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How do you treat excess scarring after TKR?

Posted by Jmacvol @jmacvol, Jul 29, 2016

I had TKR on my left knee Dec 2013. Had poor ROM performance with PT and had MUA after 3 months. Recovery from MUA was most painful experience ever and totally ineffective. As time went on ROM got worse as scar tissue took over knee. Sep 2014 I had left knee revision to remove scar tissue and had right kne TKR. 3 more months of PT and right knee recovered much better than left as left knee once again grew excessive scar tissue. Dec 2015 I had a 2nd revision on left knee to remove scar tissue and surgeon said if this didn't work he may have to replace remove appliance and start over. 3 more months of PT and ROM got worse with PT as scar tissue grew back again. ROM in left knee is about 70. As each day goes on pain increases with no improvement in site. Surgeon says that appliance is fine and there is no more he can do. Is there any solution to my problem. Contacted Mayo for help.

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gailfaith | @gailfaith | Jul 30, 2016

Wow, getting to Mayo is a real effort for you. My hat off to you. Sounds like your knee hopefully is something Mayo can solve. Again, my prayers.
gailfaith,

REPLY
Jmacvol | @jmacvol | Jul 30, 2016
In reply to @apportee "I am sorry you have had so much trouble. I had my a RTH 5 years..." + (show)
@apportee

I am sorry you have had so much trouble. I had my a RTH 5 years ago. I had my left hip done 1 year ago. I continue to have pain in both hips, even have both Total Hip Replacement. Had Bursitis in Right Hip and now I have Bursitis in my Left Hip. I. Pray your Knees get better. These types of surgeries are very painful and having to go thru physical therapy can be very hard.<br><br>

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As you know, most of the outcomes of these surgeries are improved quality of life and total recovery. And then there are those of us that never stop suffering. I'm hoping there is a solution out there somewhere for us.

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beatricefay | @beatricefay | Jul 31, 2016
In reply to @gailfaith "Do I understand you correctly, that outside of the scarring, the rest of the TKR results..." + (show)
@gailfaith

Do I understand you correctly, that outside of the scarring, the rest of the TKR results were good? If so, I am happy for you. After my second TKR also on the machine before I left the hospital, I went to a different nursing home. I expected to use the machine there, but when the she saw my ROM already, she didn't order it. However on day 1 there, they measured my ROM at something in the mid 120's. But I was having calf pain and to be sure I didn't have a clot, I did no PT over the weekend until they could confirm there was no clot. So after lying in bed for 3 days, I was concerned that I had lost some of my good 120+ degrees of bend. So when I started PT again on Tuesday, I joking asked how much did I lose. His response: you're now up to 132 degrees! As far as I can ascertain, that is about where I was pre-surgery! Now that I have monotonic dystophy, I need that 132 degrees to get up from the floor though I still need help as the legs are weak, but I can at least get my R leg under me and get ready to stand.
When you fly to Mayo, where do you fly from and where is your plane change? I fly out of Lancaster airport which is just down the street (2 miles) to Dulles, then to Minneapolis and then Rochester. But coming home the last time, they cancelled the last flight back to Lancaster as they never told us that airline had changed hands and the FAA had not yet approved them flying into Lancaster. ! So instead of a 45 minute flight, they DROVE me and another passenger right to our front doors! But that was an hour wait at first then a 3 hr drive.

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@gailfaith
I'm so amazed that you got up to 120 degrees and then 132 degrees so soon after your TKR. I'm now at 108 after 7 weeks of PT and it has been a struggle. My goal is 115. You are very fortunate to have such a great result. Beatricefay

REPLY
gailfaith | @gailfaith | Jul 31, 2016
In reply to @gailfaith "Do I understand you correctly, that outside of the scarring, the rest of the TKR results..." + (show)
@gailfaith

