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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@irenesara

How long did you suffer before your doctor agreed to go in with the scope?. Did he take before and after photos? I'm 4 months past TKR and have painful clunking since surgery really that is getting worse. He says I need to heal more and he won't do a scope for at least 4 more months. I hope to hear from you and thank you for sharing. Sara in Florida

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I'm coming up on 4 months past TKR. Had trouble with ROM both flexion and extension. Went to 3 month visit to surgeon and he suggested manipulation under anesthesia. Had the mua and started PT 5 days a week for 3 weeks after. I also started with a Dyna-Splint to help with extension. All three helped tremendously. My flexion increased and eventually pain reduced greatly. Extension is slower but still improving.
Scar tissue can be a bear! Some people develop more and quicker than others. I was very apprehensive about the mua but very glad I did it. MUA only got me to 115 flex and -3 extension but that's plenty for me. I would suggest mua early to everyone to break up scar tissue. Best of luck!

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@kenbo

I'm coming up on 4 months past TKR. Had trouble with ROM both flexion and extension. Went to 3 month visit to surgeon and he suggested manipulation under anesthesia. Had the mua and started PT 5 days a week for 3 weeks after. I also started with a Dyna-Splint to help with extension. All three helped tremendously. My flexion increased and eventually pain reduced greatly. Extension is slower but still improving.
Scar tissue can be a bear! Some people develop more and quicker than others. I was very apprehensive about the mua but very glad I did it. MUA only got me to 115 flex and -3 extension but that's plenty for me. I would suggest mua early to everyone to break up scar tissue. Best of luck!

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Oh. I was under the impression you had arthroscopy to clear out scar tissue. My RO motion is pretty good but I've got painful clunking and soft tissue catching around my kneecap.

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They will usually try manipulation before arthroscopic.
Best of luck!

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My question; is how does one know if it is scar tissue that is causing the difficulty. I was told an MRI isn't good because of the metal in the hardware, someone mentioned an ultra sound could help diagnose soft tissue. I had mua done 3 mos. after tkr. The surgeon showed me a picture of my knee in a total bend as i lay in bed in agony and I thought . . . sure you can do it but will I and then he tells me there really was not much scar tissue. I did pt 3x a week, used a cpm machine 2 x a day and still my bend was not improving. I am a year and 9 mos. out and I am now just beginning to feel like my knee is healing and it doesn't feel awful. I never dreamed it would take this long.

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@skshapiro

My question; is how does one know if it is scar tissue that is causing the difficulty. I was told an MRI isn't good because of the metal in the hardware, someone mentioned an ultra sound could help diagnose soft tissue. I had mua done 3 mos. after tkr. The surgeon showed me a picture of my knee in a total bend as i lay in bed in agony and I thought . . . sure you can do it but will I and then he tells me there really was not much scar tissue. I did pt 3x a week, used a cpm machine 2 x a day and still my bend was not improving. I am a year and 9 mos. out and I am now just beginning to feel like my knee is healing and it doesn't feel awful. I never dreamed it would take this long.

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Studies indicate MUAs are not effective if components are oversized. Have you had a second opinion?
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3777155/
My second opinion said no one would touch me until 1. A MUA had been tried and 2. A year had passed since TKA

My MUA seems to be working so far. Still exercising, icing, elevating, NSAIDS…

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@cathymw

Studies indicate MUAs are not effective if components are oversized. Have you had a second opinion?
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3777155/
My second opinion said no one would touch me until 1. A MUA had been tried and 2. A year had passed since TKA

My MUA seems to be working so far. Still exercising, icing, elevating, NSAIDS…

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Keep it up Cathy! My pain eventually got much better after exercising and PT scrapping hamstrings and tendons around the knee. I was feeling down the first week after the mua but started seeing the light at the end of the tunnel. It should get even better!

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@skshapiro

My question; is how does one know if it is scar tissue that is causing the difficulty. I was told an MRI isn't good because of the metal in the hardware, someone mentioned an ultra sound could help diagnose soft tissue. I had mua done 3 mos. after tkr. The surgeon showed me a picture of my knee in a total bend as i lay in bed in agony and I thought . . . sure you can do it but will I and then he tells me there really was not much scar tissue. I did pt 3x a week, used a cpm machine 2 x a day and still my bend was not improving. I am a year and 9 mos. out and I am now just beginning to feel like my knee is healing and it doesn't feel awful. I never dreamed it would take this long.

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My surgeon actually was listening to my knee while I was flexing at my 3 month checkup. My knee was tight every morning and would loosen some with PT, exercising and icing. It didn't ever not feel tight. He suggested the mua and it's been improving since. Everyone is different and I'm glad you're finally getting some relief. Hope it continues! That's a long time to be in pain, physically and mentally.

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@kenbo

I'm coming up on 4 months past TKR. Had trouble with ROM both flexion and extension. Went to 3 month visit to surgeon and he suggested manipulation under anesthesia. Had the mua and started PT 5 days a week for 3 weeks after. I also started with a Dyna-Splint to help with extension. All three helped tremendously. My flexion increased and eventually pain reduced greatly. Extension is slower but still improving.
Scar tissue can be a bear! Some people develop more and quicker than others. I was very apprehensive about the mua but very glad I did it. MUA only got me to 115 flex and -3 extension but that's plenty for me. I would suggest mua early to everyone to break up scar tissue. Best of luck!

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Very happy with your results and hope you continue to recover well. A word of caution, with these knee procedures (there are risks with then all) particularly MUA . My (highly regarded) surgeon achieved 125 degrees flexion, but intended up with a stress fracture in my femur, quadriceps hematoma and bleeding from blood vessels, that left me immobile for 3 1/2 weeks. At 6 months since the initial TKR I have 90 degrees ROM (on a good day) and looking at surgical removal of scar tissue in 5 weeks, with a minor revision of the TKR and rod inserted in my femur to stabilize it in case I need another MUA . It’s been a journey! So glad to have had this group to help me navigate the ups and downs

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Oh my word. How awful. What a huge impact on your life.
Mentally, physically and financially. Keep on pressing forward. You can do it!
My surgeon suggested he only did a handful of MUAs. I’d like to see better records with the Drs of these stats, and better research to handle our issues.

I have a mighty strong pain tolerance ( or so I thought), but endless sessions of torture PT is crazy if results don’t stick. There needs to be better follow-up.

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@spinner2

Very happy with your results and hope you continue to recover well. A word of caution, with these knee procedures (there are risks with then all) particularly MUA . My (highly regarded) surgeon achieved 125 degrees flexion, but intended up with a stress fracture in my femur, quadriceps hematoma and bleeding from blood vessels, that left me immobile for 3 1/2 weeks. At 6 months since the initial TKR I have 90 degrees ROM (on a good day) and looking at surgical removal of scar tissue in 5 weeks, with a minor revision of the TKR and rod inserted in my femur to stabilize it in case I need another MUA . It’s been a journey! So glad to have had this group to help me navigate the ups and downs

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Thank you for the encouraging words! The last thing I wanted to do was an MUA but I trust my surgeon, who has many years of experience. So sorry you went through what you did. Even with a highly regarded surgeon, bad things can happen. However, that seems like a lot of damage for a MUA. Best of luck with the surgical scar removal! One question. Did they drill your new knee parts to bone or use cement?

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