Member Case Study: Synvisc One Knee Injections

author : AMSSM

comments : 1

Do you have any experience with Synvisc One knee injections? After my second scope the doctor has recommended this for the osteoarthritis that has developed in my knee.

Member Question from rlc5925

"Do you have any experience with Synvisc One knee injections? After my second scope the doctor has recommended this for the osteoarthritis that has developed in my knee. I am curious as to the success of this treatment and the long term effects of this type of treatment and endurance training."

Answer from Jason M Matuszak, MD
Member AMSSM

This is a great question and one with increasing importance with the prevalence of 'Boomeritis'.  Synvisc One is a new formulation of a product that has been on the market for several years, Synvisc. It is one of a group of medications that are referred to as viscosupplements. Two other medications in this family include Hyalgan and Euflexxa.

These medications work on the synovial fluid, the fluid that provides the lubrication inside the joint. The current belief is that the synovial fluid becomes much less viscous over the course of time, much like the engine oil in your car. The theory behind viscosupplementations is to increase the viscosity by injecting hyaluronate, the key component of synovial fluid, directly into the joint. The numbers of injections that comprise a treatment vary between products, with the Synvisc One being one injection with three times the standard volume. Traditional Synvisc and Euflexxa are both three injection series.

Viscosupplementation is indicated for patients who do not get enough pain relief from simple analgesics, or from exercise and physical therapy. Because the overall benefit is felt to be by improving the lubrication and cushioning of the knee, there is a strong sentiment, and suggestion by some research, that viscosupplements may not only help pain, but also slow the progression of osteoarthritis.

Studies show that endurance athletes suffer arthritis at similar rates as the general population, although they usually have fewer symptoms associated with it. There are no long-term studies completed that demonstrate the effects of viscosupplementation in endurance training. It is not typically felt that endurance training will be adversely affected. While much is still unknown, it appears unlikely the supplementation will lose effectiveness more quickly in elite endurance athletes.

Given that you already have developed arthritis and had two arthroscopies in the knee, medical evidence would support the use of viscosupplementation. There is a very low risk and a relatively large potential benefit.

As with all medical treatments, always discuss with your provider the potential risks, benefits, and alternative treatments, and have your questions answered. Best of luck in your training.

Jason M Matuszak, MD
AMSSM member
Primary Care Sports Medicine
Chief of Sports Medicine, Excelsior Orthopaedics
Amherst, NY

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date: November 23, 2009