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Hip Injection? Cortisone Injection? (Page 4)

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November 28th, 2010
hip dysplasia
hi surrey sue, i have just found out i too have hip dysplasia and am still a little in shock....oone min i'm having an ray just to check it out and then a consultant is saying words like bilateral hip relacement and hip resurfacing operations!" how long have you known about your condition as i am finding it all hard to take in would enjoy having someone to talk to!
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replied January 2nd, 2011
I had a steriod hip injection last monday and feel so much better. Will go back to walking on a tread mill next week. The injection was a no big deal to me and im happy I got it.
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replied July 4th, 2011
I'm wondering about the tread mill. I understand getting some exercise but my pain doctor told me to take it easy. Don't overdo it and don't do anything stupid that would stress the joint. My interpretation is to walk as needed but NOT to exercise and consequently irritate the bad joint. I am getting around great but very careful not to make it mad again. Curious if any others had their pain docs tell them to exercise to that degree.
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replied January 17th, 2011
Hip pain
I had a steroid hip injection on friday its now monday and im in so much pain after it!!! The injection was very painfull i just hope it will start to work soon
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replied January 18th, 2011
i am one of those silly people who read the horror stories before the procedure. i have to go at 10am in 2days for my hip injection with ultra sound. I did ask my surgeon whether it hurts and he said its pretty painful. I have cysts on my cartlege, ligamentum teres tear and a hole in the hip. ive been in constant pain for nearly a year and hope that this will help. I am a little scared but surely it cant be any worse than the constant pain and stiffness and lack of sleep. I will post my thoughts after i get it done Smile
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replied January 27th, 2011
OK. So not only did it NOT WORK!!! it has made my pain a lot worse! how? i have no idea as i have to now wait 4frikkin months to get an appointment for my surgeon guy!!! 4 whole months!! maybe i am a percent of the popularity it doesnt work on, but the needle itself didnt hurt so much. They did it with a cat scan. The cortisone and local anisthetic were in the one needle. They didnt numb the area either. i was fine to walk but i felt like i had a big marble in where the needle went..... So i do not recommend it at all
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replied February 1st, 2011
Hi,
What a great place to know that I'm not alone. I am 57 and I too am bone on bone (right hip). My hip was destroyed from arthritis. Have always been a runner and very active on my feet. I just had a hip injection 3 weeks ago. It was absolutely excruciating. I think people should be put under for at least 15 minutes. I almost fainted. Anyway, the block has stopped working!! My hip, pelvis, thigh and leg are, once again, so painful that I cannot walk. Need your opinion about another injection. Perhaps the first one wasn't enough cortisone? I just dread getting another but I am trying to avoid a replacement.
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replied February 8th, 2011
Hip displasia, bursitis, cortisone injection
I'm 35yrs old and was born with hip displasia, found at birth and corrected with years of leg braces, physical therapy and corrective shoes. However, over the last 10yrs or so I've started having significant pain in my left hip. Been to several Drs, had x-rays, MRI's, MRI w/ contrast (ouch). All for them to tell me it's nothing. One Orthopedic did say it was likely bursitis and sent me to physical therapy which left me in agonizing pain and tears after each session. He then said he could give me a shot of cortisone and lidocane directly into the hip joint. Normally done under x-ray guidance, he is highly skilled and was able to just do it in his office. The injection itself is somewhat painful but so very worth it!!! The first couple days after I hurt worse than ever, but after that, complete relief!!! That relief lasted over a year for me. Went for a second shot and had the exact same result, a couple days of worse pain, and then complete relief for over a year. After both shots I was able to walk out of the office and drive home with no issues. The couple days of additonal pain were well worth it. After more than a year, I'm now in pain again, unable to sleep, having trouble with steps, etc. and hoping for a 3rd shot. Hope my experience is helpful to others.
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replied May 11th, 2011
Cortisone in hip
Thanks so much for this post. I had a cortisone shot in my right hip joint yesterday and last night was in more pain than ever. I was freaking out. Today I feel a little better. Hopefully I will have the same results you experienced. Of course, yesterday I also had an MRI with contrast and a CT scan. It was a very long day.
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replied March 27th, 2011
Cortisone shot in hip
Hi,
so glad I found this site. I fell in work over six months ago and been having pain in my groin since. I've been to PT for the last 3 months and finally got an arthrogram (dye injected into hip followed by MRI) It showed I had a labral tear and osteoarthrois in the hip. I just went to a new ortho. surgeon and he wants me to get a cortisone shot in hip. Beside it being really painful, I have concerns getting it. I had really bad reactions to presedonine (sorry about the spelling) they had to take me off of them immediately (bad heart palpations and hives) in additon i suffer from really high blood pressure. Does anyone know if the cortisone shot would be safe for me. I'm 44 yrs. I would prefer just getting the scope on the hip, my dr. specializes in this, but he acted like the shot was my only choice for now, and If i don't do it, I'm afraid because I am on workers comp. Sorry this is so long, would like any advice. Thank you
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replied March 27th, 2011
Especially eHealthy
chickie,

