Arthritic Knee

[graham418]

Have you tried Celebrex? Several friends swear by it.

 

[PTskier]

Me--right knee has no cartilage between the kneecap and the femur. Left has deteriorated meniscus. I'm allergic to strong anti inflammatories. Diclonefac (Voltaren) gives me hives, but both the oral and the gel (C$18 in Canada) work great. Meloxicam (Mobic) gives me a skin rash but works great. Celebrex would probably trigger an allergic reaction in me. Orthovisc (synthetic oil for the knee, similar to Synvisc) worked great in the right for 12 or 13 months for five years, then it didn't work. Euflexxa (different synthetic) didn't work at that time, either. Cortisone works in the left's deteriorated meniscus, no help in the right's patella-femoral arthritis. I combined naproxen (Aleve) with acetaminophen (Tylenol) for a long time. No problem to combine them; each may have their own problems. Worked, but not strong enough. Tumeric plus SAM-e works about the same as the naproxen, easier on the gut, costs a lot more. Glucosamine & chondroitin were no help to me. Total joint replacements aren't 100% effective for everyone, and my knees aren't bad enough to take the risk. Partial knee replacements don't have a very good track record, I've heard. Two saw bones have each recommended that after a total knee replacement the skiing level is dialed way back. Breaking the bones the replacement attaches to can be permanently crippling.

My next step is bone marrow stem cell injections into the knees to re-grow cartilage. That was done by Dr. Mark Wagner, M.D., in Seattle the first of July. He takes a large blood draw to centrifuge into platelet rich plasma (PRP), extracts bone marrow from the hip bones and centrifuges to concentrate the stem cells, and extracts some fat tissue. He says the stem cells can grow to become any type of damaged tissue (cartilage or ligament), the processed fat acts like a matrix for the growth, and the PRP nourishes it. The whole process takes about 1-1/2 hours in the day surgery center. It's about a 20-25 cc injection into each knee, and it took several days to just get over that. Five weeks now, and I can tell something good is happening. Walking or light cycling are good, and I can do either with less discomfort as each week progresses. It is at least a 3 month process. I must not stress the knees; the cartilage must be allowed to grow. A couple of local chiropractors are advertising stem cell injections in the newspaper, but they use stem cells from amniotic fluid--from placentas. After treatment to the fluid to prevent transmission of disease, the stem cells are dead. The injections contain some growth factors that may help for a few months. The chiros hire a nurse-practitioner for a day to do the injections; chiros aren't licensed to give injections.

Pete--Consider all the choices for treatment listed by all the postings in order of cost, inconvenience, risk of bad outcomes, what your doc thinks will work for you. Many things help, and every individual is different. My local orthopod is doing PRP injections into his own knees. That can offer some help. This orthopedic surgeon is considering stem cell injections into his knees subject to what he learns from my experience--I'm his crash test dummy. A good source for information is the Arthritis Foundation (as you read the articles keep in mind the three types of arthritis--osteoarthritis (you & me), rheumatoid arthritis, and psoriatic arthritis, different problems, different solutions). The People's Pharmacy has info about natural remedies that do offer some help, but none offer strong help.
http://www.arthritis.org/about-arthritis/types/osteoarthritis/

 

[coskigirl]

So, I'm going to add a bit of a personal word of caution regarding reliance on long term heavy use of NSAIDs. My mother has had RA for 30 years as she was 35 when diagnosed. It has wreaked havoc on her body (16 surgeries over the years related to it or complications resulting from its treatments). She'd been on medication for tachycardia for awhile but her former cardiologist didn't do any scans because she has low cholesterol and low blood pressure.

Thank goodness for her new cardiologist in Steamboat who decided to do a CT scan to look into it more which alerted him to an issue so he ordered an angiogram with possible stents. Too much blockage for stents mean she's having double bypass surgery later this month.

All discussions are pointing toward the long term heavy use of NSAIDs as the cause. She didn't have a choice as many of the drugs and treatments that can now reduce reliance on them weren't available in the earlier years of her battle. The amount of pain she's battled over the years makes her a total badass but that badass is going into another battle she may not have had to fight if not for the drugs.

