Total Knee Replacement and Hyaluronic Acid Shot experiences?

TripleB

Hall of Fame
Went to the doc yesterday to get the results of an MRI on my right knee.

Turns out I have no cartilage left in there, I have arthritis in the knee, and my meniscus is torn in two places.

At age 54 the doc says he can give me a hyaluronic acid shot (if my insurance approves it), he put me on Celebrex, and said when I can't put up with the pain any longer he'll perform a total knee replacement.

So I'd like to hear any experiences you've had with either the hyaluronic acid shot, total knee replacement, or both. Positives, negatives, results, would you do it again, do you wish you'd have done it earlier, how bad is PT after TKR, etc?

Some background info: had microfracture surgery on the other knee 10 years ago because it didn't have any cartilage in it and it's been great...doc told me then to never play tennis again, that lasted 6 months, been playing ever since with no problems; had a DVT blood clot 3 years ago, don't know what caused it, ran from mid thigh to mid calf, on Xarelto for 8 months to get rid of it...so that's a bit of concern any time I have surgery

Thanks for any and all input!

TripleB
 

Injured Again

Hall of Fame
Hey @TripleB Best of luck to you!

One of my hitting buddies had a total knee last August. Today, he's on court and moving around no worse than he was last August, which admittedly wasn't great, but his other knee is also worn out. He's 60 but was a professional cyclist in his younger days, and both skis and plays a lot of tennis. He did not walk normally for three or four months after surgery and was barely on the court doing mini-tennis at four months. He does say he doesn't have the kind of pain he did have before so that's a win.

I think I've had a meniscus problem for the last two or so years. I've had soreness on the inside of my left knee that entire time but it never affected me until last August when my wife and I went to Colorado and did a ton of hiking, including the summits of Evans and Pikes Peak. I came back with a pronounced click with every step. In December, it had progressed to the point where I saw an orthopedist who took x-rays. I have between grade III and IV osteoarthritis in both knees, and he prescribed PT to try and get my knees tracking better.

I then played terrible in an age group tournament in January and ramped up my training. By March, my knee was hurting to the point where I couldn't walk normally. I went to a high performance athletic PT and while performing a step-up, slightly lost my balance and acutely injured that left knee. I've been basically unable to play normally for about three weeks now, unable to walk normally since the injury, have an MRI for next Monday, and will schedule a surgical repair for what is undoubtedly a meniscus issue as soon as possible after that. The symptoms are what I've had for the last couple of years, only greatly magnified and with the feeling there's something loose inside the knee. So I've probably had a meniscus issue this entire time and never had it diagnosed correctly.

Some things I've learned. First, many people who present with x-ray indications of no cartilage remaining in their knees are still highly functional. Before one of my PT appointments, the therapist asked if I noticed the guy before me. He was in his 60's and very trim and fit looking. He was diagnosed with grade IV osteoarthritis and his x-rays looked typical of someone who imminently needed both knees replaced. Yet, he only complains when he ramps up his running mileage to more than 30 miles a week.

Second, before I acutely injured my knee, I was scheduled for a series of Euflexxa injections, which is the hyaluronic solution. My orthopedist says that it works best in those who have knees that are not totally worn and in those cases can extend the time before knee replacement out from a few to several years.

Third, from another tennis buddy who had two total knees. The first one went fairly smoothly as far as recovery for tennis, but the second one, even though the surgical recovery was better, degraded tennis movement more. I guess even with a less painful total knee replacement, the ability to push off just isn't there.

Good luck to you, and to both of us!
 

socallefty

G.O.A.T.
Surgery is always a risk for infections and it might work well or not. HA shots are easy to try and should be considered before surgery. I know many people including myself who felt that HA shots worked for 1-2 years in terms of reducing knee soreness after active sports and we are all over the age of 50.
 

S&V-not_dead_yet

Talk Tennis Guru
Went to the doc yesterday to get the results of an MRI on my right knee.

Turns out I have no cartilage left in there, I have arthritis in the knee, and my meniscus is torn in two places.

At age 54 the doc says he can give me a hyaluronic acid shot (if my insurance approves it), he put me on Celebrex, and said when I can't put up with the pain any longer he'll perform a total knee replacement.

So I'd like to hear any experiences you've had with either the hyaluronic acid shot, total knee replacement, or both. Positives, negatives, results, would you do it again, do you wish you'd have done it earlier, how bad is PT after TKR, etc?

Some background info: had microfracture surgery on the other knee 10 years ago because it didn't have any cartilage in it and it's been great...doc told me then to never play tennis again, that lasted 6 months, been playing ever since with no problems; had a DVT blood clot 3 years ago, don't know what caused it, ran from mid thigh to mid calf, on Xarelto for 8 months to get rid of it...so that's a bit of concern any time I have surgery

Thanks for any and all input!

TripleB

Two tennis buddies > 60 get periodic HA injections and both report good effects although varying duration.
 

Fintft

G.O.A.T.
Hey @TripleB Best of luck to you!

One of my hitting buddies had a total knee last August. Today, he's on court and moving around no worse than he was last August, which admittedly wasn't great, but his other knee is also worn out. He's 60 but was a professional cyclist in his younger days, and both skis and plays a lot of tennis. He did not walk normally for three or four months after surgery and was barely on the court doing mini-tennis at four months. He does say he doesn't have the kind of pain he did have before so that's a win.

