Knee Replacement Failure - Need total reconstruction

Right Knee History
2018 Road Bike Fall
2019 April Root tear to meniscus. Surgery to repair root tear to meniscus. failed
2021 Partial Knee Replacement EmergOrtho in Durham NC. Surgeon retired end of 2021. PKR failed.
2022 TKR Carolina Ortho, New Bern NC Lost flexion due to scar tissue Flexion stuck @ 72 degrees
End of 2022 surgeon put me under to perform Scar Tissue removal surgery (open Knee up), he attempted MUA - it worked - he was able to get flexion to 116 degrees - he did not do surgery. I attended PT every week for many many weeks. Flexion decreased again due to Scar Tissue.
2023 surgeon perform open knee surgery to remove scar tissue to regain flexion. Attended PT continuously, flexion of 113 degrees was accomplished. . Feb 2024 pain presented behind right knee. I could not walk for several weeks, cannot do stairs normally, I have to do one at
a time. I cannot do more than 30 minutes of any activity that requires walking, standing, etc.
No housework, I was very active prior to my inital surgery. This journey has been 4 years and counting.. Currently in PT, recently presented to Duke Ortho in NC - CT Scheduled for 7/12/24 (this coming Friday) - 2 scenarios - bone spurs or fragment of cement left behind from TKR or scar tissue impinging popetiel tendon. Experiencing extreme pain daily with aching, sometimes numbness. my gut feeling is the scar tissue scenario affecting popetil tendon. If that the case, Dr Cline at Duke will perform Ultrasound Guided Percutaneous Tenotomy. Has anyone had this procedure done to their knee???

I had a total knee replacement 3 months ago. 6 days later I got a blood clot. 10 days after that, great pain and stiffness after home PT person pushed so hard I felt the pain in my head! The hospital kept me in for two nights. No one before or after surgery mentioned the possibility of scar tissue building up to the point of immobility. I’d have appreciated that information!
I worked hard but by two months my range was only 90-95 degrees bend. I went for MUA, but afterword the pain was excruciating and swelling worse. Now I can’t get past 80-82 degrees bend.
My question to everyone is, what will break up that scar tissue best? Continued PT, yes, but will a good massage therapist be able to make good progress with the knee? Please let me know, however, I’m not up for another MUA. Machines, exercising all day? My knee is painful!

MUA experience a month ago for scar tissue. Pictures of procedure evidence that my knee was bent to 135*!
I was swollen and painful and felt like it was all over again minus the incision concerns. But I knew I had to do aggressive therapy from first day. And yes, therapy all day for awhile. My surgeon gave me another Rx for oxycodone which I used initially to help me sleep and for PT. I definitely stayed with the 1000 mg Tylenol 3x/day and Motrin 200mg every 6 hours.
I had physical therapy everyday first week, then 3x/week plus my home therapy which I am really faithful in. I elevated my leg always and am still using my ice machine at night. I graduated to 1x a week now that I am going on 5 weeks post MUA. And, my surgeon has never checked on my progress.

Your story shows scarring easily formed. It also sounds like a disconnect with your surgeon and pain control. The MUA may have worked if you had a prescribed regime for pain control. It hurt at first with that swelling.

No massage or light PT will get the joint moving if scarring and fibrotic tissue occurred again. More communication and being your own advocate is important. Don’t let them blow you off. Mine didn’t want to do my MUA. He was happy with 90*! Don’t settle. Don’t give up.

I didn’t get enough PT initially either as they sent someone with Covid to my home and I fired her not realizing that even a few days could make a difference. Gotta keep moving.

Best wishes.

Your advice is helpful and appreciated. The medication is very important for me to work though. Thanks!

I was so nervous about narcotic use and all the news of addiction. Perhaps I didn’t use it enough after my surgery because of this. I don’t know. Never went through any of this before.
Good luck.

The biggest issue for me is making progress! Getting the bend, being able to walk normally again are my top priorities. I have been aware that I have to work through the pain, so despite my hesitations in taking the drugs, I have to take them I wouldn’t take oxycodone but hydrocodone with a Tylenol and maybe a muscle relaxer for the most painful times. Now I can take halves which is working ok for me. And Benadryl for sleep helps also.
Without the drugs, progress would be so painful, I can’t imagine.

Pain control for aggressive physical therapy. Ice machine is my buddy, rest and elevation.

My PT had to teach me how to walk all over again.
You have to be able to bend your knee at least 115* to get on with life. And a pretty good full extension. If it hits too much and you don’t see improvement- your numbers never change, you probably should think of another MUA. PT the next day, ever day.

Hurts, not hits.

A ringing endorsement for being a strong advocate for yourself. I have found it exhausting to do the research, reading, questioning providers,etc at this point in my life 76. Just when you think you're retired you find that medical self advocacy is a full time job. Sigh

So true!!!