MONDAY, Nov. 25, 2002 (HealthDayNews) -- By the time she was 30, Nancy Lopez was already a golf legend. She had won 35 tournaments on the ladies' professional tour (LPGA) and was the youngest person ever inducted into the LPGA Hall of Fame.
What no one -- including Lopez -- knew at the time was that her remarkable success had a very high price tag: She had virtually no cartilage in her left knee.
Now almost 46, Lopez says it took until five years ago for her to confront her condition and do something about it.
Even though she only plans limited appearances on the ladies' tour next year, Lopez might not even be playing at all if it hadn't been for a medical treatment called viscosupplementation. It's used to treat the crippling pain of an osteoarthritic knee that was very close to requiring surgical replacement.
Viscosupplementation is a procedure that involves injecting a fluid into osteoarthritic knees to cushion and lubricate the diseased joints.
Doctors have treated Lopez with Hylan G-F 20, a fluid containing hylan polymers produced from rooster combs. It's marketed as Synvisc, which the U.S. Food and Drug Administration approved in 1997. So, instead of a painful operation with a not-always predictable outcome, Lopez opted for the injections.
"I truly don't know if I could've made it this long without those injections," Lopez said.
Lopez's knee problems began decades ago when she tore the cartilage in her left knee while playing flag football as a high school freshman.
A surgeon removed much of the cartilage and, as time went on, the rest disappeared.
Five years ago, the year she won the last of her 48 career LPGA tournaments, Lopez sensed something was very wrong with her knee.
She felt a lot of pain, as if there were little pebbles in between the bones of her left knee. When she walked, she could feel the knee grinding.
"I went to see my doctor and I told him what was happening," Lopez said. "He said, 'Nancy, you're only 40, if you're going to play golf for a long time, you may think about a knee replacement.' I said, "'Knee replacement at age 40? I don't think so.'
"The thought was devastating. I was really afraid that my career was over," she added.
Fortunately for Lopez, viscosupplementation for osteoarthritis had just become available in the United States.
Lopez, who calls herself "a real baby when it comes to pain," was scared by how much she was suffering and nervous over having some substance shot into her knee.
She took her chances with the injections, though, and is happy she did.
Three-to-four weeks after the injections into her left knee, the pain began to go away. In October 2001, Lopez also had the treatment applied to her right knee, which had cartilage and ligament damage.
Lopez said the only side effects were some swelling and pain, which eventually went away.
Although some people experience inflammation and reactions to the foreign substance being injected into their knees, Synvisc has succeeded with about 66 percent of arthritic patients who receive the treatment, according to Dr. Robert Quinet, head of rheumatology at the Ochsner Clinic Foundation in New Orleans.
Half of those get a prolonged period of relief -- six-to-eight months or longer, he said.
Synvisc, which is distributed by Wyeth Pharmaceuticals, involves three injections over two weeks. The other leading viscosupplementation treatment substance is Hyalgan, distributed by Sanofi-Synthelabo, which requires five shots. Both products are made from rooster combs.
Viscosupplementation is intended for patients with osteoarthritis of the knee who have tried everything other than surgery and may not be ready for knee replacements, Quinet said.
"They have tried anti-inflammatory medications, they're using a cane, they're trying to lose weight, they're doing exercises of the knee, they're taking medications just for pain, and they're still having substantial symptoms of the knee, and they're not quite ready for surgery," he said.
Roughly 21 million Americans suffer from osteoarthritis, and knee osteoarthritis can be as disabling as any cardiovascular disease except stroke, according to the Arthritis Foundation.
Lopez has supplemented her treatments by exercising daily with a trainer, working out on a treadmill, StairMaster and bicycle.
"Now it's up to me," Lopez said. "With my knees functioning well, I need to take care of myself."
What To Do
For more information about the types of arthritis that afflict millions, go to the Arthritis Foundation, or check out the American College of Rheumatology.