Do I understand you correctly, that outside of the scarring, the rest of the TKR results were good? If so, I am happy for you. After my second TKR also on the machine before I left the hospital, I went to a different nursing home. I expected to use the machine there, but when the she saw my ROM already, she didn't order it. However on day 1 there, they measured my ROM at something in the mid 120's. But I was having calf pain and to be sure I didn't have a clot, I did no PT over the weekend until they could confirm there was no clot. So after lying in bed for 3 days, I was concerned that I had lost some of my good 120+ degrees of bend. So when I started PT again on Tuesday, I joking asked how much did I lose. His response: you're now up to 132 degrees! As far as I can ascertain, that is about where I was pre-surgery! Now that I have monotonic dystophy, I need that 132 degrees to get up from the floor though I still need help as the legs are weak, but I can at least get my R leg under me and get ready to stand.
When you fly to Mayo, where do you fly from and where is your plane change? I fly out of Lancaster airport which is just down the street (2 miles) to Dulles, then to Minneapolis and then Rochester. But coming home the last time, they cancelled the last flight back to Lancaster as they never told us that airline had changed hands and the FAA had not yet approved them flying into Lancaster. ! So instead of a 45 minute flight, they DROVE me and another passenger right to our front doors! But that was an hour wait at first then a 3 hr drive.

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Thanks for you email. I attribute it to the passive motion machine which they have discontinued tits use. Reason they say is it is hard for the new replacements. I just had new xrays done by the surgeon. I had them done in 2004 and 2006 and in 2016 they show NO signs of wear. gailfaith

REPLY
beatricefay | @beatricefay | Jul 31, 2016
In reply to @gailfaith "Do I understand you correctly, that outside of the scarring, the rest of the TKR results..." + (show)
@gailfaith

Do I understand you correctly, that outside of the scarring, the rest of the TKR results were good? If so, I am happy for you. After my second TKR also on the machine before I left the hospital, I went to a different nursing home. I expected to use the machine there, but when the she saw my ROM already, she didn't order it. However on day 1 there, they measured my ROM at something in the mid 120's. But I was having calf pain and to be sure I didn't have a clot, I did no PT over the weekend until they could confirm there was no clot. So after lying in bed for 3 days, I was concerned that I had lost some of my good 120+ degrees of bend. So when I started PT again on Tuesday, I joking asked how much did I lose. His response: you're now up to 132 degrees! As far as I can ascertain, that is about where I was pre-surgery! Now that I have monotonic dystophy, I need that 132 degrees to get up from the floor though I still need help as the legs are weak, but I can at least get my R leg under me and get ready to stand.
When you fly to Mayo, where do you fly from and where is your plane change? I fly out of Lancaster airport which is just down the street (2 miles) to Dulles, then to Minneapolis and then Rochester. But coming home the last time, they cancelled the last flight back to Lancaster as they never told us that airline had changed hands and the FAA had not yet approved them flying into Lancaster. ! So instead of a 45 minute flight, they DROVE me and another passenger right to our front doors! But that was an hour wait at first then a 3 hr drive.

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I used the passive motion machine for my first knee two years ago but I had the same difficulty getting my ROM. This time I didn't use the machine with same results. I'm just glad that most of the bad pain is gone except when I'm working on getting that ROM which I'm confident will come in time. I have to be thankful that I'm making progress because when I read about others needing further surgery I feel so sorry for them. It's a great operation, but it has to work. Beatricefay

REPLY
Jmacvol | @jmacvol | Jul 31, 2016
In reply to @gailfaith "Do I understand you correctly, that outside of the scarring, the rest of the TKR results..." + (show)
@gailfaith