I think I've had a meniscus problem for the last two or so years. I've had soreness on the inside of my left knee that entire time but it never affected me until last August when my wife and I went to Colorado and did a ton of hiking, including the summits of Evans and Pikes Peak. I came back with a pronounced click with every step. In December, it had progressed to the point where I saw an orthopedist who took x-rays. I have between grade III and IV osteoarthritis in both knees, and he prescribed PT to try and get my knees tracking better.

I then played terrible in an age group tournament in January and ramped up my training. By March, my knee was hurting to the point where I couldn't walk normally. I went to a high performance athletic PT and while performing a step-up, slightly lost my balance and acutely injured that left knee. I've been basically unable to play normally for about three weeks now, unable to walk normally since the injury, have an MRI for next Monday, and will schedule a surgical repair for what is undoubtedly a meniscus issue as soon as possible after that. The symptoms are what I've had for the last couple of years, only greatly magnified and with the feeling there's something loose inside the knee. So I've probably had a meniscus issue this entire time and never had it diagnosed correctly.

Some things I've learned. First, many people who present with x-ray indications of no cartilage remaining in their knees are still highly functional. Before one of my PT appointments, the therapist asked if I noticed the guy before me. He was in his 60's and very trim and fit looking. He was diagnosed with grade IV osteoarthritis and his x-rays looked typical of someone who imminently needed both knees replaced. Yet, he only complains when he ramps up his running mileage to more than 30 miles a week.

Second, before I acutely injured my knee, I was scheduled for a series of Euflexxa injections, which is the hyaluronic solution. My orthopedist says that it works best in those who have knees that are not totally worn and in those cases can extend the time before knee replacement out from a few to several years.

Third, from another tennis buddy who had two total knees. The first one went fairly smoothly as far as recovery for tennis, but the second one, even though the surgical recovery was better, degraded tennis movement more. I guess even with a less painful total knee replacement, the ability to push off just isn't there.

Good luck to you, and to both of us!
Have you tried glucosamine for your meniscus?
I had one popping back in/healing in a couple of weeks and so did a younger coach.
 

Fintft

G.O.A.T.
Surgery is always a risk for infections and it might work well or not. HA shots are easy to try and should be considered before surgery. I know many people including myself who felt that HA shots worked for 1-2 years in terms of reducing knee soreness after active sports and we are all over the age of 50.
The middle-aged patient and meniscus surgery – surgeons cannot predict which patients will benefit and who will not benefit from meniscus surgery. Flipping a coin would work just as well.
A March 2020 study in the British Journal of Sports Medicine (10) questioned whether experienced orthopedic surgeons could predict who would benefit from surgery for degenerative meniscus tears and who would not.

The researchers set up an experiment. Surgeons participating in this study were given 20 cases to examine. In each case, the surgeon was asked to predict the outcome of treatment for meniscal tears by arthroscopic partial meniscectomy and exercise therapy in middle-aged patients. The surgeons were also asked to predict the beneficial change in knee function in those patients they would recommend to surgery and those patients they would send to physical therapy or an exercise program.

The surgeons combined to examine and predict outcomes in 3880 knees. The results?

  • Overall, 50.0% of the predictions turned out to be correct, the surgeons were able to predict 50% of the time which treatment would be of most benefit before treatment. The researchers of this study however noted – 50% correct would be no better than flipping a coin as it equals the proportion expected by chance.
  • Experienced knee surgeons were not better at predicting outcomes than other orthopaedic surgeons.
  • Conclusions: Surgeons’ criteria for deciding that surgery was indicated did not pass the statistical examination. This was true regardless of a surgeon’s experience. These results suggest that non-surgical management is appropriate as first-line therapy in middle-aged patients with symptomatic non-obstructive meniscal tears.
 

GeoffHYL

Professional
My 65 year old tennis buddy just had his second TKR done a few months ago. The first one was last summer. His movement was pretty limited before the first TKR, much improved afterwards, but limited by the second bad knee. Recovery time was about 4-5 months for the first TKR. He's still in recovery from the second TKR. He did a lot of pre and post surgery PT, almost every day, and it was painful, but worth it in his opinion.
 

socallefty

G.O.A.T.
The middle-aged patient and meniscus surgery – surgeons cannot predict which patients will benefit and who will not benefit from meniscus surgery. Flipping a coin would work just as well.
Had meniscus surgery three years ago and was part of the 50% of patients for whom it had no impact. HA acid shots worked better for me therapeutically for almost two years.
 

Injured Again

Hall of Fame
Have you tried glucosamine for your meniscus?
I had one popping back in/healing in a couple of weeks and so did a younger coach.

I've been taking glucosamine for the better part of a couple of decades. I started having knee problems in my early 40's and I turn 61 this year.

I think it works. At worse, it doesn't do anything and taking it hasn't impacted my health otherwise.
 

Fintft

G.O.A.T.
I've been taking glucosamine for the better part of a couple of decades. I started having knee problems in my early 40's and I turn 61 this year.

I think it works. At worse, it doesn't do anything and taking it hasn't impacted my health otherwise.
There are rumors though about gaining weight, similar to insuline effects.
 

