Synvisc-One Injections for Knee

[carlyai]

Last December, went in for a new knee in Australia, and had a Synvisc-One injection instead.

Great result, but the doctor said I may need another 'top up' in 6 months to a year.

I need that 'top up' injection.

Bangkok Pattaya hospital in Pattaya said they haven't heard of them.

Anyone know where I can get this injection in Thailand?

[dddave]

This company is listed as the Thailand importer of Synvisc-one, suggest you contact them.

Berli Jucker Public Company Limited
Berli Jucker House, 99 Soi Rubia
Sukhumvit 42 Road
Phrakanong, Klongtoey
Bangkok 10110, Thailand

(I've deleted the phone numbers per TV posting rules but if you Google Synvisc-thailand you'll get them)

[carlyai]

This company is listed as the Thailand importer of Synvisc-one, suggest you contact them.

Berli Jucker Public Company Limited

Berli Jucker House, 99 Soi Rubia

Sukhumvit 42 Road

Phrakanong, Klongtoey

Bangkok 10110, Thailand

(I've deleted the phone numbers per TV posting rules but if you Google Synvisc-thailand you'll get them)

Dddave thanks for that, but I already found that info.

I was really intererested to see if anyone had been to a hospital to have these injections or had experience in Thailand.

Seems there is a bit of a trick to the injection to get it in the correct place.

The knee specialist I went to in Melbourne did not want my scans, just felt the knee, did some twisting tests and gave me the options of new knee or the injection.

When I said injection, he just did it, not much pain, but I think he really knew what he was doing as he only does knees.

Maybe I should have worded my post differently.

[Sheryl]

Synvisc-one is not available in Thailand yet, only Synvisc. They are the same thing, only difference is that it takes 3 injections (given at same time) with Synvisc.

It is basically just an improved and longer acting form of hypaluronic acid which has been used for years so any ortho specializing in knees should be able to do this provided their hospital stocks the drug.

The best knee specialist in Thailand IMO is Dr. Panya at Bumrungrad https://www.bumrungrad.com/doctors/Panya-Wongpatimachai

Bumrungrad is also a good bet for having Synvisc.

[carlyai]

Synvisc-one is not available in Thailand yet, only Synvisc. They are the same thing, only difference is that it takes 3 injections (given at same time) with Synvisc.

It is basically just an improved and longer acting form of hypaluronic acid which has been used for years so any ortho specializing in knees should be able to do this provided their hospital stocks the drug.

The best knee specialist in Thailand IMO is Dr. Panya at Bumrungrad https://www.bumrungrad.com/doctors/Panya-Wongpatimachai

Bumrungrad is also a good bet for having Synvisc.

Great thanks Sheryl

[DogNo1]

Sheryl: Was that a misspelling? Did you mean hyaluronic acid? I take that orally twice a day and it helps my joints (and skin.)

[rodknock]

if you are getting shots now, just prepare your self down the road for knee replacement.

[carlyai]

if you are getting shots now, just prepare your self down the road for knee replacement.

I previously had a minuscus operation (couple of years ago) and the specialist said then I would need a new knee down the track.

My knee was worse so I booked into the knee specialist last December to see about a knee replacement.

He gave me 3 choices: Do nothing, have a knee replacement or have the Synvisc-one injection, which he said may or may not work but has had 80% success rate.

The injection worked well, and I can get back to walking etc.

So I do need a new knee. He said if the injections work then this would put off the operation, maybe for years.

[Sheryl]

Sheryl: Was that a misspelling? Did you mean hyaluronic acid? I take that orally twice a day and it helps my joints (and skin.)

yes misspelling. HA.

Most of the fillers used to treat deep wrinkles are HA and it has long bern injected into the space around joints to ease arthritis pain. But in ordinary form is short duration. Synvisc lasts longet.

Won't do either of these things if taken orally.

[soinowinbkk]

I have told that Thailand's leading knee specialist is Dr. Aree Tanavalee, who can be seen at St. Louis Hospital, at his knee clinic on Saturday evenings, usually 4 - 7 PM. This changes sometimes and the slots fill up quickly, often more than a week before so call to make appointment.

I heard about him from 2 different sources, one of whom has had knee problems for over 40 years (motorcycle accident in his 20s). I have seen Dr. Aree twice and totally impressed by him -- hands down more knowlegable than other ortho I saw at BNH. And Dr. Aree never operates when it's not needed.

It is my understanding that St. Louis is the only truly non-profit hospital in Thailand (it's a Catholic-run facilitiy). It's located on Sathorn Soi 13 at Surasak (BTS Surasak as well).