Do I understand you correctly, that outside of the scarring, the rest of the TKR results were good? If so, I am happy for you. After my second TKR also on the machine before I left the hospital, I went to a different nursing home. I expected to use the machine there, but when the she saw my ROM already, she didn't order it. However on day 1 there, they measured my ROM at something in the mid 120's. But I was having calf pain and to be sure I didn't have a clot, I did no PT over the weekend until they could confirm there was no clot. So after lying in bed for 3 days, I was concerned that I had lost some of my good 120+ degrees of bend. So when I started PT again on Tuesday, I joking asked how much did I lose. His response: you're now up to 132 degrees! As far as I can ascertain, that is about where I was pre-surgery! Now that I have monotonic dystophy, I need that 132 degrees to get up from the floor though I still need help as the legs are weak, but I can at least get my R leg under me and get ready to stand.
When you fly to Mayo, where do you fly from and where is your plane change? I fly out of Lancaster airport which is just down the street (2 miles) to Dulles, then to Minneapolis and then Rochester. But coming home the last time, they cancelled the last flight back to Lancaster as they never told us that airline had changed hands and the FAA had not yet approved them flying into Lancaster. ! So instead of a 45 minute flight, they DROVE me and another passenger right to our front doors! But that was an hour wait at first then a 3 hr drive.

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I used the continuous passive motion machine after all 3 surgeries. I wish I could have used it longer than the 2 weeks allowed each tine by insurance.

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apportee | @apportee | Jul 31, 2016

I am having severe left arm pain. My doctor told me my xray showed narrowing of my cervical spine in my neck. One treatment offer was a steroid injection. That is all she offered. She either don't believe how much pain I am having or she believe in letting her patient hurt. I am a diabetic. So I have to be careful of steroid injection, because it will elevate my blood sugar. Anyone else have this problem or had this problem?

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3 replies
Jmacvol | @jmacvol | Jul 31, 2016
In reply to @apportee "I am having severe left arm pain. My doctor told me my xray showed narrowing of..." + (show)
@apportee

I am having severe left arm pain. My doctor told me my xray showed narrowing of my cervical spine in my neck. One treatment offer was a steroid injection. That is all she offered. She either don't believe how much pain I am having or she believe in letting her patient hurt. I am a diabetic. So I have to be careful of steroid injection, because it will elevate my blood sugar. Anyone else have this problem or had this problem?

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Sorry @apportee for your pain. My experience is that doctors most often start with the least aggressive treatment, i.e. steroid injection before moving to a more aggressive treatment. If it does not endanger your health, get the steroid injection, see if it helps, and if it doesnt help, let her know right away. If it does endanger your health as a diabetic, tell her so and ask for a different treatment. I cannot take NSAIDS for inflammation but I cant tell you how many times I had to remind my doctor of that. Good luck to you.

REPLY
oldkarl | @oldkarl | Aug 1, 2016
In reply to @apportee "I am having severe left arm pain. My doctor told me my xray showed narrowing of..." + (show)
@apportee

I am having severe left arm pain. My doctor told me my xray showed narrowing of my cervical spine in my neck. One treatment offer was a steroid injection. That is all she offered. She either don't believe how much pain I am having or she believe in letting her patient hurt. I am a diabetic. So I have to be careful of steroid injection, because it will elevate my blood sugar. Anyone else have this problem or had this problem?

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Yes, good ol' spinal stenosis. The cortisone injections in the neck are probably not worth the wait in the doc's office. I have had several, and they worked for a few hours.

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apportee | @apportee | Aug 2, 2016
In reply to @apportee "I am having severe left arm pain. My doctor told me my xray showed narrowing of..." + (show)
@apportee

I am having severe left arm pain. My doctor told me my xray showed narrowing of my cervical spine in my neck. One treatment offer was a steroid injection. That is all she offered. She either don't believe how much pain I am having or she believe in letting her patient hurt. I am a diabetic. So I have to be careful of steroid injection, because it will elevate my blood sugar. Anyone else have this problem or had this problem?

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Thank-you so much for your replay. I can't take NSAIDS either. The problem is I also have Bursitis in my left hip, I can hardly walk, but I have to wait for a appointment from my orthopedic doctor to refer me to the pain clinic that administer the steroid injection. See I have had bilateral total hip replacements, so I can' have them both injections at the same time. One will have to wait. On a pain scale of 1-10, and 10 being the worst, they both are a 10. My left arm and my left hip. So I really don't know which one to have first. However, I have to do something. The pain is unbearable at times.

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