 

[Fuller]

Agreed.

A couple of years ago I had a routine physical exam that indicated my kidney function was almost at the chronic kidney disease level. I was taking more and more Advil to get me through my regular workouts and my 4 weeks of skiing in Montana. I was also taking a lot of Excedrin for headaches. Doc told me to give up all NSAIDs and stick with Tylenol only when necessary. A year later I'm back to the normal range of kidney function which is good but I also don't seem to need the NSAIDs either. I went all last winter without taking anything and had relatively few headaches.

 

[RoninSkier]

Knee brace to separate the knee jt - see a sports med doctor
Knee surgery, supposed to have 90% success rate
Prescription grade Volarin creme

 

[Henry]

Resurrected old thread...every knee is different. For mine cortisone didn't help. Injections of artifical synovial fluid worked for 3 years, then didn't work. I tried a couple of brands...couldn't tell a difference. Injection of stem cells from my hip bone marrow worked for 3 years with platelet rich plasma injections in each of those 3 years. Then that didn't work. The knee replacement did work. The most effective knee braces for me are Bauerfeind brand. I've been told by people I trust that Conformis is the best brand of replacement knee. I don't have that...during the Covid years everything was upset. The strong anti-inflammatories were some help to me, but not enough--Voltaren (diclofenac), Mobic (meloxicam), and Celebrex (celecoxib) until I found that I'm allergic to all three including Voltaren topical gel. Diclofenac gave me hives. Meloxicam and celecoxib fired up my psoriasis. Maintaining good muscle tone is critical. Walking, water aerobics, cycling, sessions with a physical therapist, do what helps you.

So...talk with a good knee surgeon. See what might work for you.

 

[Bad Bob]

Ibuprofen, CBD ointment, and a knee brace.
A DIY kit for the active aging person.

It is really amazing how much torque a folf swing puts on the knee in the course of a round. It isn't skiing but it is very noticeable.

 

[skibum4ever]

Ibuprofen, CBD ointment, and a knee brace.
A DIY kit for the active aging person.

It is really amazing how much torque a folf swing puts on the knee in the course of a round. It isn't skiing but it is very noticeable.

After my surgery I was told no skiing and no golf.

Well I guess avoiding one out of those two is sorta kinda following doctor's orders.

 

[pud]

After my surgery I was told no skiing and no golf.

Well I guess avoiding one out of those two is sorta kinda following doctor's orders.

I got my knees replaced so I COULD continue to play golf and ski. It's been 6 years since the double replacement, so far so good.

 

[The Ski Boot Doctor]

Thought I would post this and see if I can get some input.

Me. 75yrs, arthritis in right knee. Two winters in a row got Synvisc shot in knee. First year really help and last year didn't work.
Ski day AM at home massage Australian Dream into knee, take two Aleve, wear non-metal brace. Use hot tub (knee jet) when wears out.

Disappointing as not being able to ski more tdhan 2 days in a row is really going to limit my travel etc.

Anyone have any other suggestions ?

Been there. Right knee. Four years of Synvisc One in mid-November. Worked very well. For the last couple of years, I wore a compressive OS1st knee sleeve. I could ski multiple 25k vertical days in a row. Then last December, after the second day, I had to take a day off to ice my knee. Finished two more days, and that was it for last season.

I had been preparing myself for a new knee for a couple of years and extensively researched knee implants. I settled on the Stryker implant. I wanted a surgeon who used the MAKO robot to assist, and the surgeon had to be a skier. In April, I got my new knee. Today, I am 100% pain-free. Full range of motion. Working out for ski season.

If you get into a hot tub with a sore knee, you absolutely must ice it immediately afterward.

 

[The Ski Boot Doctor]

After my surgery I was told no skiing and no golf.

Well I guess avoiding one out of those two is sorta kinda following doctor's orders.

What was your surgery? Arthroscopic? An unstable foot causes an unstable knee. It adds internal rotation of the tibia at the knee, and tipping in of the knee, leading to lateral impingement and stress on the medial collateral ligament. The patella is also pulled sideways.