Scar tissue after knee replacement

Graston Technique and Myofascial release Massage is also option this for scar tissue, ROM, and ultimately relieving pain. I did both- Graston hurts like a mother but is probably most effective

Dry Needling works on the pain from scar tissue but it doesn’t remold so it’s not a “fix”. Grayson and ASTYM are similar. In the case of a TKR, Grayson uses stainless steel tools and is targeted to an area. ASTYM uses plastic tools and the entire leg (toes to thigh- front and back) is treated. I tried all three techniques before I agreed to have the original surgeon go back into the knee and do an arthroscopic lysis of adhesions.

Thank you so much this is the answer I was looking for the only answer is arthroscopic surgery to remove the scar tissue

Yes

I had the arthroscopic lysis done 1.5 weeks ago. Despite a ton of research, I feel like I was unprepared for the recovery. So I’ll let you know how my last week and a half has been.

Prior to the surgery, I was at 105 degrees flexion. The surgery was on Wednesday afternoon and the surgeon got me to 130 flexion. First PT was Thursday at noon. On my own, i could only get my flexion to 105. The PT therapist forced my leg to 130. I was given the following “homework”.

10 mins stationary Bike
10 mins supine leg pull
10 mins prone leg pull
10 mins extensionator
20 mins ICE
1 hour elevated rest
REPEAT 5 times
Walk no more than .25 miles in house only

That’s one hour of stretching, one hour rest for a minimum of 10 hours a day.

Next session was Friday afternoon and I got to 115 on my own pulling - and the therapist forced it to 130. Weekend I was in my own with the homework.

The next Monday, I had PT early in the AM and got to 118 on my own pulling and the therapist forced to 130. I was told then that- since there was progress over the weekend (ie I could move it more on my own - even forced) and the therapist could still get to 130 - I had a decent shot at remolding the scar tissue.

I have PT three times a week and the homework is now

10 mins stationary Bike or eliptical (alternate)
10 mins supine leg pull
10 mins prone leg pull
10 quad sets
20 short arcs
10 mins extensionator
20 mins ICE
30 mins rest
20 mins heat
REPEAT 5 times
Walk no more than .25 miles in house only

The home PT is very painful. It’s hard to pull on your leg for 30 mins every other hour all day long and I am in tears doing it. It hurts to bend and walk any right now and I’m wondering if this was the right answer.

However - I can bend it more for sure and if I’m being honest with myself, the pain is probably surgical mostly since I’m only 1.5 weeks out and will probably ultimately pass. Still, forcing movement like this and this much PT is very very hard.

Good Luck

That is very aggressive physio indeed. My flexion was 70 degrees under General anaesthetic before the arthroscopic arthrolysis and the surgeon got it to 120 degrees after surgery. I had hydrotherapy on a weekly basis for the next 6 weeks. My knee flexion now is between 96 and 100 degrees, and my surgeon has discharged me. Thankfully I am still having physio every 2 to 3 weeks. Certainly they never forced the flexion

Thank You for posting your experiences- I have been diagnosed after TKR in July, MUA in September and months of painful PT. Don't know what to do...

Hi @damewocane - Welcome to Connect! I'm sorry to hear about your painful recovery. It does sound frustrating to have worked so hard and feel like you are not getting anywhere. Can I ask what led to them doing the manipulation under anesthesia in September? It sounds as if that was just 8 weeks or so after the TKR. I don't have any experience with MUA's so I'm curious what triggers their decision to use this technique?

@damewocane @rayreich3 @gator1965

Here’s an update on the arthroscopic lysis I had done 3 weeks ago.

I was at my wits end last week - crying in each PT session as they forced my leg back to 130 - where it was after the surgery. I broke down and emailed the surgeon to see if he could do anything. He doubled my dose and said to try that for a week (eg 3 more PT sessions and the homework).

The first of those PT sessions was yesterday- and guess what? I “graduated”!!! I was able to force my leg on my own to 125 - so the PT guy said I can now walk 10 mins twice a day and reduce the homework to 3 times a day! Other than that- butt on the couch with leg elevated - but no longer 5 hours of stretching a day!!!!! Only bad news is I can’t lift my leg for a short arc anymore- but can move the kneecap - so PT just upped the quad sets to “unlimited “ or as many a day as I can stand.

I’m convinced that I’m one of those unlucky people that has a genetic disposition to generate scar tissue. This is the third surgery that I have had this issue and by far the most painful.

But - there is hope. Slot of painful work in front of me still - but hope. And if I can get back to standing and walking without pain eventually- I’ll take that pain (and the pain meds) now.

I had laser for scar tissue about 6 months after surgery. Was very quickly done and worked well.