A labral tear in the hip is a separation (or degenerative tear) of a cartilage ring that goes around the outside of the hip socket (acetabulum) to make it deeper. You also have some degeneration in the hip, which is called arthrosis (arthritis, by true definition, has an inflammatory component, and most wear and tear degeneration doesn't, so arthritis is not actually correct). Cortisone is a very powerful medicine. It was used a lot in the past (30 years or so, and was used in everyone). Now, it is still used, but not usually in young people who have normal cartilage. Once you start to get degeneration of the cartilage, then it is safer to use. If you are diabetic, you may notice a temporary small spike in your sugars.

If the injection works, you can get months to years of relief, with minimal risk. If the labral tear needs to be addressed, be sure the surgeon checks for femoralacetabular impingement (FAI). This disorder is a fairly new one, just being described about 5 years ago. If you have that, it can often be treated with a hip arthroscopy.

Once the cartilage degeneration has reached a certain point, and if you have pain that impacts your daily activities significantly, then other surgeries, such as a total hip replacement (THR) may be done. However, a THR is a major decision and a major operation. Once done, you cannot go back. If you participate in high impact activities like sports or heavy manual labor, then total joint replacements are counteraindicated (unless you are willing to curtail those activities significantly - Remember Bo Jackson, the football/baseball player). It takes a very concerted effort in post-op rehab. Also, look at the recent DePuy total hip recall. Overall, THR's are a very good operation when done for the right reasons and in the right patient.

But, as for the cortisone, yes, it had some problems in the past when it was used willy-nilly and in everyone, but when done in a properly selected patient, it is very safe.

Discuss your concerns with your surgeon. Ask what other options you have, even though the surgeon said the injection was your only one, there are always other things that can be done. Ask about the labral tear, what is going to be done about it? The cortisone shot may make the hip feel better, but it won't fix the tear.

Good luck.
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replied May 2nd, 2011
Hip problems
Idon't know if you have had the hip replacement yet but my personal experience with a hip replacement is I would not recommend one unless you have a great doctor. I went to one who put in the wrong size replacement had it redone and lost so much bone that I fractured my hip and dislocated it while in the hospital and no I did not fall. I now have had another replacement. I had a total of three replacements all in one year. Now my right hip is hurting. I have torn the labrum, osteoarthritis and I have AVN (avascular necrosis) in my right hip. My first hip injection I came off of the table it was on the outside of the hip in the bursa. That did not work so now they are going in deeper which will be in the groin. Just make sure you have a doctor that know what he is doing if you get a hip replacement.
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replied July 4th, 2011
Hip replacement
Sorry to hear you've had such bad results. I've been diagnosed with needing a hip replacement and have studied the different methods and also talked to several doctors. I am not surprised (sad to say) that you found a quack. I've read the bits about too long, too short, hammering in the metal shaft and splitting the femur, etc. The last doctor I saw said my bones were very good, strong and healthy and he does another version of the Birmingham Resurfacing BUT he stressed that many times he goes in wanting to do a resurfacing but finds he can't and does a total hip replacement. I DON'T want a total hip replacement because of all the things that can go wrong. I see no reason to cut the femur off if it's not bad. I mentioned this to a friend that he was leaning toward a total and she commented that they probably made a lot more money doing a total! BINGO!

