Bad knees

[alvertta]

Has anyone had cortisone shots in

Their knees while on prednisone? I am currently on 18mg . GCA. Started at 60 in October 2018. Due for knee replacement in June 2020. Pain in right knee has increased this week.

[Evercurious]

Just read some of the related posts to the right - varied responses to the treatment.

I had an ultrasound guided injection in my knee after a summer of limited range of movement in that knee. Two months of pain relief followed!

Sports doc says I can try again in six months or so.

Good luck, Karen.

[alvertta in reply to Evercurious]

Was able to book last minute appt w sports doctor this afternoon. She will give great advice.

[Pollyanna16]

Yes I have had a couple in a year plus aspiration of fluid & the second time I took care not to overdo things for a few days & it has lasted very well. Also felt a short term boost of energy 😄

[Lochy]

I’ve had three in my left knee as it has been swollen and inflamed. Definitely helped every time but each one has lasted a shorter time period. Give me huge relief though. Not sure what we do now!

I don’t have significant mechanical damage in my knee so no treatment planned.

Frustratingly no one really knows why my knee is inflamed. I’m supposed to have just PMR. Currently tapering from 8 to 7.5 mg. Dx March 2016 and knee a problem for 18 months.

I’d definitely give them a go as worked well for me.

[PMRpro Ambassador in reply to Lochy]

Some surgeons go on the symptoms rather than the imaging - some people can have bone on bone and no pain, others look fine but can barely move.

[alvertta in reply to PMRpro]

Both knees bone on bone. Left knee very happy. Right knee very cranky.

[PMRpro Ambassador in reply to alvertta]

That's a bit unfair in one person!!!!

[alvertta in reply to PMRpro]

I agree.

[alvertta in reply to Lochy]

Seeing sports medicine doctor this afternoon.

[suzy1959]

I have had loads of injection into both knees with very little success except the first one I had which lasted for 6 months. A word of caution: if you are having the op in June, you should check how your surgeon feels about yo having an injection now. They are usually not happy if yo have an injection too close to your operation- I think there are some risk factors involved..

I will be having my second knee replacement in February. I have been in serious pain with this knee for 5 years and no painkillers have worked at all.

[alvertta in reply to suzy1959]

Thanks. I was able to book a last minute appt w my sports medicine doctor this afternoon. She will be able to give me good advice. I saw her after my scope last year.

[Lochy in reply to suzy1959]

Was your knee problem attributed to PMR or something else?

[alvertta in reply to Lochy]

No the knees were bad before GCA. I had a knee scope in June 2018 and developed GCA in October 2018.

[piglette]

I am having PRP injections. I have three altogether and my third one is next week. I cannot tell if it is working yet. They say that it can put off knee replacement by up to 8 years. This nay be fake knews if course.

Platelet Rich Plasma Therapy, also known as PRP Therapy or Autologous Conditioned Plasma, uses your own blood to encourage the production of new collagen and to promote growth factors. It is a growing area in medicine that has been shown to help with a variety of problems. It has been shown to improve the pain associated with arthritis or injuries in the shoulder and knee.

[alvertta in reply to piglette]

Thanks for reminding me about PRP. With GCA I had forgotten about that.

[suzy1959]

I looked into PRP injections but decided my arthritis was too far gone for it to be of benefit. I would be interested to know how you get Ian with it as it is still quite a new treatment and my surgeon doesn’t think much of it!

[Delonghi]

I have Grade 3/4 arthritis in one of my knees. Initially treated with a steroid injection and 5 hyaluronic acid injections. A few months later after major inflammation I had an ultra sound guided steroid injection as well as fluid being drawn off. I was told at the time that I could not have an operation for a replacement knee for at least 3/6 months because of the injection. It seems there is a greater risk of infection. I understand you can have steroid injections whilst taking Prednisolone but I would check on the timescale if you are due a knee replacement in 2020. My knee has not really troubled me in the 14 months since the injection. However, 6 days after the injection I developed severe PMR symptoms in my hip/buttock area and I was eventually given prednisolone. Rightly or wrongly I have always believed that that my knee has stood up so well due to the inflammation reducing effects of Prednisolone but it would not appear that it is helping yourself in the same way. Good luck.

[PMRCanada]

I’ve struggled with my knees since the onset of PMR symptoms in Dec/17 where I felt the most pain and inflammation in the 6 months prior to diagnosis. My GP sent me for MRI of each knee in June/18 and we found out both knees are a mess (every type of meniscal tear between the both, left knee total ACL tear, beginning of OA, and one section of right knee no cartilage.

