When your 'skiiers knee' is just going all the way... What are the options to help you get back on track?
Here, Dr. Rena Buckstein talks about her personal experience of living with knee pain – and how a family trip to the UK gave her the opportunity to explore a novel new treatment for osteoarthritis which saw her back to ‘peak’ fitness within weeks.
“I’m an avid skier”, begins Rena (58), a Canadian doctor working in the clinical trials sector. “However, my knee has really become my ‘Achilles heel’ over the past few years”.
But whilst she might make light of the increasing levels of pain in her left knee (caused by moderate osteoarthritis and ‘wear and tear’ exacerbated by an incredibly active lifestyle) the situation was no laughing matter and at one point looked set to rob Rena of her beloved sporting pursuits.
Over the past decade, Rena had tried everything – multiple steroid and hyaluronic acid injections, several arthroscopies, even the much-debated treatment, Platelet-Rich Plasma (PRP) - but nothing worked durably, and they did nothing to alleviate pain and reduce the swelling that appeared during and after every ski trip (something Rena and her family are able to enjoy together around two to three times a year). “It’s a huge part of our family lifestyle”, she explains (alongside other activities such as cycling and hiking) – “but it had got to the point where I trained my non-medical husband to drain my knee whilst away on holiday, to ease the accumulation of fluid in the back of my knee.”
“On our last vacation – Christmas 2021 – I was so upset, experiencing real pain while skiing and missing out on days on the slopes. I remember telling my husband in tears that nothing was working, and I had no choice but to give up the sport we all loved doing so much together.
“But it wasn’t just the thought of giving up my favourite sport (even though I found that very depressing) – it was the thought of living with chronic pain."
“Even at its best, my knee was always low grade sore and annoying. I was taking anti-inflammatories at least three times a week, which were taking their toll on my stomach. I said to my older son (who works in the pharmaceutical industry), “I wish I could put a cushioning ‘shock absorber’ into my knee joint.”
He then directed her to Arthrosamid®….
In June 2022, a planned visit to the UK to visit her middle son, provided Rena with the opportunity to book a treatment at the London Orthopaedic Clinic. She’d carried out her own research into Arthrosamid (including its efficacy and safety profile) and had come to the conclusion that this was now the moment to find out if it could also work for her too!
Scans and x-rays had already been sent to Consultant Orthopaedic Surgeon, Mr Mark Webb (who specialises in sports-related injuries)– and so the consultation and procedure was quick, and virtually painless. In fact, Rena continued with her final two days of sight-seeing around the Capital before heading back to Toronto – clocking up to 10kms of walking per day!
The results, in Rena’s words, have been “amazing”. Getting out of bed in the morning had been associated with predictable achiness and stiffness – a feeling which has now almost completely disappeared. And, putting it to the ultimate test, Rena, her husband and a group of friends went on a challenging hiking holiday in the Dolomites just a month after the procedure.
Rena explains:
“There’s absolutely no way – given the gruelling descents over those 5 days – that I would have been able to have taken part in this trip had it not been for Arthrosamid!”
“As a physician who works in clinical trials, I’m a big believer in testing innovative therapies to propel the field forward. The exciting thing is that 5 months from my Arthrosamid injection, I’m still surprised by little moments or movements when I think, ‘hey, that didn’t hurt!’.
“I guess the real test will be when I hit the slopes again later this year on our family ski trip over Christmas. I’m nervous, of course, but also feeling really optimistic that my knee will finally hold up throughout the holiday.
“And, if my right knee ever started to cause me problems, I’d come back to London in a heartbeat to have an Arthrosamid injection on the other side (that is if it’s not available in Toronto by then – which I’m hopeful for!) “But for the time-being, I believe I could well be the first North American to have benefitted from this novel treatment!”
Consultant Orthopaedic Surgeon, Mr Mark Webb concludes:
“Rena is a passionate skier, and her knee was impacting on her ability to do something she loved. However, she was also having trouble with less demanding activities and was looking for something to help keep her active and delay the need for any major surgery, such as a knee replacement.
“Rena had found herself in an unfortunate, but not uncommon position. I see patients every week, unable to perform the activities they’d like to due to the pain and swelling caused by osteoarthritis whether this is going to the shops or long-distance running. People naturally want to remain active and do the things that they enjoy. When people can’t do this, there can be a negative impact on their physical health, mental health and also the health of their joints.
“Arthrosamid offers a treatment option to patients like Rena who want to avoid surgery, including its associated risks and prolonged recovery, with the aim to keep as active as possible.”
Arthrosamid® is a new type of treatment for knee osteoarthritis that offers patients an effective alternative to current therapies1. It is a non-biodegradable hydrogel that is injected into the knee (as a minimally invasive, single injection) to cushion the joint and relieve pain.
Once injected into the intra-articular cavity, Arthrosamid® integrates into the synovial tissue of the inner joint capsule and thickens the synovial membrane2. The non-absorbable, non-biodegradable and non-migratory characteristics of Arthrosamid® provide durable cushioning of the inner capsular tissue4-5, thereby reducing pain, decreasing joint stiffness, and improving function of the knee affected by OA4-5.
Exciting new data presented at the Orthopaedic Research Society International (OARSI) 2022 World Congress, showed that a single injection of Arthrosamid® continued to be well tolerated and demonstrated clinically relevant and statistically significant effectiveness in reducing pain, at 2 years after treatment.3
References:
1. Bliddal H, Overgaard A, Hartkopp A, Beier J, Conaghan PG, et al. (2021) Polyacrylamide Hydrogel Injection for Knee Osteoarthritis: A 6 Months Prospective Study. J Orthop Res Ther 6: 1188.
2. Christensen, L., et al. (2016). “Synovial incorporation of polyacrylamide hydrogel after injection into normal and osteoarthritic animal joints.” Osteoarthritis and cartilage vol.24, 11:1999-2002. doi:10.1016/j.joca.2016.07.007.
3. Bliddal H, A, Beier J, Hartkopp Conaghan PG, et al. (2022) A Prospective study of Polyacrylamide Hydrogel Injection for Knee Osteoarthritis: Results from 2 years after treatment. Poster presented at OARSI 2022.
4 .Henriksen M, Overgaard A, Hartkopp A, Bliddal H. Intra-articular 2.5% polyacrylamide hydrogel for the treatment of knee osteoarthritis: an observational proof-of-concept cohort study. Clin Exp Rheumatol. 2018 Nov-Dec;36(6):1082-1085. Epub 2018 Jul 18. PMID: 30148430.
5. Tnibar A, Schougaard H, Camitz L, Rasmussen J, Koene M, Jahn W, Markussen B. An international multi-centre prospective study on the efficacy of an intraarticular polyacrylamide hydrogel in horses with osteoarthritis: a 24 months follow-up. Acta Vet Scand. 2015 Apr 15;57(1):20. doi: 10.1186/s13028-015-0110-6.
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