Severe Arthrofibrosis post TKA. Radiation w/Revision?

Definitely will be looking this up.

A good friend of mine broke his knee years ago and had to have surgery to repair it with pins. Not a knee replacement. After surgery and the immobilization that occurs with knee fractures, he had arthrofibrosis and hit a limit for bending his knee, which he wasn't satisfied with. His physical therapist suggested a machine called a Flexionator which he rented for at home use. Luckily insurance paid for this. He used it for several months, and he said it was hard work. In the end his persistence paid off and he was able to bend his knee to a greater degree that before using the Flexionator. I would only suggest using it under the advice of a physical therapist or surgeon to make sure it's safe for arthrofibrosis after Total Knee Replacement, and not just after knee surgery.

Thanks Kathrine. I will look into this machine. My second opinion, which was at HSS, Manhattan, was to proceed with a revision to a hinged prosthesis. The doctors at HSS are not using radiation for revisions due to severe Arthrofibrosis.

HSS told me they don’t use radiation in revision surgery because of the lack of adequate studies and fear of infection, as the radiation slows healing. There is ongoing research into the use of radiation, as it reduces scarring post revision surgery.

My doctor recommended low dose radiation after I get my scar resection. I’ve had a partial knee replacement that was converted to a full knee replacement after a year with a lot of pain still. Turned out the cement didn’t hold and it was rattling around in there. Ended up not working out, after 10 more years, had a total knee revision and it was great for about 10 months, had great range of motion until I fell down the stairs. I fractured a rib, a vertebral body, concussion, knee and shoulder pain. I focused on the ribs, vertebral body and concussion and my knee ended up getting arthrofibrosis. I barely have any range of motion now. I am having surgery June 30th and hoping this will give me some relief and range of motion.

Has anyone done radiation for this? My doctor said there isn’t enough studies out there yet but he has had patients with success. He said he doesn’t know if it will make a difference, but said it might be worth trying.

My surgeon said he had heard of a study out of Europe where they used radiation. Apparently they have been doing it for folks who develop heterotopic ossification. Mine was at a cancer hospital attached to the surgical hospital where I had my knee revision. He suggested it might kill off those inflammatory cells that generate the Arthrofibrotic scar tissue after surgery. So far, I have about 100 degrees of flexion, and I still have 0 degrees extension. My first knee replacement, 10 years ago, generated so much Arthrofibrosis that I only had 40 degrees flexion, between 20 and 60. I limped for those ten years, so the ligaments and tendons shrunk, and they were LOADED with fibrotic tissue. He removed them and put in a hinge. I'm still experiencing some swelling, but I use the ice machine regularly to deal with that - didn't have one the first time around - highly recommend it. Sending you lots of good luck - you deserve it, after the rocky experience you've had. Best wishes! Oh - by the way, if your surgeon can use a cauterizer to avoid generating lotsa blood during surgery, that would help - and no tourniquet if possible. Look at the International Arthrofibrosis Association website - they have a great deal of helpful advice.

Thanks for that information. Very helpful. Just got the notes from my surgeon (I requested) on Revision and MUA. Most informative. Thx for sharing.