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Re: Synvisc injections for chondromala cia patella?

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I am definitely no expert....but I would bet that most of us have less

osteoarthritis than we think, and the pain is actually from bone to bone

contact....or bleeding within the knee where the cartilage is being

damaged....

Synvisc injections for chondromalacia

patella?

I was just reading on webmd.com about synvisc as an alternative to

knee surgery for those with osteoarthritis. It states

" In knees with osteoarthritis, normal joint fluid becomes thin and

inflexible. " Thus injections of knee fluid (from chickens by the

way) may offer some relief.

But here's my question. I know that chondromalacia is lumped in

with osteoarthritis. But technically is chondromalacia different than

regular osteoarthritis in some ways?

In particular are our knees in pain in part because our knee joint

fluid has become " thin and inflexible " ? Or is it that our joint fluid

is working great. Its just that our cartilage is mangled, resulting

in pain from our bones rubbing up against each other?

(This article was in reference to

http://my.webmd.com/content/article/18/1681_50322

<http://my.webmd.com/content/article/18/1681_50322>

http://webmd.lycos.com/content/article/18/1681_50625

<http://webmd.lycos.com/content/article/18/1681_50625> )

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After I had surgery I found out that arthritis is a term used differently by

different people. If you look it up, it technically means swelling of the

joint(or something close to that). I had very little swelling, almost none, but

a full thickness cartilage lesion. Most doctors I saw did refer to it as

arthritis, so I think the term is used to mean any cartilage damage, whether

swelling is present or not. I think bone on bone is arthritis, as the term is

used by most doctors and patients.

btw, Dr. Dunn update. I'm in Maui right now, quite a place. Anyway I ran about

5 miles yesterday, and felt pretty good. My knee doesn't feel perfect, but if

it's good enough to run 5-10 miles, I'll be happy. I'm going to call when I get

back, next weekend, and get an MRI. Hopefully it will show some improvement,

and what I'm feeling isn't just the result of muscle strength.

Chuck

Re: Synvisc injections for chondromala cia

patella?

I thought bone to bone contact was osteoarthritis??? Jen

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btw, Dr. Dunn update. I'm in Maui right now, quite a place. Anyway I ran

about 5 miles yesterday, and felt pretty good. My knee doesn't feel

perfect, but if it's good enough to run 5-10 miles, I'll be happy. I'm

going to call when I get back, next weekend, and get an MRI. Hopefully it

will show some improvement, and what I'm feeling isn't just the result of

muscle strength.

My God! If I could walk ONE mile w/o having to use a cane for 3 days

following, I'd be happy.

Ann

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I know, but it's a big step down from my activity level a year and a half ago.

kind of hard to accept running marathons a couple years ago then not being able

to run at all for quite a while.

here's the definition I got for arthritis from dictionary.com

Inflammation of a joint, usually accompanied by pain, swelling, and stiffness,

and resulting from infection, trauma, degenerative changes, metabolic

disturbances, or other causes. It occurs in various forms, such as bacterial

arthritis, osteoarthritis, or rheumatoid arthritis.

RE: Synvisc injections for chondromala cia

patella?

btw, Dr. Dunn update. I'm in Maui right now, quite a place. Anyway I ran

about 5 miles yesterday, and felt pretty good. My knee doesn't feel

perfect, but if it's good enough to run 5-10 miles, I'll be happy. I'm

going to call when I get back, next weekend, and get an MRI. Hopefully it

will show some improvement, and what I'm feeling isn't just the result of

muscle strength.

My God! If I could walk ONE mile w/o having to use a cane for 3 days

following, I'd be happy.

Ann

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About activity level: from 1990 to 1993 I was the hiker from hell, climbing

mountains all over CA. In 1993 my R knee started hurting & I ended up with

a lateral release in 1995. Then I was OK till 1999, but I was so crippled

during those 3 bad years (it took me a year to recover after the surgery, my

quads had gotten so atrophied) that I got out of the habit of getting up at

4 am and driving 200 miles to kill myself ascending a mountain for 10 hrs.

And then the knee pain started again & now I'm pretty crippled again and

this time my surgeon says he doesn't recommend surgery. Actually, I think

he's just gotten bored with me, because he's treating me differently than he

did in 1995. Unfortunately, he's one of the best surgeons in town. The

other really good one is hated by everyone -- very bad bedside/office

manner. I wish health insurance was like it was 10-15 years ago when you

could go to see any doc you thought appropriate. Anyway, right now I'd just

be happy if I could walk a mile w/o residual pain.

About arthritis: I wouldn't put too much faith in dictionaries (or docs for

that matter) about arthritis being inflammation. It may be inflammation in

rheumatoid arthritis, but rheumatoid arthritis is a whole nother world.

