that I have previously experienced all these years. That's what it's supposed to do. It's supposed to last at least six months, but I've heard that some experience benefits lasting a year or longer. I guess every person's knee joint problem is different and some people's bodies respond differently to medications and treatment. Maybe I'm just lucky that the cortisone helped me so much. I hope that's a good indicator that the Euflexxa will do the same...and last a long time.

There's nothing better than going from a constant 7-10 pain scale level (on a scale of 0-10) for 30 long years all the way down to a 1 pain level. I want that to continue! Talk about "buying some time" before needing a TKR - my knee feels almost as good as it did before I damaged it in my late 20s! If I can keep my knee to continue feeling anything close to this good I shouldn't ever need a TKR. We'll see how it goes!

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