Injured Again

Hall of Fame
This coming Friday will be four weeks since my acute injury to my medial knee. I could barely walk for the first week, and the second week was walking with a hobble. This third week has seen some pretty quick progression and I'm able to move at maybe 50-60% of my normal level. I can walk normally and only have a sensation of tightness but no pain in my medial knee. I'm able to squat, do leg extensions, and hamstring curls with no pain and so I've been at the gym practically every day doing resistance training.

Though I have excellent insurance, there's been a holdup in getting the Euflexxa authorized. They apparently need me to have had no benefit from oral or topical NSAIDs, or from a corticosteroid shot. The corticosteroid shot would have included two weeks of very limited exercise afterwards, something which I wasn't willing to do, and also comes with a risk of degenerating what little cartilage and meniscus I already have, something I didn't think was worthwhile to do. The topical (Voltaren) was ineffective and the oral NSAID (naproxen) was only partly effective.

There is an age group tournament at the end of this month that I'd like to play, and then immediately after that my wife and I are heading to the east coast to do what was to be a lot of hiking. I'm working my butt off to try and get to the point where I can do both of these things. If desire and hard work were enough, I'd get there but I'm afraid my body won't cooperate.
 

Injured Again

Hall of Fame
There are rumors though about gaining weight, similar to insuline effects.

I haven't had that - not that I haven't gained weight but I know why it is that I have gained weight, and I've also substantially dropped weight while taking it. As far as insulin kind of effects, my A1C and blood glucose levels are well within normal limits so fingers crossed that those markers will stay there!
 

mmk

Hall of Fame
My wife had no cartilage and tried hyaluronic acid, and as predicted by her ortho it didn't help - you really need some cartilage for synvisc/omnivisc/etc. to work. She has since had both knees replaced and revised, where a revision is basically replacing parts from the original replacement. She's also had her right hip replaced (at 36) and revised (at 44) and both shoulders replaced.
 

Bambooman

Hall of Fame
My wife had no cartilage and tried hyaluronic acid, and as predicted by her ortho it didn't help - you really need some cartilage for synvisc/omnivisc/etc. to work. She has since had both knees replaced and revised, where a revision is basically replacing parts from the original replacement. She's also had her right hip replaced (at 36) and revised (at 44) and both shoulders replaced.
What is the reason for so many joints failing at a young age? That seems excessive.
 

mmk

Hall of Fame
What is the reason for so many joints failing at a young age? That seems excessive.
Legg Calve Perthes disease caused her right hip to go bad starting when she was about 12, and her parents sent her to a quack who x-rayed her left hip instead, over her protestations, and told them it was all in her head. Compensating for her right hip over the years led to the other joints going bad.
The hip revision surgery was required due to the plastic interface having been irradiated to sterilize it, but that caused the plastic to disintegrate, and the plastic particles ate away at her pelvis, which cracked and needed freeze-dried bone material packed into it to provide enough bone to do the revision. She gets Prolia treatments to get her bone density up. I'm not clear on what caused the issues with the knee replacements, although getting the right sized parts for the knees contributed.
She's also been told she's eligible for ankle replacement, but she won't do that. Her left hip may need to be replaced in the next few years, but hip replacement surgery is a lot more advanced than it was in 1994 when she had her right hip done the first time.
 

socallefty

G.O.A.T.
Though I have excellent insurance, there's been a holdup in getting the Euflexxa authorized.
My doctor warned me that my insurance wouldn’t pay for HA shot and so, I didn’t bother trying to get them to approve it.

I got a single injection shot (Durolane) and it cost less than $300. I feel like it helped me for about 2 years during which I played tennis 8-9 times a week and so, it was worth it. After two years, I am starting to get slight soreness again in my knees still playing at the same rate. I have very little cartilage left too and had a meniscus arthroscopic surgery three years ago which didn’t help much.
 

Fintft

G.O.A.T.
My doctor warned me that my insurance wouldn’t pay for HA shot and so, I didn’t bother trying to get them to approve it.

I got a single injection shot (Durolane) and it cost less than $300. I feel like it helped me for about 2 years during which I played tennis 8-9 times a week and so, it was worth it. After two years, I am starting to get slight soreness again in my knees still playing at the same rate. I have very little cartilage left too and had a meniscus arthroscopic surgery three years ago which didn’t help much.
I forgot, are you playing on clay year around?
Since I've switched my indoor seasons from hc to red clay about 5 years didn't have a single injury (not to jynx myself).
I also replace shoes often and the stock insoles with gel ones with plastic reinforcement in the arch (Dr Scholl's active).
 

socallefty

G.O.A.T.
I forgot, are you playing on clay year around?
Since I've switched my indoor seasons from hc to red clay about 5 years didn't have a single injury (not to jynx myself).
I also replace shoes often and the stock insoles with gel ones with plastic reinforcement in the arch (Dr Scholl's active).
Hard courts in California.
 

