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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@gator1965

My scar tissue started occurring at just under 3 weeks post TKR, certainly this was when a very observant physio noticed that things were not progressing as they should do. At this point my knee flexion was under 70 degrees, and then despite intensive physio this continued to worsen in between physio appointments. It felt like my knee was surrounded by concrete. I had a manipulation under anaesthetic at 11 weeks post TKR, I was then advised that I had arthrofibrosis. The scar tissue reformed at 2 weeks post manipulation despite more intensive physio, and I was unable to maintain by range of movement between physio sessions. 13 weeks after the manipulation I underwent arthroscopic arthrolysis and debridment of left knee for extensive fibrosis . It is a daily battle to keep my knee flexion at 90 degrees, it feels as though my knee is surrounded by Velcro.

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@gator1965 For the ROM, the X-10 machine is really amazing. Look it up. I used it early on and wish I could have used it longer. (Its hard to rent a machine bec there is such demand.) Now, some 4 months later, (8 months post op) without enough good PT, I feel like I have bubble wrap around knees. Am learning here that it sounds like scar tissue.

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@lkinny I'm confused about the efficacy of the X-10 machine if you now have scar tissue ... did you not use it long enough? Did you stop PT too soon?

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@lkinny

@gator1965 For the ROM, the X-10 machine is really amazing. Look it up. I used it early on and wish I could have used it longer. (Its hard to rent a machine bec there is such demand.) Now, some 4 months later, (8 months post op) without enough good PT, I feel like I have bubble wrap around knees. Am learning here that it sounds like scar tissue.

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This x10 machine looks good. I used a CPM machine post TKR, MUA and following my recent arthroscopic arthrolysis and debridment of left knee surgery, but only when I was in hospital, as both the surgeon and physio wanted me to get the ROM by myself. After the TKR and MUA I was having physio twice weekly and they were using a cybex machine, but the scar tissue was reaccumulating between these sessions.

Although the physio at the operating hospital has discharged me on Tuesday , she said the knee flexion was 120, the Royal Orthopaedic Hospital said ROM yesterday was +5-105, so slightly confused! I am still having hydrotherapy, but this caused a lot of pain yesterday and this morning. My knee still feels like it is surrounded by Velcro, which I have to break down every day....

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@babette

@lkinny I'm confused about the efficacy of the X-10 machine if you now have scar tissue ... did you not use it long enough? Did you stop PT too soon?

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I'm experiencing a persistent , painful tendon pain back of knee. Don't actually know if scar tissue is the cause .. thought I'd read this group's experience. I haven't found much info about this. You are right: I couldn't get the machine as long as I wanted. I think my PT was so amazed at my early progress that they were way too "easy" and stopped too soon. They also told me to go easy on the exercises, so I wasn't aggressive at home. The literature says I am more prone to scar tissue due to 40 years of knee problems and dozens of dislocations. The machine is pretty amazing and I've asked to get it back again. Like most who use it my ROM had initially and easily, comfortably, with zero PT pushing, had gotten to 122- 128. Then had to give back machine 🙁

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@gator1965

This x10 machine looks good. I used a CPM machine post TKR, MUA and following my recent arthroscopic arthrolysis and debridment of left knee surgery, but only when I was in hospital, as both the surgeon and physio wanted me to get the ROM by myself. After the TKR and MUA I was having physio twice weekly and they were using a cybex machine, but the scar tissue was reaccumulating between these sessions.

Although the physio at the operating hospital has discharged me on Tuesday , she said the knee flexion was 120, the Royal Orthopaedic Hospital said ROM yesterday was +5-105, so slightly confused! I am still having hydrotherapy, but this caused a lot of pain yesterday and this morning. My knee still feels like it is surrounded by Velcro, which I have to break down every day....

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What exactly do they do in hydrotherapy? I am really not as informed as others on this blog ... I also feel I have to "restart" to some degree each day... doesn't everyone in the first 3 -12 months? The stationary bike helps with that. My understanding from friends and the surgeon was that it would 3 - 12 months for that to improve. Especially true for me since my problems started 40 years ago when I was young and I did bilateral. I had a very unrealistic picture from the healthier people I read about on the internet!