I have been talking to a good friend who is a nurse in San Antonio and works in a surgical hospital. She has recommended a couple doctors who she says seem to do the best work. I went to one of their websites and he mentions the one that is in essence the Birmingham and talks about how much better it is and the fact that it leaves bone mass intact. I will be making an appointment with him in the next few weeks.

I note also the pain and issues that some of you have had with shots. I went to a pain doctor in San Antonio on June 7, 2011 and he gave me a shot with the help of an x-ray. I was given an IV and partially knocked out for the procedure. I did feel the pinch he said I would when he inserted the needle. After that I felt NOTHING! No pain, no side effects, nothing. After the sedative had worn off, (20 minutes max) we were out of there. I've been walking as pain free since then as I have in over 2 years. He is going back in on July 15th with a combo of drugs that he hopes will hold me over for several months. I do take one Celebrex in the morning and if I really do a lot during the day I can feel a little soreness in the hip joint. That evening I take 2 200mg ibuprofen and that is is. He was up front when we first talked that different people do have different results. He said some have lasted as little as 3 days, others can get a month or two, sometimes even longer. I knew this guy was good from what he did for my mother a couple years ago but in all honesty I wasn't expecting this good a result. I feel like a big black pain cloud was lifted off of me. Obviously won't be forever but am ever so thankful that at least for a while I can do some things.

I will continue to visit doctors until I find the one that I trust to do the right thing and that doesn't necessarily mean putting the biggest lump of $$$ in his pocket at my expense! I want to be able to do things and not be a walking vegetable. I drive tractors, trucks, 4 wheelers, etc. I work in my shop, build things, etc. Before I give up my life I'll live off of pain pills and let it be. I don't want to do that but there are a lot of idiot doctors out there who can make you a lot worse off than you were when you went in to see them!

Good luck everybody. I hope my July 15th shot has the results he's hoping for. There is no reason to have these shots and be hurt from getting them.
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replied July 4th, 2011
Failed to mention that the doctors have said I am not only bone on bone in the right hip but also that the femur head has already worn down from what it's supposed to be. They do all agree that a hip repair is going to be needed and is not an option.

Also found that the Birmingham Resurfacing is purely the name of the system made by the Smith and Nephew company. My 2nd doctor had essentially the exact thing in his office and said that they were made by another company. The parts he had even looked like the Birmingham parts!

As for another horror story I talked to a guy the other day that had his hip replaced in December. He had now finally gotten off his cane and was still limping. He had a list of no-nos a mile long of things he could never do again. He had evidently gone through h*ll and then some. Yet he thought his doctor was the best! He said the doctor had cut almost every one of his leg muscles and that they had to heal back together. Ironically I asked the 2nd doctor about cutting muscles and he said that he cuts 2/3s of them. The one I haven't seen says on his website that he moves most of them out of the way and cuts 3! I will verify that when I go see him. The less healing we have to go through the quicker we'll bounce back and the stronger we'll be down the road. I don't care how good muscles heal back, why cut them if you can work around them?

Lots of butchers out there and they all have diplomas and certificates on their walls. They are glorified car mechanics working on 'us'. I will keep looking until I find the one that I feel will do it right and then hope for the best.
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replied May 13th, 2011
Hi, First I want to thank everyone for all the great info and sharing their experiences.

This morning I had the cortisone shot to the hip joint via the groin area. I haven't had this much relief from pain in a long while and I know that the linocane sp?/numbing meds have worn off. This was my first shot in the hip. I'll need a replacement at some point as it is bone on bone. Prior to the appt, I think I read all four pages here.lol and it helped a lot in understanding what was going to happen.

If you do not mind needles and are not afraid of the stinging sensation of novacain (which I'm not) the rest of the proceedure is quick and is more of a very strange feeling of uncomfortable pressure rather than pain. Also, I thought that the groin area would be more sensative to a needle than the shoulder or mouth, but it isn't. least not to me.

