8 Months after TKR Serious Grinding

My TKR surgery, 3/3/22, was "unremarkable" Seems that everyone including the surgeon expected that I would be right back on my feet and would have no problems - because I am fit and healthy and active. There was slight crepitus early on that was deemed innocuous. The PT guy thought there might be patellar tracking issues, but after a while it seemed like there was a distinct catch upon straightening my leg from a flexed position. It seemed to fit the description of "patellar clunk" which the PT guy had never heard of!!!! At my 3 month appt, my surgeon, after feeling the grinding when I straightened my leg, almost winced and said something like - " it's too early to panic; only 3 months" etc. Let's see how things are at the 6 month appt". Meanwhile at around 4 months the PT guy noticing that the situation wasn't improving said that I should see the surgeon before the 6 months. Due to scheduling I only got in to see him a few weeks early. Nothing was decided except that it was an unusual or rare situation. Apparently out of 150 surgeries that Dr W had done this past year, I and one other person had a catch like this on straightening. The surgeon suggested that he could open the incision and clean out scar tissue, which is what he had done with the other patient with this problem. ( This fellow seems to be doing well several months after the corrective surgery; I spoke with him about it to find out what his experience was like)

I am very hesitant to have surgery again and of course there's no guarantee that the scar tissue won't recur ( assuming that is what it is) Plus I asked the surgeon about a less invasive procedure - such as a scope to correct the scar tissue. He feels that he prefers the open surgery. ( I'm thinking in his practice ( he does a LOT of TKRs) perhaps he doesn't do scopes very often? dunno) Anyway, he suggested seeing another surgeon. Made 2 referrals to guys who are supposed to be great. Neither would see me. 🙁 My cousin, a nurse suggested I see a sports med guy who she says is brilliant and who helped her with her knees. That referral which I first initiated Oct 15 or so is in progress - and obviously is taking a while!! Meanwhile I am not even sure that it's an appropriate referral....but I guess I will find out - if the Doc says he won't see me. Then on to the next referral?

Meantime the knee is NOT getting better. I do have full ROM - but what good is it when every time I stand from a sitting position, walk down stairs, try to step up I get this terrible grinding- and it's painful, depending on how much pressure I am putting on the joint. I am still doing exercises that the PT guy gave me ( second PT guy) Trying to keep the muscles strong. (Also - I walk most days and swim and am pretty much on my feet and moving around a lot unless I am at my part time job which involves a lot of computer work. - can walk a few miles but it gets a bit stiff and sore. Have not been able to get back to hiking and biking. ) PT guy also tried dry needling to try to release the scar tissue - but some of it seems to be right between the kneecap and femur, so hard to get the needle in there. The first PT guy, btw also tried ultrasound to break up the scar tissue.

The knee is still often a bit warm to the touch compared to my other knee and a bit swollen - but not terribly. This is all really stressing me out. And is sometimes depressing. I wonder if my expectations were just too high? I thought I would get back to normal - which for me is a LOT of physical activity.

Something HAS to be done. I am willing to wait this out for a while - maybe get some more PT, keep working it to see if the grinding will lessen with time, but I can't live with this forever, for sure!!! At this point I feel like I am on my own. I know I have to advocate for myself. I know I may have to have another procedure, but I want to figure out the best approach - plus I want to have a clear diagnosis. Can MRI ever be helpful in visualizing what is happening with TKR?

I've been reading other people's posts in this forum for a while so I thought I'd see if anyone has had a similar experience or has any suggestions.
Thanks!