Scar tissue after knee replacement

Posted by leithlane @leithlane, Jan 31, 2017

I had knee replacement surgery 6 weeks ago . Through PT I have been working on breaking up the scar tissue only for it to regrow by the time I get back to PT two days later. I have been massaging at home, using a hand held massager and roller. It is painful and swollen. I am getting very disheartened. Any suggestions as to what else I can do. Has anyone had laser treatments to break up scar tissue? Were they effective?

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@annekaz52

Thank you for the suggestion. I am now upping my at home exercises.

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Other than PT the greatest help for me 8 months post op on my left TKR has been medical massage. Not a spa but a trained medical masseuse in lymphatic drainage and cupping. My walking standing etc stiffness licking up at my sartorial muscle has all improved after lengthy PT. I’m also doing 30 mins 6 days a week on a recumbent bike but despite the expensive masseuse txs im getting better and I found her myself. I told my surgeon he should have referred me but ONLY after I found her myself!!! I told my masseuse that surgeons should make it a common practice to refer PT is effective but after 5 months you need more

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I had 1year ago a knee replacement on my right knee. I now recently discovered that my calf is stiff and the leg became weak. Is it normal?? I have pains in my hip and lower back and on the right hand side of my bum so what am I suppose to do.

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@gwendolinehen

I had 1year ago a knee replacement on my right knee. I now recently discovered that my calf is stiff and the leg became weak. Is it normal?? I have pains in my hip and lower back and on the right hand side of my bum so what am I suppose to do.

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Gwen - your symptoms sound more like sciatica. I've had sciatica and it's usually caused by a bulging lumbar disk, causing pain and numbness in the back of the leg, sometimes including the glutes. FWIW I've also had both knees replaced and did not get any of these symptoms.

I would check with your knee surgeon and he may give you a reference to a spine surgeon. I'm certainly no expert and that's why I'd start with the surgeon who replaced your knee.

All the best.

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@gwendolinehen

I had 1year ago a knee replacement on my right knee. I now recently discovered that my calf is stiff and the leg became weak. Is it normal?? I have pains in my hip and lower back and on the right hand side of my bum so what am I suppose to do.

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Medical massage continues to help me. They have decreased swelling, softened and eliminated hard knots and worked on my hips and legs muscles my surgeon was very good but I found this out myself. Not a spa massage but a medical masseuse with special training

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Six weeks is not a long time. I did not begin massage that early. Your swelling sounds like you are doing too much too early

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@terry002

Medical massage continues to help me. They have decreased swelling, softened and eliminated hard knots and worked on my hips and legs muscles my surgeon was very good but I found this out myself. Not a spa massage but a medical masseuse with special training

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Thank you for your advise will do so

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@gwendolinehen

Thank you for your advise will do so

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Gwen I still have knots and swelling 8 months post and my medical masseuse works it out. My sartorius muscle was locking and now it doesn’t. Find someone good and you’ll see. PT doesn’t do everything and after four months 3x week religiously my doctor told me the same thing!

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Did you get diagnosed with arthrofibrosis? It is an excess amount of scar tissue buildup after surgery. It cannot be broken down by PT. I had arthroscopic surgery to remove the scar tissue and got my extension so I could walk. It is very painful and tight. It has been 15 years since my TKR . It is a disability I have learned to live with as it all came back a year after it was removed. I have done everything possible to cure it except a revision. I am NOT having my left knee replaced.

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@lamerex4

I had my first knee replacement at the age of 47 years in 2001. I was plagued by spasms on the outer aspect of my calf caused by scar tissue. After a closed manipulation and traditional PT I got relief with acupuncture and osteopathic manipulation. I know many physical therapists practice under the theory that you have to push through the pain, but when you are a prolific scar tissue creator, I feel a more gradual, alternative approach is better.

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Hello. Are you still doing well with scar tissue issues? Please share how you got help. Thank you!

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@gutthookd

Dear Gator -

There are still surgeons who sort of "declare victory" (reminiescent of that banner on the carrier deck) at anything over 90 degrees.
In my own case... it's been a process of lowered expectations based on a "self-educating process" over the last 3 years. Not all
expensive educations are "ivy league"... (and in my case discounting the about $1,000 a month for medical insurance - I'm at about
$90+K out of pocket... and counting). When I talk about "expense" - it would be worth it if I could have less daily pain and inflammation
(but you do finally "get educated"). IF... I could ever go back and put that genie back in the bottle... I would NEVER have done this
surgery (knowing what I know now - and continue to experience). I'm still still looking for "a way out", "a way back", ... something and
am determined to NOT give up (although I personally know local people in my situation or nearly who have basically done that). There
is no doubt that all this pain, stress, sleeplessness, medications, etc... does take a toll. It's a question of how long the money holds out
and how long my health does (because who knows what else becomes collateral damage - or when ?). It would be a little idealistic to
assume 3+ years of this would have NO effect to my health.