It was done with xray and floroscopy. I know that I had a really good doctor. I told him I have constant leg muscle spasms that sometimes contract painfully so he told me to let him know if it happens during the procedure. Well, the needle went in (little ouch) then came the linocain (another ouch)and then while he was delivering the cortisone, my thigh started to spasm and then contract with pain. I let him know, he said hold on a sec, delivered the meds and got the needle out in time for me to move my thigh around before a major charlie horse occured. The spasms are a separate issue for me and not because of the hip injection. I was so scared of a major charlie horse onset and so grateful he was able to get that needle out in time, that any pain I did feel was minimal.

He said I would be sore tomorrow but I don't think so.
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replied May 21st, 2011
Hip injections, verbose
I'm 41 years old, squatted (weights) way more than I should have for ~20 years and feel that I'm now paying the price. I have had diagnosed moderate+ osteoarthritis in my left hip for...probably 3.5 years, and I estimate I had pain for at least a year before going to an ortho. and getting diagnosed. I had the cortisone injection done today, and thought I'd put the experience up here for those who were interested...also I put in a bit about the MRI "with contrast" below as the procedure is very similar and may be useful for comparison to those who have had that and want a pain comparison if they're thinking of getting the cortisone injection. I'll also post a follow-up in a few weeks if I can remember to do so (regarding the efficacy of the shot). I like to be precise, so this post will be long...sorry in advance!

As I mentioned, during the initial diagnosis 3.5 years ago I had an MRI "with contrast" (dye injected into hip) done, which I recall was injected on the groin side of the "crown" of my leg (top of quadriceps muscles). The anesthesia shot was done some time (5 minutes? 10?) before the big needle went in (VERY slowly and methodically...creepy with some pressure, but not painful) and the dye was injected. There was a substantial amount of dye injected into the joint - I heard my hip *pop* in addition to the expected sensation of fullness in the joint, and I could not flex my hip at all when walking from the injection table to the MRI machine. By the time I left an hour later, I was able to walk somewhat normally but my hip felt very stiff and full of fluid, and did not feel normal for more than a day. However, I experienced no real pain post-procedure...and I would rate the pain of the procedure as maybe a 3 (out of 10), from what I recall.

I was then prescribed Meloxicam (Mobic) which worked wonders at the time - for nearly three years I felt nearly no pain. Unfortunately, for the past 6 months or so the pain has gradually returned, and after going in again my arthritis was now classified by my DR as being at a "hip replacement level." (As an aside, I go to the Rothman institute, which their commercials tell me is one of the top-rated ortho centers in the US...for what that's worth.) After some begrudging discussion on my DR's part (I'm not a fan of brusque MDs who sidestep pertinent questions related to major medical procedures), he agreed that a cortisone shot might be of short-term value instead of just lopping off bones right away.

Keep in mind that the cortisone injection requires that you take *NO* NSAIDs for five days prior to the procedure, so I was in worse shape than normal (pain-wise) prior to the injection being done. You also can't eat/drink for 5 hours before, which I think is mostly to make the janitor's cleanup easier if the patient pukes at the sight of the needle. In my case, the entire "drop your pants" to being wheeled out in the wheelchair probably took 10 minutes, with probably no more than 3 minutes being the cleaning of the site and the injections. I believe the needle was x-ray guided, in any case there was imaging of some sort being used...I would be VERY skeptical of a DR who wanted to just poke around blind.

The DR doing the procedure warned me that there is a major nerve in the joint area which, if hit during the process, would cause weird sensations and numbness in my entire leg if he hit it with the needle...and would require that I sit around for basically the entire day since I wouldn't be able to safely walk until feeling returned. Clearly, some of the other posters here have experienced this phenomenon, although he described it as "very rare" (of course, he may have been talking about in his personal experience, as opposed to in general).

I was laying very flat and couldn't see the actual procedure being done, unlike the MRI dye, so I'm not sure if he used a single needle with a two-stage injection or what, but the first step (local anesthetic )was injected by the DR starting to numb just below skin,go deeper, numb, etc. so the local was pretty far down); and then almost immediately thereafter the cortisone was injected, as I could feel the pressure build in the joint much like the MRI dye. There was one point in the cortisone injection where I felt a sharp pain and hissed, but he slowed down or something and it stopped immediately. However, the joint never became as full-feeling as with the MRI, and the main injection was extremely quick (maybe 30 seconds, if that). I mentioned the fact that this process was easier than the MRI, and the DR said the gauge of needle is smaller for the cortisone shot than the MRI. Also, he went in from slightly on the outside of the crown of my leg, rather than toward the groin...maybe 3 inches up toward the crown of my leg and an inch closer to my torso from where the femur/hip is most readily felt on the side of your leg. I would rate most of the pain as a 2, maybe the brief spike as a 5. All-in-all, it was quick and relatively painless and something I would do again if it works.