Both my knee docs feel chondromalacia and osteoarthritis are not really

inflammation. When I took Naprosyn, it did absolutely nothing for the knee

pain, which it should have if it's an inflammation. Tylenol helps better

than anything else. It's just an analgesic. Ice does help me also, which,

in the context of Naprosyn not helping, makes me think I'm getting an

accumulation of fluid in my knee for some reason. I hate being thrown out

on my own to try to figure this out. I thought that's why we had doctors.

Ann

Re: Synvisc injections for chondromala

cia patella?

I know, but it's a big step down from my activity level a year and a half

ago. kind of hard to accept running marathons a couple years ago then not

being able to run at all for quite a while.

here's the definition I got for arthritis from dictionary.com

Inflammation of a joint, usually accompanied by pain, swelling, and

stiffness, and resulting from infection, trauma, degenerative changes,

metabolic disturbances, or other causes. It occurs in various forms, such as

bacterial arthritis, osteoarthritis, or rheumatoid arthritis.

RE: Synvisc injections for

chondromala cia patella?

> > btw, Dr. Dunn update. I'm in Maui right now, quite a place.

Anyway I ran

about 5 miles yesterday, and felt pretty good. My knee doesn't feel

perfect, but if it's good enough to run 5-10 miles, I'll be happy. I'm

going to call when I get back, next weekend, and get an MRI. Hopefully

it

will show some improvement, and what I'm feeling isn't just the result

of

muscle strength.

> My God! If I could walk ONE mile w/o having to use a cane for 3 days

following, I'd be happy.

> Ann

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about the activity, sorry to hear that.....but I think you probably understand

about how it's hard to let go.

and about the definition. I agree with you, I'm just trying to illustrate that

the word arthritis is used differently by different people, you say bone

degradation, others say just pain, others say cartilage damage, and the and

technically it means swelling in the joint.....but like I said I've got almost

no swelling, never did...and I've got a full thickness lesion. so does that

mean I don't have arthritis?

RE: Synvisc injections for

chondromala cia patella?

> > btw, Dr. Dunn update. I'm in Maui right now, quite a place.

Anyway I ran

about 5 miles yesterday, and felt pretty good. My knee doesn't feel

perfect, but if it's good enough to run 5-10 miles, I'll be happy. I'm

going to call when I get back, next weekend, and get an MRI. Hopefully

it

will show some improvement, and what I'm feeling isn't just the result

of

muscle strength.

> My God! If I could walk ONE mile w/o having to use a cane for 3 days

following, I'd be happy.

> Ann

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hey Chuck,

From an earlier post you said you have " a full thickness cartilage

lesion on my femoral condyle " . Can you tell us the size this lesion

was and do you think it has healed up now? ie post Uncle Dunn, do

you have any investigative info eg MRI's, arthro etc has the

grinding gone now? Do you know how's Rob getting along too?

In any case, running 5-10 miles is fantastic, whatever!

My own case i'm slowly getting better on my own, thru

stretch/excercise. Can just about walk upstairs 2 steps at a time

now and tried a few paces running last week which wasn't too bad.

But a 5-10 mile run would be great!!

Joe

> about the activity, sorry to hear that.....but I think you probably

understand about how it's hard to let go.

>

> and about the definition. I agree with you, I'm just trying to

illustrate that the word arthritis is used differently by different

people, you say bone degradation, others say just pain, others say

cartilage damage, and the and technically it means swelling in the

joint.....but like I said I've got almost no swelling, never

did...and I've got a full thickness lesion. so does that mean I

don't have arthritis?

> RE: Synvisc injections for

> chondromala cia patella?

>

>

>

> > > btw, Dr. Dunn update. I'm in Maui right now, quite a

place.

> Anyway I ran

> about 5 miles yesterday, and felt pretty good. My knee

doesn't feel

> perfect, but if it's good enough to run 5-10 miles, I'll be

happy. I'm

> going to call when I get back, next weekend, and get an MRI.

Hopefully

> it

> will show some improvement, and what I'm feeling isn't just

the result

> of

> muscle strength.

>

> > My God! If I could walk ONE mile w/o having to use a cane

for 3 days

> following, I'd be happy.

>

> > Ann

>

>

>

>

>

>

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hi Joe,

my operative report said 1X2 cm, but after showing the pictures to various docs,

they think it's probably larger, somewhere around 2X3 or 4 cm. I've also been

told that I've probably been running around with this thing for quite a while.

I tore my acl when I was 14, I'm 30 now. that still has not been repaired.

they think I probably chipped off a bit more cartilage some time in 2001 and

that's why it became symptomatic. my pre-op MRI is pretty bad. the word

chronic is used way too much.