[DogNo1]

Thanks Sheryl. I don't have any joints that need Synvisc injections yet. The inflammation and pain at the base of my left thumb and in my right shoulder are well-managed by taking 100 mg of Lyprinol tid. It's expensive and I have to have it shipped from Australia but it works better than Glucosamine for me. There is a variety available in Bangkok - Lifetune Green Lipped Mussel Plus Fish Oil. It's not as effective as Lyprinol since it's green mussel extract powder mixed with fish oil and costs about 900 THB for 45 capsules. The powder is not as potent as the concentrated oil extract used in Lyprinol.

[chubby]

I have had viscosupplementation, these synovial fluid injections, orthopods do them, but there is no "80% success"; in fact, I think the jury is out if the risk of invasiveness/knee infection is worth what data there is on the available injections.

same goes for glucosamine, but ortho doesn't make any money doing procedures for the evidence to support it's use.......

same goes for arthroscopy of knees, and stints for people's hearts, YMMV ; personally did nothing for me, MD out here does Makoplasty, seems like the only thing short of TKR worth trying , depending on your Dx, if it's not just DJD/OA.......

Oral Nonsteroidals, Intra-Articular Corticosteroids Better Comparators

"For clinicians, it is best to look at the comparator of oral nonsteroidals, since to compare against placebo injection essentially eliminates all of the side effects or the potential harms related to the control group," he said. He suggested that using a control group of patients receiving intra-articular corticosteroid injection would also be a reasonable comparator.

According to Dr. Richmond, who led a recent American Academy of Orthopaedic Surgeons workgroup that developed guidelines on treatment of knee OA not related to arthroplasty, the majority of the study's results actually show a clinically relevant benefit, despite what they say.

"I would suggest that the authors have come at this with some bias and are not really involved in the care and treatment of patients," he said. He also added that "the risk of adverse events is always going to be higher if you are performing a treatment versus a totally negative placebo."

Dr. Richmond concluded that the "real question remaining in this topic what is the risk-to-benefit for treatment using intra-articular HA [hyaluronic acid] versus oral nonsteroidals for the patient with osteoarthritis of the knee, who is not yet an appropriate candidate for surgical treatment."

The study was supported by the Arco Foundation. Other than financial support from the Arco Foundation, the study authors have disclosed no relevant financial relationships. Dr. Richmond has disclosed no relevant financial relationships.

Ann Intern Med. Published online June 12, 2012.

Edited August 23, 2015 by chubby

[carlyai]

Just back from the round trip to have the injections with the specialist sheryl recommended.

Had 3 injections as they dont have the single injection here as sheryl mentioned.

Had great success with the first injection and hope so with these.

[dddave]

Just back from the round trip to have the injections with the specialist sheryl recommended.

Had 3 injections as they dont have the single injection here as sheryl mentioned.

Had great success with the first injection and hope so with these.

I, and am sure others would be very interested in reading some follow up reports...maybe after several weeks, several months.

[carlyai]

This injection evidently doesnt work for rveryone.

My first injection 6 months ago took about 3 weeks to really see the difference and before i struggled to do my 5 km morning walk on a fairly flat surface but after the first injection i was walking 10 k up and down good hills and here in patts walking 2 circuits of the pratanac hill fitness park and up and back to the radio station at top of the hill.

For me the injections worked well, but i also take a small 7.5 mg antiinflamtory fish oil and sometimes colos....

Spelling not one of my strengths

[Sheryl]

Its degree of effectiveness depends on the extent of the underlying OA. And of course it will have little or no effectiveness for knee problems of other types.

Most people with OA will have some degree of pain relief and improved mobility with this drug. Its big advantages are (1) it is a natural substance and in itself largely without side effects (some adverse effects possible if incorrectly injected); (2) it can reduce or eliminate use of NSAIDs, which have definite adverse effects especially if taken daily for extended periods; (3) it is safer than steroid injections which have the adverse effect of weakening the joint over time; and (4) it can postpone the need for surgery.

It does not however reverse the actual disease process of OA so many people will eventually still need surgery. However if combined with measured that slow or halt the progression of OA (weight loss and exercise, mainly) the need for surgery may sometimes be averted altogether.

[chubby]

the problem is the efficacy in some thing like this is always nuanced, and may very well, be deprecated in the not so distant futures, but medical standard practice often , if not usually either lags behind the available evidence, or often ignores it, in favor of "doing something" for the patient, in this case, somehow the bar, to get the drug on the market was sufficient, but I'd like to see a RCT that shows any statistical signficance, if there is one ........ for my own sake....