My situation (of the inflammation, stiffness, etc.) is not the situation that most of you will ever face, but some of you will. If anyone out
there is considering a TKR and wanted my advice (and I don't blame you of you don't), I'd say to get a 2nd opinion from a well regarded surgeon who knew he wasn't going to do the surgery (and maybe better if they are a little outside your local area), then...
I'd at least explore what regenerative medicine has to offer (this is improving all the time, but unfortunately can not do much for you
AFTER you've had a TKR... before...maybe yes, after... most likely not). THEN if you feel like you have educated yourself to the extent
possible (and still want the TKR surgery)... DEFINITELY get yourself metal allergy tested (MELISA... there are links online) and then
maybe talk to the surgeon you've chosen (and maybe this should be someone who you have multiple recommendations from people
you know who've been a patient) and have discussions with this surgeon (and also who you're thinking about being your PT provider)
about how engaged they are going to be - in case things DON'T go as well as expected. Then if you're determined to have the surgery,
maybe a VERY good idea to prepare yourself (physically) - and by that I mean exercise daily (or as often as possible - especially your
legs, back, and core (you'll need those stomach muscles to get yourself "up and down" to reach for things you need when you are
largely incapacitated and etc. If you are carrying significant extra weight - consider dropping at least some of this (it just makes your
recovery more difficult). People who tell you "this is no big deal" and is just "minor surgery" are nearly always people who haven't had
a TKR surgery themselves. I had a friend (joking) ask me if I knew what "minor surgery" was ? Answer: That's surgery done on some
one ELSE.
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I appreciate everyone who responded to what i wrote. My intentio is not to be "alarmist" or some sort of "prophet of doom", but to
hopefully help others potentially avoid some (maybe all ?) of what I've been through. I know there are people (and this is a majority)
who are helped 9and some of these helped greatly) by having this TKR surgery. BUT... I also know (now) that this joint implant
surgery "buisness" has become a giant industry and unfortunately we as older folks represent to them (maybe First) "a cash cow"
like no other. I grew up instinctively trusting doctors (even growing up around a family doctor who had treated multiple generations,
knew the family history, and in urgent cases... made "house call". My mother was a single parent teacher in Tennessse - with (4) kids... so that shoulfd tell about how much extra money we had. At that time, I never doubted that my doctor's primary interest and
motivation was my health. I can not honestly say I believe that to be "mostly true" now. What i do believ - is that in many cases that
"First do no harm" has been replaced by answering two questions - which are: Is this proposed procedure on this patient legally defensible ? (yes - in nearly all cases) and Can I get paid for this ? ( which is "yes" - that in most cases... if an orthopedic surgeon
recommends it, your insurance will pay at least a majority of the costs). Despite what you hear about "frivolous medical lawsuits",
these are nearly impossible to win (yes - you do hear about class action cases occasionally, but in the case of an individual "less
than optimal outsome" - these are common and as long as the surgeons stay within the broad confines of "the local standard of care"
which does differ area-to-area... they almost have to perform surgery on the "wrong" leg for you to get a favorable judgement (and
I can guarantee you'll be signing some sort "aggreement to arbitration" - which means you are going in front of their arbiter even in
thevery worst case scenarios... not a judge and jury). No, I never sued anyone in my life and have no intention now... but never
doubt that surgeons have looked at this from all angles "upfront" nd covered themselves completely... the only one suffering any
negative consequences (if any) - will be the patient. That's not "spinning this" any certain way... that's just the way it is (and no
accident that it's that way).
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For the people who have unresolved issues of disability and pain as a result of this surgery (or really, as a consequence of any surgery, illness, accident, etc.) all I can say is "keep fighting" and most of all - don't give up on yourself. BUT... also be advised
that (as a group) we are vulnerable to every possible kind of "questionable medical" scam... most of these very expensive - and
nearly all of these are absolutely NOT covered by anyone's medical insurance. What wouldn't you pay to be able to walk (even
with limited pain - if you can't now) ? I guess the obvious answer is - Anything, nearly (and that's what makes us so vulnerable).
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In answer to Debbra (thanks for your question) - No, I've never had the shoulder surgery (yet) which is (also) in constant pain.
I've been trying to get over the knee first (idealistic me). This has deteriorated to the point of needing the "reverse type" replacement
surgery... and one problem for me being that there aren't a whole lot of options for hypoallergenic shoulder replacement joints in
the US (elsewhere - there is Ceramtec and others... although supposedly there is a carbon-fiber one of these coming out soon...
I hope). Thanks again for the question - and certainly am interested in any suggestions other may have,

Just FYI. I am weight size proportional, exercise vigorously (what I can) daily, and am on a fairly restricted diet gluten-free
generally, but also as anti-inflammatory as I can get (which is not "inexpensive").

I have had ASTYM therapy, but this deals only with surface scar tissue accumulations - not scar tissue literally "in the joint"
which seems to be my problem.

I understand that - my "joint" will not rotate properly (maybe - at all) which prevents the leg from straightening (extending)
fully. Per my previous, I am at about 11 degrees short of full extension (on my own - this can be "forced" closer).

Has anyone out there heard or better yet experienced "The X10 Knee Recovery Syetem" ? Sounds Elon Musk "Space
Shippy" named and no doubt terribly expensive. But... has anyone heard of this or better yet - any direct experience ?

Obviously... my options are pretty limited at this point - and I do appreciate any ideas from others.

And i wish you all - the very best,

John

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John Bobmac here after reading your post I'm 93 and when I read how educated you appear to be I wan't to kick myself for lacking the education that you seem to have, when I had my knees done 8 years ago I thought it would be a walk in the park if I could kick my self I would be covered with bruises after having it done a few days latter I felt a funny feeling when I asked everyone said it will get better ,I swear that was the start of ny stiffness cain, walker,rollater and after I fell and broke my tibber wheelchair for last 2 years went too 8 different Doctors all took X-rays and said how good the knees looked well after 8 years they have started to hurt 24/7 mostly in my recliner (gave bed up a couple of months ago. I thing the worst part of it is nobody but me feels the pain so I just keep my mouth shut I don't want to soundlike a broken record ,about 5 months ago I had cortisone shots ad all they did was make my knees tighter your note give me hope that i'am not alone and may be some day the Docs will figure it out did learn something when I got out of the Navy should have used the GI bill and went College Thanks for the sounding board Bob Mac

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