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@lkinny

I'm experiencing a persistent , painful tendon pain back of knee. Don't actually know if scar tissue is the cause .. thought I'd read this group's experience. I haven't found much info about this. You are right: I couldn't get the machine as long as I wanted. I think my PT was so amazed at my early progress that they were way too "easy" and stopped too soon. They also told me to go easy on the exercises, so I wasn't aggressive at home. The literature says I am more prone to scar tissue due to 40 years of knee problems and dozens of dislocations. The machine is pretty amazing and I've asked to get it back again. Like most who use it my ROM had initially and easily, comfortably, with zero PT pushing, had gotten to 122- 128. Then had to give back machine 🙁

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I used it very early on and then PT discharged me before I wanted. So now it's like 5 - 6 months later. I've developed the tendon pain more recently.

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@lkinny

What exactly do they do in hydrotherapy? I am really not as informed as others on this blog ... I also feel I have to "restart" to some degree each day... doesn't everyone in the first 3 -12 months? The stationary bike helps with that. My understanding from friends and the surgeon was that it would 3 - 12 months for that to improve. Especially true for me since my problems started 40 years ago when I was young and I did bilateral. I had a very unrealistic picture from the healthier people I read about on the internet!

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Hydrotherapy is really lush, like getting into a warm bath but it is a very small swimming pool. The warmth of the water relaxes the muscles and eases the pain of the joint. The water supports your weight meaning that you can get a better range of movement.

The exercises are very similar to what you normally do post knee replacement, so lots of knee bending, stepping up and down , pool walking etc. The session I have usually lasts for 30 minutes with 3 other people with similar conditions and a physio gets in the water too. Your exercises are individually tailored to your needs. I have had 6 weekly sessions to date, I am due another one on Thursday and the physio said she will reassess me then as to further treatment.

I had been going to our local swimming pool prior to hydrotherapy and been exercising however the water is much colder so I found I could not bend as much as I can in hydrotherapy.

Like you I have to restart every day trying to bend the knee, it is hard work!

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@gator1965

Hydrotherapy is really lush, like getting into a warm bath but it is a very small swimming pool. The warmth of the water relaxes the muscles and eases the pain of the joint. The water supports your weight meaning that you can get a better range of movement.

The exercises are very similar to what you normally do post knee replacement, so lots of knee bending, stepping up and down , pool walking etc. The session I have usually lasts for 30 minutes with 3 other people with similar conditions and a physio gets in the water too. Your exercises are individually tailored to your needs. I have had 6 weekly sessions to date, I am due another one on Thursday and the physio said she will reassess me then as to further treatment.

I had been going to our local swimming pool prior to hydrotherapy and been exercising however the water is much colder so I found I could not bend as much as I can in hydrotherapy.

Like you I have to restart every day trying to bend the knee, it is hard work!

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OK, I didn't understand; thought hydrotherapy caused some pain. Sounds nice. I hate how cold pools are.

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@lkinny

OK, I didn't understand; thought hydrotherapy caused some pain. Sounds nice. I hate how cold pools are.

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No, it is normally quite painless, they get you to stop an excercise if it becomes painful , and always check how you are following the last session. I have heard mixed reports from people about hydrotherapy but for me it has helped.

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I’m 3 weeks out from knee replacement and have experienced the same issues you have with the scar tissue. It is very painful and nobody told me about this part of the process. I began outpatient therapy yesterday with a new therapist. She elevated my feet out the e-stem machine on the 4 corners of the knee, avoiding the incision. She then out cold packs right out of the freezer in it and set it for 15 minutes as high as I could tolerate the electric stimulus. At first it seemed comfortable but the last about 4-5 minutes is almost more than I could handle. Next time I’ll ask that she not out the ice packs directly on skin as it burns. Afterward I had leased pain and could move the knee a little more.

I think if I were you, have dr write a script for an at home tens unit and try to duplicate something like this at home. My insurance bobs did pay for it 100% - maybe your wil to. If the dr is aware of your situation see if you can get therapy 5 days a week for awhile. The pt I go to is also going to use hydro therapy in the pool once my incision is completely healed in about a month. Said it would help in movement but also in breaking scar tissue. Maybe find someplace near you with a pt with a pool- they are out there and I can’t wait to get started in moving again.

Until then I feel your pain and nobody that hasn’t experienced this cannot imagine the intense pain that comes with it. I’m sick of the almost constant pain and discomfort. Hang in there, I know it’s hard. Find a way. Rad about therapies online and ask a lot of questions and don’t take no for an answer!

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