Cortisone shot now how long to wait for PKR or TKR

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dogtracker

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New to the site. Lots of info! Here's the story. Male, 70 yrs old. Had the three lubricating shots for the knee last summer . Worked great but did not last the time it was supposed to. Heed and hawed over surgery and went and saw OS. He gave him cortisone shot and said it would be a month before he could get another set of those lubricating shots and 3 months before they would consider any replacements! Well, cortisone shot has caused more pain even, given a week ago. Pain is in 10 range now - little sleep. He thinks the lubricating shots have actually caused bone growth on his knee! And yes, his knee does have a boney growth at the tender spot and it DOES seem bigger! Here's my questions: Has anyone had the cortisone shots and then went on to a replacement? If so, how long did you have to wait? I'm wondering if it's standard to wait as long as 3 months. Also, wonder if anyone's had a PKR with the new hand held robotics or with the new mini-incisions I've read about. Has anyone experienced any bone growth due to the lubricating type shots for the knee (cannot remember the name of the injections - three of them, once a week for three weeks). Any help or ideas would be appreciated.
 
Welcome @dogtracker! Glad you found us! I had Synvisc and Orthovisc injections (same stuff, different manufacturer if I'm not mistaken) three times in one knee and twice in the other. Each was a series of three, given a week apart. I was lucky, they gave me about two years of relief. I can't say I ever heard of any bony growths due to them, but hopefully someone more knowledgeable than I am about these things will pop in. I didn't have cortisone after that....I found a new surgeon and the X-rays showed both knees to be bone-on-bone. Cortisone won't fix that!


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Never heard of bony growth but know that some surgeons will not do knee replacement within 6 months of the injections due to some concern of infections ...same as far as dental work and waiting period....I know many who have had injections and found that the relief lasts less with additional injections..
 
I know many who have had injections and found that the relief lasts less with additional injections..
How true! The first several series of injections lasted me up to a year at a time decreasing with each series. When my PCP stopped giving them I went to an orthopedic doctor who instead of the series used Synvisc-1, a single injection which didn't last me 6 weeks. Subsequent cortisone injections trying to hold off getting my left knee done while the right one healed didn't last very long either.
 
It's highly unlikely the cortisone shots actually caused the bony growth. More likely it was either already there and he missed it or already developing. And yes, I'm afraid that a 3 month wait between injection and surgery is quite common. Injections carry the risk of infection and I can assure you you DON'T want that in a new knee.

As for the partial vs total, that's an old and long standing debate. Lots of people have partials but lots of people also have to have them converted to a total in 6 months to 6 years. Trouble is, you get 'enthusiasts' of surgeons who just like doing partials and may have a tendency to make the patient fit the criteria rather than vice versa. Not such a good idea I think you'll agree.

So before you rush into having a partial, do make sure you get at least two opinions that say unequivocally that your knee is suitable. This means that the arthritis is confined to only one compartment of your knee and no other. This shows the usual priority of deterioration of compartments though it can vary.

compartments MAKO.jpg


But if there is any hint of disease in either of the other two compartments, you will be very likely to need a conversion to a total within a few months.
 
@dogtracker

i am a veteran of the gel shots and the cortizone. I found, as others have said, that they diminish in effectiveness over time. As for that bony growth, that could be any number of things, most likely due to bone damage in an unhealthy knee. I received a cortizone shot in September and my surgeon made it a point to wait three months before doing my surgery.

good luck and please keep us posted...
 
Hi, I am hoping someone can answer me tonight, (just hoping, I realize that may not happen). I am having a partial knee replacement the last day of March, 2015. My surgeon said you could have a cortisone and lubricant injection a month before this surgery in the surgical knee. Does that sound ok to people or is that cutting it close? Does anyone go into surgery with extra protection for the immune system, like vit c , beta glucan and other supplements? Thanks.
 
@Caulie

I have always heard three months minimum wait time after injection to have replacement surgery. One month doesnt sound right. I will tag @Josephine and @Jamie and see if we can get you some quick answers.
 
Three months is the usual. Mostly to make sure the cortisone is well absorbed by then and to obviate any chance of infection from the injection. I can't see why on earth he would want to inject Synvisc only a month before surgery - that's just asking for trouble as it won't be absorbed even by three months. If it were me, I'd decline both treatments. It's too much of a risk.
 
Thanks for your quick responses. With all the snow, these shots also got delayed. I think now I will forgo the cortisone, but do you think the sy visa ( lubricant ) might help with being able to exercise more before surgery, and less narcotics. I was trying to take less anti inflammatories , as I have term. ( but am also on Prilosec) and do have some break through heartburn. Thanks
 
3 months minimum my OS says 6...why take the chance if you are so close to surgery...the delay for the shots is protection against the risk of infection..

Vinny
 
Welcome to the forum. The gel shots---SynVisc---worked for me all of three days, yet I had to get the entire protocol of three injections in each knee. Cortisone did get me eight months, but the last set of shots were time to wear off right before surgery---three months.
And yes, I'm afraid that a 3 month wait between injection and surgery is quite common.
My Os wanted to time the shots to wear off right before the BTKR---and they did.
 
Has anyone experienced any bone growth due to the lubricating type shots for the knee
Definitely not.
do you think the sy visa ( lubricant ) might help with being able to exercise more before surgery, and less narcotics.
I really wouldn't bother about this. You have only 4 weeks before surgery. I can see no benefit in being so focussed on exercise now but I can see a potential for harm in the form of a pain storm from acutely inflamed bone. Trust me, you do NOT want to experience this.
 
I'd say just give your knee a break from now to the surgery.
 
I agree--relax as much as you can, ice, elevate, rest, and then look forward to be fully recovered with a new knee that will be pain-free.

There come a point in time when you just have to make a slight adjustment---albeit temporary---in your life style to allow the knee to rest prior to the surgery.
 
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