good news for patients with arthritic anklesPosted by Ed Davis, DPM on 5/09/05 at 22:20 (174622)
Good news for patients with arthritic ankles
Posted by Ed Davis, DPM on 5/09/05 at 22:14 View Thread
Paitent with arthritic knees have had, for some time, the otion of injections with sodium hyaluronate (Synvisc or Hyalgan) which is basically a synthetic joint fluid. For some reason, when the effect of the hydraulic pressure created by the injection wears off, the body is somehow stimulated to create nw joint fluid on its own. this has been a means of stalling or preventing knee joint replacement surgery for years.
Several years ago, a group of podiatrists including myself started injecting Hyalgan into arthritic ankles as an off label treatment. The dilemna was that since the Hyalgan was 'off label' no insurance company would pay for it. Patients had to pay out of pocket for the injection. It involved a series of 3 injections of 20 mg. of Hyalgan, one per week for 3 weeks per ankle. The results have been excellent. John Marty, DPM of Pittsburgh, PA is in the process of writing up a research project for this in order to try to get FDA approval.
The good news is that a third player has just entered the market, Supartz brand sodium hyaluronate, manufacutred by Smith and Nephew and presumably equal in chemical composition to Hyalgan. Supartz is considerably less expensive than Hyalgan which is less expensive than Synviisc.
The introduction of Supartz should make treatment of arthritic ankles more available to patients and offer good relief and as probable surgery prevention in mamy cases. This took a bit of investigating because Smith and Nephew cannot detail Supartz for ankles due to FDA restrictions.
Re: good news for patients with arthritic anklesEd Davis, DPM on 5/09/05 at 22:47 (174624)
See http://www.supartz.com for some relevant information.
Re: good news for patients with arthritic anklesJohn H on 5/10/05 at 10:43 (174645)
Ed: A close fried of mine has two bad arthritic knees from sports injuries. He has a series of the shots into the knees once a year and says it does wonders for him. I think he has a series of 5 shots but I may be wrong on that. He says sometime the effects of the shots last almost a year but as you note he is probably looking at a knee replacement someday. I am almost sure it is the synthetic fluid you mention.
Re: good news for patients with arthritic anklesEd Davis, DPM on 5/10/05 at 15:28 (174653)
It may be 5 of hyalgan or 3 of synvisc.
Re: good news for patients with arthritic anklesKathy G on 5/10/05 at 19:56 (174666)
So far, the arthritis in my ankles is minor but I am definitely going to make a note about this, Ed. I wonder if they can use it in the CMC joint of hands? I have decided against the surgery for now. I need to find a surgeon who will discuss other options with me. I left a message to see if one of the surgeons I saw would call me to discuss options and via his secretary he said he would do only the type of surgery he discussed with me. He never gave me a chance to air my concerns about how the surgery on the left hand would impact the OA in the right hand. Surgeons don't get the reputation of suffering from a God complex without reason!
What I'm hoping is that it will just abate for a while and maybe they will come up with something similar to what you're talking about, only for the hands.
Thanks for the information!
Re: good news for patients with arthritic anklesEd Davis, DPM on 5/11/05 at 12:27 (174711)
It has the potential to work in any joint with osteoarthritis but is 'off label' if not used in the knee.
Re: good news for patients with arthritic anklesDr. Z on 5/13/05 at 15:56 (174947)
I will have alot of information about this drug this week. I will be trying this out in the next few weeks. Will keep you updated. I am excited