Hyaluranic Acid injections - anyone use these?

[EricG]

Looking for input from these that may have gone this route. I’ve met with the orthopedic that brought this up and suggested starting the treatment this fall (October-ish). His only concern was that at my age I would likely be doing these every 3-4 months indefinitely. In talking with our insurance they will only cover the treatment 1x/yr, so I’ll be looking at $3-4K/year out of pocket on treatments. This is a ‘band-aid’ to postpone knee replacement.

I’m very torn on starting this process and looking for input/results from others that may have tried these in the past. Any input is much appreciated.

Thanks

 

[Rod9301]

I do it twice a year for both knees and hips. Works great.

If the insurance doesn't cover it, get the product in Canada or turkey, and your doctor will inject it. It will cost about 200 for 3 injections

 

[rcc55125]

I've done it for a couple of years now. My insurance only covers once per year. However, my doc suggested alternating hyaluronic acid injections with cortisone injection injection every six months. Insurance will cover this. It works OK. The HA takes a little longer to kick in but has been lasting almost six months.
It doesn't fix anything, only reduces the pain. Your knee will continue to deteriorate. When you can't stand the pain any longer it's time for TKR.
However, talk to your doc about pain after TKR. Quite a few people still have pain years after TKR.

 

[Rod9301]

Cortisone shots are evil. They will weaken ligaments and tendons. This is why it's recommended not to have more than 3 in a lifetime.

Ha acts like a lubricant, so it's possible that the joint might last longer.

 

[Jilly]

I had this done about 4 years ago for OA. The choice was Euflexxa. I had to buy the drug as my insurance wouldn't cover it. Think it was $350 for the 3 injections. Did a cortisone shot with the first one. Cortisone covered by OHIP. Then the damn brace....$1800. Insurance paid all but $300.

OHIP nor Empire Life would cover the Euflexxa, but OHIP will cover a knee replacement. So they will cover major surgery, but not a preventative application.

 

[EricG]

I do it twice a year for both knees and hips. Works great.

If the insurance doesn't cover it, get the product in Canada or turkey, and your doctor will inject it. It will cost about 200 for 3 injections

I’m only an hour from Canada, so that might be an option to explore. How many years have you been doing them?

I've done it for a couple of years now. My insurance only covers once per year. However, my doc suggested alternating hyaluronic acid injections with cortisone injection injection every six months. Insurance will cover this. It works OK. The HA takes a little longer to kick in but has been lasting almost six months.
It doesn't fix anything, only reduces the pain. Your knee will continue to deteriorate. When you can't stand the pain any longer it's time for TKR.
However, talk to your doc about pain after TKR. Quite a few people still have pain years after TKR.

I can’t do cortisone anymore. I’ve had way to many and have tons of scare tissue from it. My dr is suggesting the HA as a temp solution till I get older and can’t deal with the pain any longer. He is concerned that if I did a knee replacement now I’ll likely need another one in my 50’s. It’s just setting off a chain of predictable events that are concerning.

I had this done about 4 years ago for OA. The choice was Euflexxa. I had to buy the drug as my insurance wouldn't cover it. Think it was $350 for the 3 injections. Did a cortisone shot with the first one. Cortisone covered by OHIP. Then the damn brace....$1800. Insurance paid all but $300.

OHIP nor Empire Life would cover the Euflexxa, but OHIP will cover a knee replacement. So they will cover major surgery, but not a preventative application.

So odd what these insurance companies will cover & not cover. Did you just order the injection thru the pharmacy (w/ dr’s RX)?

 

[Fishbowl]

Generally speaking, if you qualify for HA injections, you qualify for TKR. So, the question becomes if there is any benefit to putting off the surgery? By this stage, most patients are suffering in pain and have a lack of mobility that affects their quality of life. There is debate about the pros and cons of delaying surgery, but in my experience the vast majority of TKR patients, looking back post surgery, wish they had not waited.

 

[Jilly]

So odd what these insurance companies will cover & not cover. Did you just order the injection thru the pharmacy (w/ dr’s RX)?

OHIP is the provincial plan. Empire Life is the company benefit plan. Ordered through local pharmacy through doctor's scrip. Had to keep it in the fridge. Injections over 5 weeks I think. I'm pretty sure it wasn't every week. Yet OHIP covered the doctor's visit and the cortisone. Now maybe it was the name of the drug and some other similar would have been covered.

Oh, I tell you where the injection was made. Scar tissue has formed a lump at that spot on the outside of the knee.

