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Orthopedics/PKR post surgical pain - will SynVisc help?


I had a partial knee replacement (medial) 18 months ago. After recovery I noticed the arthritis was a lot better but now I have painful clicking with the lateral joint compartment (possibly knee cap - not 100% sure) and the lateral muscle on the upper outside of the knee feels painful/fatigued all the time. When I walk it feels like the knee is going in and out of joint – a clicking bone passing bone feeling which causes me to limp. I went back to my surgeon and they did an x-ray, CT scan and MRI but the surgeon said they didn’t show anything abnormal. At least, the artificial component has not moved or loosened. All the surgeon could say was, “the scans look fine” and there’s nothing else they can do.

After a year of pain and having trouble walking I finally convinced them to refer me to the pain clinic. At my first appointment my doctor, an Anesthesiologist, pushes on my knee (something the surgeon never did which I find surprising) and recommends a medial unloader knee brace.  This really helps.  I am able to walk further with less pain but it’s still not great. I still have a lot of pain even when I am at rest – located at the top of the medial compartment and where that lateral fatigued muscle attaches to the bone.  I can point right to these specific places but, as I said, the surgeon claims nothing is wrong.

My surgeon says I am too young for them to consider a total knee replacement at this time. The pain MD just recommended a SynVisc injection. I'm not sure this will be beneficial.  Will SynVisc help me?

Dear Jim

This Chicago Orthopedic Podiatrist, Elmhurst Podiatrist & West Loop Podiatrist says.......
See a sports medicine podiatrist-who can evaluate you for orthotics. Sometimes an orthotic may place your knee in a more neutral position-the patella should be facing forward for the most part. Also have a limb-length evaluation-which the orthotic can address also. Try to find exercises that will strengthen the weak muscles of your knee. See a physical therapist, who should be able to point you in the right direction.
Syn-visc helps with an arthritic joint.The injection may help if there is arthritis-or narrowing of the joint space.  Get your x-rays, MRI & CT scan (copies-not the report) and seek a second opinion from an orthopedist who does knees only.
Good Luck!
The podiatrists of are specialists in foot & ankle orthopedics & sports injuries.

Dr George Tsatsos & Svetlana Zats
Podiatrist Chicago 60618 & Elmhurst 60126 Podiatrists
Board Certified in Foot and Ankle Surgery & Orthopedics
New South Loop Location-Chicago 60661

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Dr George Tsatsos


All questions related to orthopedics of the Lower Extremities-with a specialization in Foot & Ankle Orthopedics & Surgery-Adults & Children Sports Medicine questions of the lower extremities-including runner's injuries. Second Opinion specialist in Foot and Ankle problems including fractures and revision surgery. All questions relating to foot and ankle problems in Children, Sports medicine of the foot and ankle Runner's and walking problems


Board Certified in Surgery & Orthopedics of the Foot & Ankle. PRIVATE PRACTICES: Ankle N Foot, 2220 W Belmont Ave., Chgo., IL 60618 since 1979 Ankle & Foot Center of Elmhurst, 401 N.York Rd., Elmhurst, IL, 60126, since 1989. Physicians Suites, Bethany Hospital, 3435 W. Van Buren, Chgo., Il, 60624, since1980. HOSPITAL & SURGICAL AFFILIATIONS: Bethany Hospital, 3435 W. Van Buren, Chgo., Il.- Podiatry staff since 1979 Glen Oaks Medical Center, 701 Winthrop, Glen Dale Hts, IL – Podiatry staff since 1997. Elmhurst Medsurge, 401 N. York Rd., Elmhurst, IL, 60126, since 1999 Resurrection Health Care Surgery Center, 3101 N. Harlem Ave., Chicago, IL, since 1999 Chicago Neurologic & Orthopedic Hospital, 4501 N. Winchester Ave., Chicago, IL, since 2008 Organizations

Member American & Illinois Podiatric Medical Association Member of the National & Midwest Academy of Ambulatory Foot Surgery. Member of American College of Sports Medicine. Member of American Medical Athletic Association. Member of Chicago Metropolitan Ski Council.

Prolotherapy in the Treatment of Foot Problems Clinical Correspondence, June 2002. Vol 92- no. 6 Journal of the American Podiatric Medical Association. Paper on Treatment of Delta-Phalanx of the Foot – submitted for publication to Journal of Foot and Ankle Surgery & for Fellowship of ACPPS., September, 1998 Sports Medicine Consultant for the book-Triathlon 101 Essentials for Multisport Success by John Mora – 1999 ISBN 0-88011-811-3 Windy City Sports – October 1996 Marathon Issue “Keeping Your Feet Happy” American Running & Fitness Association, Clinic Advisor & Lifetime Member – Editorial Staff since 1990.

Fellow-American College of Foot & Ankle Orthopedists, since 1991. Fellow-Academy of Ambulatory Foot Surgery, since 1980. Fellow- American Institute of Foot Medicine , since 1987. Fellow-American College of Foot & Ankle Pediatrics, since 1998. Certified in Laser Surgery- by Wenske Laser Center, Ravenswood Hospital, 1991. Certified in Foot and Ankle Arthroscopy – by Doctor’s Hospital, 1991. Certified Preceptorship Director-Scholl College of Podiatry 1993-2006 Board Certified in Foot & Ankle Surgery-A.B.M.S.P., since 1987. Recertified 8/08 till 3/31/2012 Board Certified in Podiatric Foot & Ankle Orthopedics-A.B.P.O.P.P.M., 1991. Recertified 10/2003 till 12/2013 Board Certified in Pain Management-A.A.P.M., since 1990.-retired Clinical Instructor – Department of Medicine at Rosalind Franklin University 10/2007 until present

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