I was put in a wheelchair and left to recover for maybe 10-15 minutes, at which point he had me walk. Frankly, I was very disappointed when I put weight on the leg as I basically felt my normal "type" of pain, but probably 2 pain-grades higher (in addition to the full sensation and a slight weakness). This got worse shortly after I left, to the point that I was afraid that I'd fall over before getting a cab outside. Getting in bed once home required lifting my left leg up with my arms, rather than using my leg muscles. However, I popped a Meloxicam and whether it was that or just the cortisone settling in, within a few hours I could hobble around Ok, and now (15 or so hours later) feel substantially better than immediately after the procedure...and probably better than I have in several weeks, although I don't feel immediate miraculous improvements - I still have some pain and at the moment I still have a slight feeling of weakness in that hip. Having said that, it's barely half a day since I had the injection, so I'm still hopeful.

I asked a number of questions of the (much friendlier) DR who did the procedure...some of them may be of interest here. First, I asked about the synovial fluid replacement injections (synvisc) which he said are still not approved (by insurance) for hips in the US. I asked how long it would take before I would know exactly how effective the cortisone will be in my case, and he said it can take two weeks to reach full effect. Since he had said some people responded very well to it, and some not at all I asked if he had a breakdown percentage-wise, but he did not. In terms of duration, he was as non-committal as with the percentage of people who respond to it at all, saying it might provide relief for two weeks or it might do so for six months (but probably not more than that, at least in my case). Similarly, he could not give me a breakdown of what % of people fell at either of those ends of the spectrum.

Anyway, I think that is all for now -hopefully people can find some useful info buried in there.
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replied June 4th, 2011
I have had hip pain for nine months since riding a bike again for exercise. Bone on bone, spurs, arthritis determined after xray. Orthopedic surgeon who did a knee replacement on my left knee in '05 did a cortisone injection TODAY. In at 10:30 a.m., out at 2:30 p.m. Had an anesthetic, fluoroscope while under xray (so I'm told.) I don't remember anything. No pain. Not one negative about the experience. Relief is there now. I'm 62 yrs. old, 6'5", about 70 lbs overweight. I am anxious to see how this plays out, but so far, very good. I just want to be without pain and ride my bike. Dr. wants to do a THR. I'm considering it. The pain at night deters sleep. We all need our rest.
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replied July 4th, 2011
Well it was fun while it lasted and I was so full of hope for extended relief, but the immediate relief that the cortisone shot gave me only lasted 3 days. Since it is bone on bone, I opted for the hip replacement while I'm relatively healthy. Scheduled Aug 1st. I did a lot of research to find a Dr who specializes in hip replacement (The dr I was seeing was not a hip replacement specialist). I have to say that the pain in my hip is a full level 7-8 most days and wakes me up at night. I can't wait to get rid of the diseased hip all I want is to be able to walk without a painful limp.
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replied August 19th, 2011
I have just had a cortisone injecion in the hip. I must have a brilliant doctor, because all I felt was a slight sting - no worse than a blood test. I'm feeling great - will it last?!
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replied August 19th, 2011
Especially eHealthy
Depends upon the underlying conditon. If it is a relatively short duration, discrete, inflammatory problem, it may even cure it. If it is a condition that has been long term, has significant degenerative changes with it, then it may only be temporary. But even here, sometimes the relief can last 3, 6, even 12 months.