Bambooman

Hall of Fame
Legg Calve Perthes disease caused her right hip to go bad starting when she was about 12, and her parents sent her to a quack who x-rayed her left hip instead, over her protestations, and told them it was all in her head. Compensating for her right hip over the years led to the other joints going bad.
The hip revision surgery was required due to the plastic interface having been irradiated to sterilize it, but that caused the plastic to disintegrate, and the plastic particles ate away at her pelvis, which cracked and needed freeze-dried bone material packed into it to provide enough bone to do the revision. She gets Prolia treatments to get her bone density up. I'm not clear on what caused the issues with the knee replacements, although getting the right sized parts for the knees contributed.
She's also been told she's eligible for ankle replacement, but she won't do that. Her left hip may need to be replaced in the next few years, but hip replacement surgery is a lot more advanced than it was in 1994 when she had her right hip done the first time.
Wow. I also had that as a child and refused to wear the Forrest Gump style braces.
I took me years to walk and run properly but I've been generally OK since.
Oddly the part of the world where I was born has one of the higher if not the highest incidences of that disease.
Makes me wonder if Murray's hips and knee disorder have a similar cause, whatever that is.
 

Injured Again

Hall of Fame
My doctor warned me that my insurance wouldn’t pay for HA shot and so, I didn’t bother trying to get them to approve it.

I got a single injection shot (Durolane) and it cost less than $300. I feel like it helped me for about 2 years during which I played tennis 8-9 times a week and so, it was worth it. After two years, I am starting to get slight soreness again in my knees still playing at the same rate. I have very little cartilage left too and had a meniscus arthroscopic surgery three years ago which didn’t help much.

My insurance just requires that two out of the three precursor treatments fail to provide relief and we've met that threshold so the authorization should be forthcoming. But my injury seems to be getting better quite rapidly. I guess it's from a lifetime of always being injured and always needing to heal up something or another. Went for a five mile, mostly flat hike today and only had mild post-exercise soreness in my medial knee.

A couple of my tennis friends recommended an orthopedic surgeon who did several of the joint replacements for players at our club. I'll wait out this week to see where I am and then may go see that guy.

My ortho didn't recommend the single shot HA. He says that most people who benefit get much greater relief from a three shot regimen. I'm glad it worked for you and hopefully if you get another one, it'll give you another two years of relief.
 

mctennis

Legend
I saw the OP statement. I did not read any of the replies so here is my answer. I have been using HA injections since 2004. My physician uses Euflexxa , synthetic HA not made from chickens as most are. I had been getting injections one a year until my knees started aching more then I went to twice a year HA injections ( 6 months apart). My insurance company pays for an injection twice a year. It helps a lot and keeps the pain away. My xrays say I have bone to bone or near bone to bone ( depending on what angle the xrays are taken). My physician says professional athletes use the HA injections a lot more often ( of course they can afford to pay for the HA shots and their jobs depend on them being able to preform). So I would try the injections first. My physician holds off doing any knee/ joint replacements until the pain and movement is really effected.
 

TripleB

Hall of Fame
I appreciate all of the input and experiences you all have shared!!!

Update: 3.5 weeks ago I received my hyaluronic acid injection in my right knee for no cartilage, arthritis, and meniscus torn in two places. No help at all for the first two weeks, then had one day with no pain, then three days with pain again, and then pain free for the last 6 days. Went to the courts today and played a little less than 2 hours. Right now absolutely no pain! Supposed to go back to the doctor the first week in June and discuss how the HA injection has worked out.

TripleB
 

mctennis

Legend
I appreciate all of the input and experiences you all have shared!!!

Update: 3.5 weeks ago I received my hyaluronic acid injection in my right knee for no cartilage, arthritis, and meniscus torn in two places. No help at all for the first two weeks, then had one day with no pain, then three days with pain again, and then pain free for the last 6 days. Went to the courts today and played a little less than 2 hours. Right now absolutely no pain! Supposed to go back to the doctor the first week in June and discuss how the HA injection has worked out.

TripleB
Did you have the three shot series for your HA injections or just one injection?
 

LOBALOT

Hall of Fame
Does anyone have any thing that actually works for knee pain other than Naproxen 500mg which doesn't seem to help me much?

I am experience arthritic knee pain in both knees and was just wondering what your experiences are with the best remedies, ointments, CBD, or what-have-you that actually works.

Haven't really found anything that touches the pain and I go through cycles of play, pain, take a day or two off and feel better, play, pain, take a day or two off, etc.
 

socallefty

G.O.A.T.
Does anyone have any thing that actually works for knee pain other than Naproxen 500mg which doesn't seem to help me much?

I am experience arthritic knee pain in both knees and was just wondering what your experiences are with the best remedies, ointments, CBD, or what-have-you that actually works.

Haven't really found anything that touches the pain and I go through cycles of play, pain, take a day or two off and feel better, play, pain, take a day or two off, etc.
I take one Advil before tennis and play every day on hard courts. I took a HA shot in early 2020 which helped for maybe about 18 months to reduce soreness. For some reason, I’m less sore when I play tennis daily than when I have to take a break for a few days due to travel or other reasons. Once in a while, I’ll also use IcyHot spray if the soreness is more than usual before I play.
 

LOBALOT

Hall of Fame
I take one Advil before tennis and play every day on hard courts. I took a HA shot in early 2020 which helped for maybe about 18 months to reduce soreness. For some reason, I’m less sore when I play tennis daily than when I have to take a break for a few days due to travel or other reasons. Once in a while, I’ll also use IcyHot spray if the soreness is more than usual before I play.