 

[rcc55125]

If your talking about needing another knee replacement in your 50's if you do it now that means your 40-ish. Knee replacements last approximately 15 years depending on how hard you use them. Since your on a ski blog I assume you want to keep skiing, something dr's don't typically recommend after TKR.
Since your close to Canada there may be another option, stem cell therapy. Insurance won't cover the cost. In the US it will be about $8000, no idea of what the cost would be in Canada. There are two methods, both use your own stem cells. One uses stem cells taken from bone marrow in the pelvis. The other uses stem cells taken from fat tissue around the abdomen. This second method requires a Plastic Surgeon because it uses lipo suction to harvest the stem cells. A lot of Plastics guys have gotten in on the "regenerative medicine" market. Knees are a speciality. Hyaluronic acid and stem cells mix so both can be used simultaneously. Platelet Rich Plasma (PRP) may also be used with the stem cells. Again your own plasma. So, they're putting your own stuff back into your body.
I had it done in 2012 and it gave me 5 good years. I had trouble walking up and down stairs and had swelling every day I skied. Even now I can do stairs no problem and skiing is not an issue, no swelling. However, the pain is getting harder to control and I can't afford another stem cell treatment unless insurance will cover it. Interestingly, there are a couple of Orthopedic clinics in this area that now do stem cell therapy for knees so some of the cost may now be covered.
If I do a TKR it should last the rest of my life because I'm 72. But, I'm not willing to give up my factory parts unless it's absolutely necessary.
Do some more research. Find an Orthopedic doc that does stem cell therapy and talk to them. It usually doesn't cost to talk. See if theres a Regenerative Medicine clinic in the town close to you in Canada. If it's cost effective it might be worth a try. The good thing about stem cell thera

 

[EricG]

@rcc55125 - You are right, I just hit the 40's and thus the discussion around using HA for a while vs TKR. I asked my ortho about stem cells and other similar alternatives, He Is not part of any research. but gave me the name of another dr that is involved in arena. But I have not called or made an appointment yet as he is not covered under our insurance and the consult etc would be all outa pocket. I just need to keep exploring and reading so I better understand.

 

[Rod9301]

I’m only an hour from Canada, so that might be an option to explore. How many years have you been doing them?



I can’t do cortisone anymore. I’ve had way to many and have tons of scare tissue from it. My dr is suggesting the HA as a temp solution till I get older and can’t deal with the pain any longer. He is concerned that if I did a knee replacement now I’ll likely need another one in my 50’s. It’s just setting off a chain of predictable events that are concerning.



So odd what these insurance companies will cover & not cover. Did you just order the injection thru the pharmacy (w/ dr’s RX)?

I've been doing ha injections for at least 10 years.

 

[Jerez]

My cousin has done the HA injections for over 10 years now too. He's now in his 60's. He is a daily runner and a skier.

Do some careful research on stem cell if you decide to explore that route. The evidence is scanty and there are some really scandalous (literally) players out there.

One thing to consider re TKR is how good the tissues are and if further deterioration could make the surgery less successful. I have no knowledge about this except that my husband had a shoulder surgery and had put it off for a long time with pain injections. By the time he had it, the surgeon said that the tissues he had to attach were like lace and that if he'd done it sooner, he might have had a better outcome. That said, he has been fine with it for 15 years, so YMMV.

 

[EricG]

made an appointment today fir the end of September with a ortho that is part of an office that does some cell stem research. Looking forward to hearing what they have to say, unfortunately they are out-of-network.

 

[Asnis]

I had this done about 4 years ago for OA. The choice was Euflexxa. I had to buy the drug as my insurance wouldn't cover it. Think it was $350 for the 3 injections. Did a cortisone shot with the first one. Cortisone covered by OHIP. Then the damn brace....$1800. Insurance paid all but $300.

OHIP nor Empire Life would cover the Euflexxa, but OHIP will cover a knee replacement. So they will cover major surgery, but not a preventative application.

Insurance doesn’t cover it because it hasn’t been shown to be better than placebo in double blind studies

 

[HardDaysNight]

Insurance doesn’t cover it because it hasn’t been shown to be better than placebo in double blind studies

True. One of the features of OA that confounds people is that it naturally waxes and wanes considerably over time. If a period of relief coincides with a visit to the chiropractor or starting a quack remedy, the sufferer concludes that the treatment works.

 

[EricG]

Insurance doesn’t cover it because it hasn’t been shown to be better than placebo in double blind studies

True. One of the features of OA that confounds people is that it naturally waxes and wanes considerably over time. If a period of relief coincides with a visit to the chiropractor or starting a quack remedy, the sufferer concludes that the treatment works.

Really? The research I’ve read seems to indicate it really depends on the severity of the degeneration. Some folks respond better to weekly injections and some are ok with monthly/quarterly. The research also showed that some folks didn’t see any measurable result to 5 or greater subsequent injections. I’m not patient enough to wait for 5 or more injections, but I still haven’t committed to this HA therapy. I’m waiting for my rescheduled appointment with the dr that is delving into stem cell research before I made a choice.