I’ve seen two ortho surgeons, the first one administered the first Medrol injection in fall/18 in right knee (the worst), and instant relief that lasted 9 weeks. Put on 2 year wait list for total knee replacement as xrays taken one year apart indicated shrinking of space between major bones. Still significant pain when it wore off. Second injection Feb/19, again instant relief for 9 weeks. In fact went on vacation to Miami and walked 20+ blocks per day, swam, danced, etc. Was on 11 and 10mg respectively before injections.

Referred to new ortho surgeon in summer/19 who had shorter wait list (9-12 months). He looked at latest xrays and commented it didn’t look that bad to him, but he would monitor and do it especially if the right knee continued to worsen. He was well aware of PMR and said with pred I would have a higher risk of post operative infection (from 1-2% up to 4-5%). He said we cannot forecast what dose I’ll be at by surgery time, but what I could control was my weight and he encouraged me to try and lose 15 more pounds (I had already lost 30 over the past year and half). He asked a few times if I had noted any difference since losing weight and I honestly replied “no” when it came to knee pain.

He administered another Medrol injection in right knee on Sept 6 after a very active summer when I reported that my right felt better, but still some minor pain. I am now waiting for a call to schedule tkr surgery supposedly some time in Feb/2020.

Now, however, I am noting that I don’t have ANY pain in my knees at all....just the odd ache or pain if I really overdo it. All the other injections only lasted 9 weeks. It’s been over 13 weeks now and still pain free. I will be getting new annual knee xrays in January when I meet with the surgeon again, and will discuss the necessity of a total knee replacement. Perhaps it will get delayed as the deterioration may have declined with my gradual weight loss.

I also had a consultation in Michigan at a clinic that provides stem cell treatment. They did xrays and went over my MRI’s and explained the condition of my knees VERY throughly, mentioning that yes my right knee is “worse”, but no bone-on-bone at this time. Narrowing and other issues that occurred likely from a past skiing injury and from being overweight most of my life. Apparently I’m a great candidate for stem cell treatment....shame I can’t afford it and the financial risk is to high for me to ok the treatment in hopes it MAY work.

I guess I’m saying the following:

1) Medrol injections gave me instant relief that lasted at least 9 weeks after each injection.

2) I was told by both surgeons that steroid injections are limited as in the long term they can advance deterioration of the knee.

3) losing weight and being active really does positively impact knees and knee pain

4) you can have steroid injections in your knee and it doesn’t impact your daily oral dose of pred

5) I’ve been told by both surgeons that they will replace my knee while I’m on (10mg) of pred. They would give a high dose of hydracortisone both before and after the operation to mimic what our bodies do in response to the trauma of surgery.

Hope this all helps! Each of us must make our own decisions regarding our health. Let us know you made out. Good luck and I hope you get some relief from your knee pain as I know, first hand, how debilitating it can be. Our mobility is key, and when it becomes limited our mindset is affected too.

[PMRCanada in reply to PMRCanada]

Oh yes, as mentioned, I was told I could not have a knee injection within 3 months of knee replacement surgery.

Also, none of my injections were guided by ultrasound, all done by both surgeons directly into same area of knee, and no pain receiving the injection.

[alvertta in reply to PMRCanada]

Thanks. I agree. Mobility is key. I am scheduled for right knee replacement in June 2020. Til then I need to be able to move. Going to Asia for the month of April. Walking!! Happy holidays!!

[Roltuba]

I've had 2 corticosteroid injections in my left knee this year, one May, next in August. My gp drew off 28ml first time and 50 ml second time. The symptoms are swelling, pain at the back of the knee and inability to flex it more than about 45 degrees without severe pain. I had my legs xrayed a couple of years ago as part of the sceptical rheumatologist's assessment of my condition. No significant damage found.

The injections and aspiration produced almost instant relief, but it lasts no more than a couple months. I'm due another aspiration and jab (I hope) next week. No body has a clue why this happening. I've been on pred for over 4 years and am currently on 6.5mg reducing very slowly due to too many false dawns. Most of the replies seem to associate the swelling with arthritis but that doesn't apply in my case.

Finally I've been told I can't have more than 3 or 4 injections a year as otherwise the joint will be damaged. I've never expected to have this type of on-going treatment. I've been hoping that the current treatment would do the trick. A year ago my right knee swelled up over a couple of weeks but it got better all by itself. I keep telling it explain to the left one how it did it but so far it's stayed mum!