Question: Greetings, Dr. Gupta! I would appreciate your professional opinion of the use of injections to "replace" cartilage such as Uflexa and Hyalgan (the hyaluronicacid is derived from roosters, from the combs on their heads). Although my right knee with the arthritis does not (yet) have bone-on-bone pain (but has the muscle tightening when standing from a chair) would such injections be appropriate for me at this stage?
I have been approached by a clinic that does Hyalgan with fluoroscopic injections (that they say is best for ensuring that the material gets to the correct location). Or are such injections to be used only when pain is regular when cartilage and disappeared? In addition, of course, I have 9-10 mm osteochondral lesions on the distal femur and lateral femoral condyle of that leg. Thanks.

Thank you for you reply as always. Since I have reduced cartilage from degenerative osteoarthritis, why wouldn't the shots assist in maintaining the integrity of whatever amount of cartilage is still around?

I was also advised to take egg membrane capsules (NEM) to assist on the cartilage? I am still doing physiotherapy with exercise and massage of the knee area where all those muscles are tight. It has helped somewhat.

And how do muscles around the knee/calf/thigh get into a spasm when simply sitting and hardly moving the leg at all? One would thing that spasms develop from improper movement. Is there a likelihood that despite the effects of my gait on my knee caused by the posterior tibial transfer I may still yet avoid so much cartilage deterioration requiring a knee replacement one day?Thanks.

Is there a likelihood that despite the effects of my gait on my knee caused by the posterior tibial transfer I may still yet be able to avoid cartilage deterioration requiring a knee replacement one day? Thanks.