Thank you. I am taking Naproxin (basically Advil) before (and after) with minimal relief. I did get feedback that I should play more to help. I am currently playing for 2 hours Sunday, Monday, Wednesday, and Friday. I will give Icy Hot a shot thanks.
 

socallefty

G.O.A.T.
Thank you. I am taking Naproxin (basically Advil) before (and after) with minimal relief. I did get feedback that I should play more to help. I am currently playing for 2 hours Sunday, Monday, Wednesday, and Friday. I will give Icy Hot a shot thanks.
Advil is Ibuprofen and Naproxin is a different drug - Ibuprofen is better for the stomach if you use it chronically. I don’t know if you tried a HA shot as I didn’t reread the old posts, but it is worth trying. 1-shot Durolane cost me only about $250 in 2020.
 

LOBALOT

Hall of Fame
Advil is Ibuprofen and Naproxin is a different drug - Ibuprofen is better for the stomach if you use it chronically. I don’t know if you tried a HA shot as I didn’t reread the old posts, but it is worth trying. 1-shot Durolane cost me only about $250 in 2020.

I wasn't aware they were different and just googled and you are correct they said they are similar but not the same. I didn't know that. The web site I went to said Naproxin lasts longer but as you indicate there are stomach issues. I have not tried the HA I will look into that. Thanks
 

mctennis

Legend
I wasn't aware they were different and just googled and you are correct they said they are similar but not the same. I didn't know that. The web site I went to said Naproxin lasts longer but as you indicate there are stomach issues. I have not tried the HA I will look into that. Thanks
You probably will need the HA injections to get relief.
 

Injured Again

Hall of Fame
Does anyone have any thing that actually works for knee pain other than Naproxen 500mg which doesn't seem to help me much?

I am experience arthritic knee pain in both knees and was just wondering what your experiences are with the best remedies, ointments, CBD, or what-have-you that actually works.

Haven't really found anything that touches the pain and I go through cycles of play, pain, take a day or two off and feel better, play, pain, take a day or two off, etc.

Naproxen works well for me. If I take one 220 mg tablet at night, the next morning my knee feels almost totally normal. Unfortunately, taking it day after day gives me pretty significant constipation. And while I don't have any gastric effects, my mom was given a dose of Naproxen once and almost died from vast amount of GI bleeding that it caused.

Physical therapy seems to be most effective for those who have some biomechanical deficiency or muscular imbalance that can be corrected. Tennis players tend to overdevelop and have overly tight muscles that drive the side-to-side motion and that can cause patella tracking issues. While my wife doesn't play a lot of tennis, this was also her problem, but some physical therapy corrected both issues and she recovered from moderate knee pain to having no knee pain and full functionality even during six+ hour hiking days. It's always worth a try to see if a physical therapy sees in your gait or through functional strength testing that can help.

I had an HA injection in my knee in September and didn't notice a lot of immediate benefit from it, but that was only four weeks after the second identical acute injury to it (a full thickness, non displaced tear of the medial meniscus) so it was healing all the time. I'll be getting another HA injection in probably early March and will have a better idea then if it works or not. My insurance required me to go through a series of progressively more intrusive therapies prior to authorizing a knee replacement: OTC NSAIDs, PT, cortisone injection, and then HA injection. Cortisone injections are coming under increasing scrutiny and there are increasing more peer reviewed medical research articles showing that cortisone causes greater degradation of the knee joint than other therapies.

Good luck!
 

Injured Again

Hall of Fame
Thought this was the most appropriate place to post this. Over the past two months or so (the holidays), I've been indulging in the celebrations probably a bit too much. The result was about five pounds that I put on. But what I noticed over the past weeks has been that I really haven't felt as good overall, and I had periods of knee stiffness and achiness that seemed to have increased. I had quite a few pretty uncomfortable days on court, not only in the knees but in most every joint.

My wife is a firm believer in anti-inflammatory diets. Her main comment to me was that I seemed to be eating more surgary things. My kids filled my stocking with those dastardly Lindor chocolate balls and I've been eating enough of those to become diabetic. Some of that was probably depression from missing a one of the few age group tournaments in our area due to injury, and what was worse was that tournament was at my club. Anyhow, a week or so ago, I got back on the wagon. I cut out the sweets (well, they're mostly gone anyway) and started back on my regular, fairly strict diet. Darned if now, several days later, and I'm feeling kind of back to my normal self. Just everything feels better.

So in my case, it really does seem to be sugary, refined sweets that make my body ache more than it should. That sucks big time but feeling good doing physical things really does make up for it.
 

Injured Again

Hall of Fame
I'm now two days short of 28 weeks since my second meniscus tear. I had a couple of week vacation in Florida where all we did was walk and I worked out in the gym almost every day. Without playing tennis, I found that my knees actually became more stiff and uncomfortable during normal activity. But they did have two weeks of "downtime" and since returning last Friday, I've been on court almost every day.

