TMBRA - Rider Board

[speedyd10]

I am 52 year old weekend warrior that has put my joints thru lots of misery,Marathons,triatholons,multiple miles of biking over the last 30 years.I have had one knee scoped and cleaned out twice.I stopped running 5 years ago and am suffering no signifigant pain but do have a lot of crepitis just walking around.My question is should I consider hyurlonic acid injections to prevent additional damage to my joint or should I wait until my symptoms become more severe. My artho dr. says to wait but it seems to me that the additional cushioning would be a good preventative measure.What are your thoughts please.

[The Bike Doc]

speedyd10:

There is a nice review of hyaluronic acid injections for chronic osteoarthritis that is summarized at this link http://www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD005321/frame.html . The studies that have been done to date have shown patient and physican report of improved arthritis symptoms after injections, however, the studies were designed to show short term benefits (up to 12 months). There are no studies that have been published to date that were designed to show long term benefits in reduction in osteoarthritis symptoms and improvement in function. Thus your orthopedic doctor nor I can give you the answer of whether or not getting repeated injects of hyaluraonic acid will prevent long term joint deterioration or are there significant long term side effects.

There have been several studies some short term some longer term (3 years) show benefit of glucosamine and/or chondroitin supplimentation reducing osteoarthritis symptoms: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12374520&query_hl=14
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15134386&query_hl=18
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15134386&query_hl=18

Visit further with your orthopedic doctor and discuss options of hyaluronic acid injections versus glucosamine and/or chondroitin supplimentation to help with your osteoarthritis.

Thanks.
_________________
Paul K. Nolan, MD
AKA: The Bike Doc