Hope you get some lasting relief.
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replied August 24th, 2011
Cortisone Shot to Hip - NOT FUN
WHO ARE YOU PEOPLE WHO ARE PAIN FREE FROM THIS INJECTION?!?!?! I just had my second needle-to-hip joint experience today and I wanted to kill myself in the middle of it. It CAN HURT if you're someone who is susceptible to pain - and each person is different. Reading a forum is not going to help you decide based on individual pain tolerance. I am still waiting to see if this was worth it, but so far, all I think I need are mind altering drugs to help me forget the torture I encountered. I am literally up at 2am praying to God above hoping that this is the answer to my impingement and dysplasia. And I am praying for you too - that it doesn't hurt, that this is the answer you've been waiting for.
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replied August 24th, 2011
Hi there...new to this site and glad I found it. I have been having hip/lower back pain now for about 5 weeks. My doc referred me to physio and I have had 1 session up to yet. The doctor I am seeing wants me to have the injection but has not actually diagnosed what my problem is yet! No blood tests,scans,xrays or anything just one physical examination. Can they just inject anywhere in the hip/back? Surely they need to know where the problem is first.
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replied August 25th, 2011
Cortisone vs. Synvisc
I had orhtoscopic hip surgery a year ago to repair my labrum and to reshape my hip joint, went well until a few months ago. I started to get sharp shooting pains down the fronton my leg and groin, knee pain etc. I saw my surgeon again who recommended trying cortisone. I've never been keen on the stuff, especially in my hip where my cartilage is already damaged and I have osteoarthritis. Aside from the discomfort of the injection, does anyone have any bad or good experiences with cortisone in the hip joint (not bursa). And also, thoughts on Synvisc in the hip?
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replied August 25th, 2011
Especially eHealthy
tc11,

Cortisone and hylan-20 (Synvisc is one brand) injections address two different problems.


Cortisone (corticosteroid) is an antiinflammatory medicine, that has been used for decades. Thus, in joints that have inflammation as a significant component, possibly an overproduction of synovial fluid, overgrowth of the synovium, degeneration within the joint, etc, then cortisone may calm down the inflammation. Thus, reducing the pain, swelling, decreased range of motion, etc.

Cortisone is a quite powerful medications. It should be used with caution in joints which still have most of its articular cartilage. Because, over zealous use of the cortisone (i.e. too frequent of injections or too high of a dose of steroid) can lead to articular cartilage damage. If the joint already has significant cartilage destruction, then the cortisone can be used a little more freely.


Hylan-20 injections are designed to replace the synovial fluid in joints that have reduced fluid due to mild to moderate degenerative changes. It works best in joints that still have some decent articular cartilage in them. It basically makes the joint surfaces slippery again. Thus, it may reduce stiffness, pain, decreased range of motion, etc.

Hylan-20 does not have any antiinflammatory properties. It fact it has been shown to set up a mild to moderate inflammatory flare in the injected joint occasionally. This is the most common side effect of the injection. Hylan-20 was designed for the knee joint. Almost all of the research has been on that joint. Its indications have been expanded to just about any synovial joint, that can be safely injected. But, the overall success rate for other joints has not been studied.



Hylan-20 is supposed to be given in a series of three injection (over several weeks), whereas cortisone is done in a single injection. Hylan-20 is very expensive compared to cortisone. Both have the same risk factors relating to the actual injection process. Each has its own therapeutic properties.



Each patient must discuss their particular case with their surgeon, to determine which is the best for them, as they are not the same, nor do they treat the same problems.
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replied September 8th, 2011
I have Osteoarthritis in my hips and have been suffering for the past 8 months in pain. Before opting for a THR I opted to have the shot and today I had it and the procedure was almost painless for me... I must have had a super doctor! It's been 5 hours since I had the shot and so far so good. I have noticed a remarkable difference in my pain level and I can actually walk without a limp now. Of course, only time will tell, how well the shot actually worked for me. But for now, I feel so much better and am hopeful that the decision to have the shot was the right decision for me, at this particular point in time. I know however, that a THR is definitely in my future, but if I was able to buy some time, then the procedure was definitely worth it for me! I'm so happy right now.... I hope it lasts!
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replied September 14th, 2011
After reading so many horror stories,I was so afraid to have one,so will give you my experience. I am a 79 year old grandmaw and was told I should get the hip injection. NEVERE have it done by anyone but a pain management doctor!! It was sooo easy.Done under a florascope,had a numbing medicine injected VERY slowly till it entered the hip joint. No pain at all. Went home and never had any pain or problems at all.
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