I've gained a few pounds over the last couple of months, and went through a period where my entire body just didn't feel good. Now with the longer days, that seems to help my mentality and I seem to have fully recovered from feeling just generally yucky about a month ago. The two weeks of rest and gym rehab also let my shoulder heal up and I can serve again with no pain. Also after coming back and doing a lot more stationary bike riding and heavier leg resistance training, the knees feel really good on court. As an example, just today I played a guy who has a winning record at 40+ 4.5 singles. I was up 6-1 5-3 and serving for the match when I ran out of gas. I lost that second set 7-5 and made a huge effort in the ten-point tiebreak, going up 9-4 before getting wobbly-kneed and LOSING 12-10. Ouch. But I was able to run for dropshots, get into and out of deep corners, and plant and twist without any bad sensations. Only when I plant and then have to lunge do I feel anything, and the times I do get a twinge, it's gone within 20-30 seconds.

I'm going to start the process to get a second hyaluronic acid shot in my left knee. My first shot was early September and so I'm hoping to get my second shot in March. I'm considering those shots as help prevent further deterioration more than providing relief of symptoms. I've also continued taking the Vital Proteins collagen. I can't be absolutely sure how much it helps, if any, but I am absolutely not going to jinx the recovery I have had since I started it.

If I can get my knee feeling as good when I'm not exercising as it does just doing my everyday living, I will have considered this a full recovery. I still am a little hesitant to go 100% on the tennis court but going 90% feels comfortable and the knee never feels like it is at risk of reinjury. I feel confident enough to have scheduled a couple of long hikes with my son for this coming year, doing Half-Dome at Yosemite (16 miles, 4000 feet elevation gain) in June, and then the Enchantments (21 miles, 5000 feet elevation gain) in July.

The very best to those struggling with knee/joint issues. Keep working at it!
 

SteveI

Legend
I'm now two days short of 28 weeks since my second meniscus tear. I had a couple of week vacation in Florida where all we did was walk and I worked out in the gym almost every day. Without playing tennis, I found that my knees actually became more stiff and uncomfortable during normal activity. But they did have two weeks of "downtime" and since returning last Friday, I've been on court almost every day.

I've gained a few pounds over the last couple of months, and went through a period where my entire body just didn't feel good. Now with the longer days, that seems to help my mentality and I seem to have fully recovered from feeling just generally yucky about a month ago. The two weeks of rest and gym rehab also let my shoulder heal up and I can serve again with no pain. Also after coming back and doing a lot more stationary bike riding and heavier leg resistance training, the knees feel really good on court. As an example, just today I played a guy who has a winning record at 40+ 4.5 singles. I was up 6-1 5-3 and serving for the match when I ran out of gas. I lost that second set 7-5 and made a huge effort in the ten-point tiebreak, going up 9-4 before getting wobbly-kneed and LOSING 12-10. Ouch. But I was able to run for dropshots, get into and out of deep corners, and plant and twist without any bad sensations. Only when I plant and then have to lunge do I feel anything, and the times I do get a twinge, it's gone within 20-30 seconds.

I'm going to start the process to get a second hyaluronic acid shot in my left knee. My first shot was early September and so I'm hoping to get my second shot in March. I'm considering those shots as help prevent further deterioration more than providing relief of symptoms. I've also continued taking the Vital Proteins collagen. I can't be absolutely sure how much it helps, if any, but I am absolutely not going to jinx the recovery I have had since I started it.

If I can get my knee feeling as good when I'm not exercising as it does just doing my everyday living, I will have considered this a full recovery. I still am a little hesitant to go 100% on the tennis court but going 90% feels comfortable and the knee never feels like it is at risk of reinjury. I feel confident enough to have scheduled a couple of long hikes with my son for this coming year, doing Half-Dome at Yosemite (16 miles, 4000 feet elevation gain) in June, and then the Enchantments (21 miles, 5000 feet elevation gain) in July.

The very best to those struggling with knee/joint issues. Keep working at it!

Welcome back!!

Thanks for the posts regarding your recovery. One note and question. Vital Proteins collagen comes in two versions, one with HA and a basis one. Can you share which version you are using? The version with HA is more expensive of course. Keep up the work. I am 6 weeks into my PT knees recovery. 2x a week.. at clinic.

Be well,,, keep hitting.
 

Injured Again

Hall of Fame
Welcome back!!

Thanks for the posts regarding your recovery. One note and question. Vital Proteins collagen comes in two versions, one with HA and a basis one. Can you share which version you are using? The version with HA is more expensive of course. Keep up the work. I am 6 weeks into my PT knees recovery. 2x a week.. at clinic.

Be well,,, keep hitting.

I'm taking the basic version that just contains the collagen and no HA. Costco just had a sale on it so I've stocked up!

I was in Florida for a couple of weeks of vacation with no tennis and really no strenuous activity. My knees got worse by the day, so that they were pretty stiff and sometimes painful just walking around. Once I got back and hit the gym and the court, the stiffness went away pretty much right away. This last week, I've had a few days where the knee feels totally normal. I've also had a few tennis sessions where even on off-balanced, twisting movements, I don't even twinge the knee.

Unfortunately, I've gained a few pounds over the last couple of months so I'm on a plan now to lose about 12 pounds by the summer - lowering my weight can't help but improve my knee comfort further. I've also just visited my ortho and will be getting HA shots at six month intervals in both knees - the left one to continue the healing process from the meniscus tears and the right one as a preventative against further wear.

Best of luck with your PT - I hope now that it's been a few weeks that it's feeling much better! The days are getting longer and pretty soon we'll be playing tennis outside again!
 

