Hyaluronic Acid Protocol Brings Knee Relief

Navigate pain through GenVisc 850 viscosupplement injections program.

Alan Sherman

A love of music was the inspiration behind Alan Sherman’s 30 years in the retail music business. He owned a thriving full-service store on Long Island until 2011, when he sold the business and left New York’s wintry weather for balmy Florida.

“We lived on Long Island, which is surrounded by water, so I grew up with water,” observes Alan, 55. “When I was 40 years old, I decided I wanted to learn to sail. Once I did, I fell in love with it. We sailed while living in New York, but New York has a thing called winter. We moved so we could enjoy our boat 12 months a year rather than just six.”

Alan has always been an active guy. Unfortunately, some of the vigorous activities he enjoyed took a toll on his body.

“My lifestyle damaged my knees,” Alan reveals. “Moving pianos for 30 years put a strain on them. I bicycled and did martial arts for many years as well. I practiced a style of Korean karate called Kempo Moo Duk Kwan in which you throw 200 kicks a night. It put a lot of pressure on my knees and certainly contributed to the damage.”

A physician in New York diagnosed Alan with osteoarthritis, the degeneration of the cartilage in joints. He also sustained serious damage to the anterior cruciate ligament (ACL) in each knee. The ACL is a major stabilizing ligament. Alan underwent an ACL replacement in his right knee and suffered a severed ACL in his left knee.

“The pain was tremendous,” Alan reports. “It was a constant, aching pain that was an eight or nine on a scale of one to 10 every day. The pain limited my ability to enjoy an active lifestyle. I still had to move pianos because I owned the store, but I had to stop the martial arts and wasn’t able to bicycle anymore. It also hurt to walk.”

Hoping to avoid joint replacement surgery, Alan underwent several arthroscopic procedures to clear out arthritis-related debris from his knees. He also tried physical therapy with little relief.

When he relocated to Florida, he discovered that the solution to his problem lived next door.

“Dr. Brown and I lived in the same building and became friends,” Alan expounds. “At first, she didn’t tell me what she did. Then one day she saw me limping and said, Perhaps I can help you.

Lora L. Brown, MD, is a double board-certified, Cleveland Clinic fellowship-trained interventional pain specialist at TruWell Health in St. Petersburg. For Alan, she suggested TruWell Health’s comprehensive knee program. The goal was to relieve Alan’s knee pain without major surgery.

Supported by Research

“When Mr. Sherman came to us, he was experiencing severe knee pain that impaired his walking,” Dr. Brown recalls. “He was diagnosed with osteoarthritis and wanted to avoid knee replacement surgery.

“Our practice offers a one-of-a-kind program that utilizes all aspects of knee arthritis treatment that has evidence-based research to support it. I recommended that program to Mr. Sherman.”

The first step in TruWell Health’s knee program is a comprehensive physical exam and history. Before any treatment is started, Dr. Brown takes x-rays in the office to evaluate the knee and the status of the arthritis. The doctor then performs an arthrogram, a special x-ray using contrast dye, to determine if the knee joint capsule is intact.

“If the joint capsule is not intact, the program may not benefit the patient,” Dr. Brown discloses. “However, we have other nonsurgical treatments we can try. If the capsule is intact, the patient is a good candidate for the knee program, which includes a series of viscosupplement injections. The viscosupplement is a hyaluronic acid. The one we like is GenVisc® 850.

“GenVisc 850 is a fluid injected into the knees that supplements the joints’ natural fluid. It helps to lubricate and cushion the joint. Research shows GenVisc 850 is effective and has great longevity. It is a synthetic substance; it does not contain any animal products. Because it is synthetic, there is no risk for allergy or adverse reaction.”

“I just received my second shot and I have no pain or discomfort in my knees.” -Alan

When a knee is affected by arthritis, the inside part of the joint typically compresses, causing a loss of joint space, Dr. Brown describes.

“When we perform the injections, we must get into that compressed area because that is where the pathology is,” she explains. “To access that area, we place the patient in an offloading brace, which stretches the knee and opens up the joint space. This step is unique.”

All of the injections performed at TruWell Health are image-guided, using x-ray or ultrasound.

“We never do blind injections,” Dr. Brown stresses. “The clinical data shows blind knee injections miss the spot 30 percent of the time. We always use image guidance so we know exactly where to place the fluid.”

TruWell Health’s comprehensive knee program includes a very specific physical therapy that focuses on eccentric exercises concentrating on the stretch phase of movements, which patients cannot do on their own.

“Our practice has customized exercise machines that perform eccentric strengthening and target the muscles that unload the knee,” Dr. Brown informs. “The machines target the quadriceps, hamstrings, gluteal muscles and the iliopsoas muscle in the hip. They help strengthen the core and hips and offload the knee.”

“No Pain Whatsoever”

Alan completed Dr. Brown’s comprehensive knee program two years ago. He achieved excellent results and was able to avoid knee replacement surgery.

“When Dr. Brown started the injections, I noticed a difference in my knee pain right away,” Alan reports. “In the beginning, I had minimal pain and by the second injection I had absolutely no pain whatsoever. I had no pain for two years.

“Then recently, I started feeling a little discomfort in my knees again, but it’s nowhere near the amount of pain I had before I went through Dr. Brown’s program. This time, my pain only got to a four or five out of 10. I’m getting the injections again now. I just received my second shot and I have no pain or discomfort in my knees.”
Without pain, Alan has been able to resume his active lifestyle.

“I can walk, run, jump, hop, skip. I am able to do whatever I want,” he enthuses. “I walk five to 10 miles a day, I’m riding my bike again, climbing steps comfortably and sailing is a breeze.“

Dr. Brown is brilliant,” Alan raves. “She’s so dedicated to pain management. When I go into TruWell Health, she makes me feel like a million bucks. And her staff is fabulous. Everyone at TruWell Health is wonderful.”

© FHCN article by Patti DiPanfilo. Photo by Jordan Pysz. mkb

 

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    • TruWell Health

      TruWell Health is located in a professional medical building in downtown St. Petersburg. There is free parking and free valet service. Our office is elegant, warm, comfortable and modern, and we utilize the latest technology... Read More

    • Lora L. Brown, MD

      Lora L. Brown, MD, is board-certified by the American Board of Anesthesiology and American Board of Pain Medicine. She is also a fellow of the American Board of Interventional Pain Physicians. Dr. Brown earned her bachelor’s degree cum laude... Read More