New Procedure May Reduce Knee Pain

PITTSBURGH (KDKA) – Many people deal with knee pain and go through a variety of ways to treat it. Now, a new procedure could prevent surgery and still keep you active.

"I see it with golfers here all the time," Mark Borden said as he walks along a local golf course. "I don't want to be one of those guys that's walking around with a new hip or a new knee, in my 50s."

Borden, 54, has knee pain. It's not all the time, but enough that he notices it.

"Just basic wear and tear that's caught up with me," Borden said. "When I'm carrying my bag on my back, it causes a lot of pain in the left knee. Right now, the only pain I have is going up and down steps."

He doesn't want steroid injections, and he doesn't want a knee replacement. All he wants is to stay active without either.

Instead, Borden is going with a series of three injections called Synvisc. The fluid is derived from the combs of roosters, where there's a high concentration of hyaluronic acid.

"Hyaluronic acid is a substance your knee naturally makes," Dr. Sam Akhavan, an orthopedist at Allegheny General Hospital, said.

It acts as a lubricant for your joints. It allows things to glide and reduces inflammation. It may even help the body make more of its own.

"What we try to do is pick patients that do not have too much arthritis, but yet, you know, have a little bit. Those are the people that probably have the most benefit from it. With his activity level, and the mild degree of arthritis that he has, I think he would do very, very well from these injections," Dr. Akhavan said. "This is another tool that we have in an effort to try to avoid more extensive surgery, such as a knee replacement."

"If that's the worst part of it, that's not so bad," Borden said after the first shot.

He wants to play golf right away, but he has to take it easy for at least 24 hours.

While you can do the treatment with just one shot, the amount of fluid required can be uncomfortable.

Since the idea is to kick-start the body's own production of lubricant, three injections, a week apart, give more of a chance for this to happen.

"Typically most of my patients, by the third shot are starting to see some difference, and typically when I see them back four weeks later, that's when I see most of the difference," Dr. Akhavan said.

"I have some patients where we do one series and that's all we do, and I have some patients where we do a series and it doesn't really work. So, it's variable who it's going to work with, but you know, I think six months is a reasonable amount of time to get good pain relief."

It's important to mention that about two percent of people can be allergic to the fluid.

Borden felt fine except for extreme dizziness for a few days after each injection, which is something essentially unheard of.

"This is actually the first time I've heard of someone having vertigo after this," Dr. Akhavan said. "We'll keep an eye on it, and if it continues, I may have him evaluated to see if there's anything else going on."

A week after his last dose, Borden was back to his old self.

"No crunching, no grinding," he said. "It's like, 'Wow, I haven't carried my bag in six months. I can carry my bag again.'"

When he goes for a check up in a few weeks, and again in a few months, he hopes he won't need any more shots, or a knee replacement for many years.

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Allegheny General Hospital