Injured Again

Hall of Fame
I'm about six months and three weeks past my hyaluronic acid shot in my left knee. Over time, my left knee has continued to heal. It almost never feels like I'm going to re-tear my meniscus, and especially over the past month, the stiffness and soreness from daily activities has decreased further.

Unfortunately, I'm now experiencing a lot more discomfort when on the court. I'm moving worse than a month ago, and it hurts whenever I increase my stride length. It's not the meniscus - it feels like pain from the worn out spots in my knee.

I'm in the insurance process for authorizing another shot - hopefully that will happen in the next week or so.

I'm about to get a full month off from tennis. My wife and I will be traveling all of May and I'll be lucky to get in a couple of hits, though if I do it will be on red clay.

Hope everyone is well!
 

mctennis

Legend
I'm about six months and three weeks past my hyaluronic acid shot in my left knee. Over time, my left knee has continued to heal. It almost never feels like I'm going to re-tear my meniscus, and especially over the past month, the stiffness and soreness from daily activities has decreased further.

Unfortunately, I'm now experiencing a lot more discomfort when on the court. I'm moving worse than a month ago, and it hurts whenever I increase my stride length. It's not the meniscus - it feels like pain from the worn out spots in my knee.

I'm in the insurance process for authorizing another shot - hopefully that will happen in the next week or so.

I'm about to get a full month off from tennis. My wife and I will be traveling all of May and I'll be lucky to get in a couple of hits, though if I do it will be on red clay.

Hope everyone is well!
I just had my series of three HA shots in my knees. It really helps me with everyday living. It was very painful a few weeks before the HA shots. I would not have been able to play any tennis before these shots. They have been life savers for me.
 

Injured Again

Hall of Fame
So now, for whatever reason, my insurance is balking at increasing the frequency of the HA shots to more than once per year. My insurance has no problems with authorizing an MRI, and I can even self-refer to physical therapy at any point. But they have so far refused to cover the shot at six month intervals.

I'll probably pay out of pocket this one time just to get it done, at $1k per shot. We're leaving in less than four weeks for a month-long trip where we will be walking all day and climbing up and down lots of steps so I need to be as pain free as possible.

Best of luck to all of you out there.
 

socallefty

G.O.A.T.
I'll probably pay out of pocket this one time just to get it done, at $1k per shot.
I paid only $250 in 2020 for a Durolane HA shot and that needs only one injection. My insurance would not cover it then for knees. Has the price of HA shots gone up so much? Have you tried a 2nd opinion from other doctors on how much it costs?
 

mctennis

Legend
So now, for whatever reason, my insurance is balking at increasing the frequency of the HA shots to more than once per year. My insurance has no problems with authorizing an MRI, and I can even self-refer to physical therapy at any point. But they have so far refused to cover the shot at six month intervals.

I'll probably pay out of pocket this one time just to get it done, at $1k per shot. We're leaving in less than four weeks for a month-long trip where we will be walking all day and climbing up and down lots of steps so I need to be as pain free as possible.

Best of luck to all of you out there.
Is it $1k per shot series. Normally , with my physician, it is a series of three HA shots. One shot per week for three weeks. Is that $1k for one knee or for both knees? I had to pay out of pocket one year. With me doing that they gave me a discount. I know there are different types of HA injectable they are using. Do you know what injectable they are using in your knees?
I wish you luck and have a great vacation.
 

TripleB

Hall of Fame
It's been exactly one year since this post so I thought I'd give you and update.

I'm having total knee replacement surgery on my right knee on May 1st. The shots just don't work any longer and I can't sleep at night because of the pain. The pain during the day is one thing, but I can't survive on no sleep. So while I wish I could wait until I'm a bit older than 55, it's just time to have this problem taken care of so I can try and get back to pain free living.

Doc is supposed to be one of the best in the state...using robot assisted surgery. Only hiccup is I had a DVT blood clot for nine months back in 2019/2020 and had to be be on blood thinners during that time...so now I have to be on them for two weeks after surgery. From what I've read, because of this, there will be more swelling, more pain, and a longer recovery time.

Again, just wanted to give an update since it's been exactly a year.

TripleB
 

Injured Again

Hall of Fame
An update on my HA shot adventure. First, let me say that I'm not sure how the average person is expected to be able to navigate through the health care process and be a good advocate for themselves. We know the health care system because my sister and niece are doctors, we have a couple of nurses in the family, I cared for my mom for the eleven years she battled Parkinsons, and my wife is the primary care provider for my 99 year old mother-in-law. Even with all that, I had to work hard to figure out why my HA shot was denied.

I have retiree medical and I'm 62. I've got a great health care plan where I can self-refer to physical therapy at any time, and getting something like an MRI just requires a doctor's say-so. So it was mystifying why my ortho's request for coverage for an HA shot would be denied. It turns out after being on the phone for a couple of hours, that there are THREE ways to pursue an authorization for something like the HA shot: through the specialty pharmacy, through the medical side of our health insurance coverage, and through the facility side of our health insurance coverage. Apparently, the medical side sets the guidelines for how often specialty medications can be dispensed, so when a request goes through the specialty pharmacy, they will deny the request if it doesn't meet those timelines. So what needs to happen is the ortho's office needs to send the request through to the medical side of the insurance coverage.

