Question

Hello Dr. Thanks for giving us the opportunity to share our health issue with you, please let me state the problem from the very beginning until now, i'd try to be detailed yet concise as much as possible.
It all started about one year ago, when my mother started exhibiting symptoms of osteoarthritis: pain at both knees, inability to go upstairs, feeling tired when exerting effort, and crackling sound from both knees.
Therefore, we visited a local orthopedist (let it be doctor a), that diagnosed my mom with osteoarthritis and prescribed her (diacerein) and some other anti-inflammatory drugs alongside with a topical cream.
My mom followed the instructions and took her medications as prescribed and then, without the doctor's advice, she stopped all medications.
And this how things went, sometimes taking medications and sometimes suddenly discontinue using them, until she felt the same pain the felt a year ago (but way, more severe) in august 2021 (this year), we visited the same doctor (doctor a, firstly he rebuked us for discontinuing the medications, and then he suggested performing an x-ray on both knees, and we did (attached here) url Google.com/file/d/105v-jjdzwve0l0tcbaznpdvae8aawqx_/view? Usp=sharing
after checking the x-ray, he stated that my mother is suffering from a 4th degree osteoarthritis with left knee being more affected, he prescribed us some medications, but more or less, nothing improved.
Until that day that was about two months ago, my mother was walking when suddenly, without any introduction, she felt that her right leg is (twisted) and she felt like (the bones of her leg aren't intact and her leg isn't interconnected) that's as stated by mother exactly after this sudden (twist), so, we visited another doctor (doctor b, and after telling him the whole thing, he stated that there might be a tear in the radial meniscus in the right knee, so he proposed making mri to check further (and the injury was strange for me, as the x-ray shows that the left leg is more damaged than the right one, so how come the right one is twisted ?).
We did, we performed mri (attached):
left knee: url Google.com/file/d/1_z0hpdb7tdpxpbxdwf2s9uqu8lhc5i45/view? Usp=sharing
right knee:
url Google.com/file/d/11swrypscko5k6ruipqwprphthlves_i_/view? Usp=sharing
and after doctor b checked the mri, he stated that there's a tear in the meniscus and we should perform what is known as (arthroscopy) to fix this torn meniscus.
Before taking this step, we visited another doctor (doctor c), and we showed him the mri result, he stated that this (twist) and the entailed pain happened as a result of osteoarthritis, and there's no tears in the meniscus. He suggested performing some physical therapy and we may, may need to perform a joint replacement surely, and that's it.
Then, we visited another doctor (doctor d) and after doing the exact same steps of telling him the story, showing him the mri, he stated that there's no need for either arthroscopy or joint replacement therapy, also another doctor (doctor e) stated the same as doctor d, and this doctor e suggested injecting a vial inside the knees, and after searching over the internet, I concluded that there is a famous type of injections known as (hyaluronic acid) and another way less famous injection known as (polyacrylamide gel), and unfortunately, we were persuaded to inject the second type, which is the polyacrylamide gel.
So Dr. e injected my mother with this infamous drug, its name is (noltrex) by the way, and to be honest I have never seen anyone around me taking the same drug, all people inject this hyaluronic acid vial.
He stated that an improvement will be felt and seen after a month, and it have been 5 weeks now, and nothing happened.
Mother is still suffering, and we still have nothing to do, we are very very confused, so dear dr, what do you suggest? Do you suggest trying another injection therapy? And what does the mri read? Please guide us to what you see the best.
Thanks in advance dear dr.

Dr.Sushma Shah · Accepted Answer

Hello, in fourth degree injury no injection give any relived.
Truly speaking I am suffering from just similar complaints. Exactly same. So my doctor advice physiotherapy to strength the thigh muscles. Igot lot of relief. But knee to replace is sure shot. Yet we could not make it. N unable to go for physiotherapy.
So don't believe on any inj results high or low price.
Only pain killer till you arrange knee replacement.

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