I have no objective evidence that it's healed up. I did get x-rays while down

there, but to be honest I don't hold much stock in the fact that the space

between the bones increased. I talked to my uncle, a vet who also has knee

problems and is getting an allograft soon, about this. he said we're talking

millimeters and that could be almost anything. I did call Dunn and ask him

about getting an MRI. he said call back in mid-March, that the healing process

would be complete by then.

it does not feel totally normal, but it does feel improved. I can still feel

something in there from time to time, but it's rarely painful. running is where

I'd like to get back to. I can do machines(stair master, elliptical, etc)

without any problems and I can bike outside fine too. I have started back with

more aggressive leg exercises, for example deadlifts, leg presses and front

squats. I've never stopped partial rom leg extensions. I am not sure if I'm

feeling better because of leg strength or cartilage regrowth or both. I hope

both.

Rob was down in Miami last week for a vacation and visit with Dunn. I haven't

talked to him since he got back. I'm guessing he'll be reading these posts soon

if he hasn't already.

sounds like you're heading in the right direction. stretching and exercise can

take us a long way. not to be a sales man, but the super joints book is pretty

good. basically rom exercises aimed at lubricating the joints. I've been doing

some of the exercises, only for 10 minutes or so a day for various beat up parts

of my body and they seem to help. they're good for a warm up prior to exercise.

keep up the good work, maybe we'll both be running soon. just curious, what

exercises are you doing? are you using weights or just body weight?

it's about 6 here in Maui, looks pretty nice out. I think I'm going to try

another run. hope I don't regret it. my wife, 2 kids and I did some hiking on

the road to hana yesterday. I had my daughter, who is about 22 lbs, on my back

in a back pack. my knee felt funky going down hill.........they were uneven,

sometimes slippery slopes. but, all in all there was no real pain.

hope you continue to improve, keep at it and you will.

talk to you later,

Chuck

RE: Synvisc injections for

> chondromala cia patella?

>

>

>

> > > btw, Dr. Dunn update. I'm in Maui right now, quite a

place.

> Anyway I ran

> about 5 miles yesterday, and felt pretty good. My knee

doesn't feel

> perfect, but if it's good enough to run 5-10 miles, I'll be

happy. I'm

> going to call when I get back, next weekend, and get an MRI.

Hopefully

> it

> will show some improvement, and what I'm feeling isn't just

the result

> of

> muscle strength.

>

> > My God! If I could walk ONE mile w/o having to use a cane

for 3 days

> following, I'd be happy.

>

> > Ann

>

>

>

>

>

>

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hi Chuck

That's a fair size lesion, so the fact that you're as active as you

are means it must have healed somewhat.... it would be hard to

imagine your level of activity if this lesion was still the original

size. I agree not to get too excited about the increase in joint

space, but at the same time if this was accurately measured both X-

rays then it must have some significance...

I don't use any weights for my excercises, and basically these

consist of

1. staying normally active during the day (walking quite a lot,

stairs, kneeling as required)

2. a night-time regime of a) simple vmo stretches B) deep lunges held

for 30 seconds c) stepping onto and off a pile of telephone

directories 12 " high 50x each leg d) 10 full squats e) further

squats but returning to a standing posture by a more natural action

of placing weight on one foot and standing up using this leg to bear

most of the weight.

In a short time i'll hook up the drive belt on my excercise bike and

start some resistance-cycling. Also i'll be increasing the height on

the telephone directories further (an average staircase step is 8 " ).

Now that you've mentioned it it might be interesting also to try some

additional weight when doing the squats...

I've said this many times on this board, but there is absolutely no

doubt that these excercises have helped me tremendously. Initially I

usually get some pain after a new or increased excercise, but this

stabilises after a while and i find i can then do an excercise, which

otherwise I would never have been able to do again.

Good luck with your own regime! But be careful with the limited ROM

extensions! I'm not a big fan of this excercise as perhaps you

realise!

keep up the good progress...

Joe

> > about the activity, sorry to hear that.....but I think you

probably

> understand about how it's hard to let go.

> >

> > and about the definition. I agree with you, I'm just trying to

> illustrate that the word arthritis is used differently by

different

> people, you say bone degradation, others say just pain, others

say

> cartilage damage, and the and technically it means swelling in

the

> joint.....but like I said I've got almost no swelling, never

> did...and I've got a full thickness lesion. so does that mean I

> don't have arthritis?

> > RE: Synvisc

injections for

> > chondromala cia patella?

> >

> >

> >

> > > > btw, Dr. Dunn update. I'm in Maui right now, quite

a

> place.

> > Anyway I ran

> > about 5 miles yesterday, and felt pretty good. My knee

> doesn't feel

> > perfect, but if it's good enough to run 5-10 miles, I'll

be

> happy. I'm

> > going to call when I get back, next weekend, and get an

MRI.

> Hopefully

> > it

> > will show some improvement, and what I'm feeling isn't

just

> the result

> > of

> > muscle strength.

> >

> > > My God! If I could walk ONE mile w/o having to use a

cane

> for 3 days

> > following, I'd be happy.

> >

> > > Ann

> >

> >

> >

> >

> >

> >

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