I had to get the ortho's billing person on the line with both a representative of the pharmacy and the medical side of the insurance coverage to get everyone on the same page. I think it's going to be handled now in the correct way. Now the problem is that it has taken so long I'm running into a huge time crunch, in that I need this shot so I can comfortably go on vacation for a month starting in less than four weeks. The authorization through the medical side will take at least two weeks, and then the pharmacy must procure and send the HA shot to my ortho, who then has to schedule it with me. That isn't going to happen in time so I'll pay for the shot out of pocket and bill after the fact, hoping that it will get covered. If not, oh well... My ortho carries Gel-1, which is right about $1k per shot.

Best of luck to all of you, and hopefully there's some nugget of help in what I went through in case you also are having the same problem with getting insurance authorization.
 

mctennis

Legend
The key to this is, like you found out, it to get the physician office involved with the insurance person that has felt with your particular insurance before. Even year to year can be a PITA. I have different insurance than my wife. She wanted to try a policy that was less expensive per month. With hers the "specialty pharmacy" had to call her to get her approval to send the HA injectable to the physician's office even though the physician's office is the one that ordered it with the pre- approval of the insurance company. The " speciality pharmacy" had to call her , it has been over a month and they still not have called her for the approval. She calls them and the " speciality pharmacy" will check the physician's oder and get back to her. I have already had my three injections done a few weeks ago. The physician's office has told us since the insurance company has switched to this " speciality pharmacy" the call to the patient is taking longer and longer to get the call and then get the HA injectables to the office. You just have to stay diligent and make the calls over and over and over again. Frustrating since you are trying to get out of pain and need the injectables. It is not like you are asking for pain meds.
 

atatu

Legend
It's been exactly one year since this post so I thought I'd give you and update.

I'm having total knee replacement surgery on my right knee on May 1st. The shots just don't work any longer and I can't sleep at night because of the pain. The pain during the day is one thing, but I can't survive on no sleep. So while I wish I could wait until I'm a bit older than 55, it's just time to have this problem taken care of so I can try and get back to pain free living.

Doc is supposed to be one of the best in the state...using robot assisted surgery. Only hiccup is I had a DVT blood clot for nine months back in 2019/2020 and had to be be on blood thinners during that time...so now I have to be on them for two weeks after surgery. From what I've read, because of this, there will be more swelling, more pain, and a longer recovery time.

Again, just wanted to give an update since it's been exactly a year.

TripleB
Good luck and keep us updated on the recovery process.
 

Injured Again

Hall of Fame
Hello all. Hope you are all doing well.

I haven't been on here in several weeks. I had HA shots in each knee just before going to Italy for a month and in all the walking and climbing stairs with 100 pounds of luggage in hand, I had minimal symptoms. I came back really hopeful that the HA shots would help my mobility around the court.

That wasn't the case. The twisting and bending are the main pain producers and those issues have only minimally decreased. I still can't run and I only have about three steps of faster mobility in any direction. The knee stiffness is returning slowly so I'm pretty sure the effects of the HA shots won't last until my next injections at the six month mark in October. My right knee is now starting to experience the same kind of pain as my left knee.

The bad thing is I'm hitting the ball as well as any time in the last several years. I do have some days when the knees are fairly decent and on one of those, I beat an age group player in the 55's with a UTR of 12.xx and he was trying. I'm rallying weekly now with guys my age who were division 1 standouts in their day and holding my own.

But I have too many bad days when getting out of a chair is painful, and getting out of a car after driving for a couple of hours seems almost impossible. I have plans this year to do the iconic hike in our state with my son in about four weeks. It's 20 miles with 4800 feet of elevation gain and 7000 feet of descent. From a fitness aspect I could do it but my knees can't seem to tolerate more than about 12 miles and almost lock up on long downhill stretches.

So I have an appointment with my surgeon in about three weeks. I think the plan now is to do a total left knee replacement in October, and my right knee in about February 2024. That will give me time to fully rehab and take on the 65's in 2026.

It's pretty disappointing. I had such high hopes because I felt so good in Italy but walking comfort doesn't translate into court capability. I think my other worry is that whatever the reason for my good timing at this moment, that it will be gone after I get the knees done and get back on court. I really do wonder if I'll ever be able to hit again like I am doing now. I'll be another year older by the time I should be fully healed.

The best to all of you and hope you're all healthy and enjoying life!
 

mctennis

Legend
It's been exactly one year since this post so I thought I'd give you and update.

I'm having total knee replacement surgery on my right knee on May 1st. The shots just don't work any longer and I can't sleep at night because of the pain. The pain during the day is one thing, but I can't survive on no sleep. So while I wish I could wait until I'm a bit older than 55, it's just time to have this problem taken care of so I can try and get back to pain free living.

Doc is supposed to be one of the best in the state...using robot assisted surgery. Only hiccup is I had a DVT blood clot for nine months back in 2019/2020 and had to be be on blood thinners during that time...so now I have to be on them for two weeks after surgery. From what I've read, because of this, there will be more swelling, more pain, and a longer recovery time.

Again, just wanted to give an update since it's been exactly a year.

TripleB
Please let is know how the knee replacement surgery went. I hate to say it but sooner than later I a going to need a knee replacement. I hope everything went well and that you are recovery is also going well.
 
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