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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@gutthookd

Dear JK (and all) -

Re the X10... I'm having problems getting answers (of any kind) after my first short phone conversation with a person
who was mainly in the "sales" end of this (these are a kind of short term lease @ about $ 125 per day). He suggested
that I speak with or have my physical therapist speak with a "physical therapy person" they have on staff, but in over
a week of calling - no response. Everything I was able to read off their site suggests that best results are immediately
AFTER surgery or an MUA (which makes sense - because that's when they have the best chance of "moving" the knee
towards gains in both directions. It's unfortunate that their area of availability is so limited and that they are so difficult
to get answers out of. If you think about it - they don't really have to provide much, because they have so many desperate
people out there who are willing to try anything at any cost or inconvienence. That's a tragic statement in itself.

But... I will continue to research this further and if I end up making this pilgrimage, I'll keep everyone there updated on
the results (good or otherwise). My main question is "Can this help me now 7 weeks after the MUA and about 14 weeks
after the surgery ?" All I'm getting is a sort of unspecified "maybe" (which sounds like we are only certain of the same one
thing - they will get paid regardless).

best all 9and thanks),

John

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@gutthookd Please do keep us updated. Does insurance cover the X10 at all? If you have to use it for long that's a pretty high per diem. How long do they recommend using it?
JK

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@contentandwell Your wise to avoid then

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@annfaber

6 yrs. Last time they did full leg block, used pain pump and discharged after 2 days with percoset 1 to 2 as needed every 4 hours. Stopped percoset quickly except for PT. Excellent recovery. Quick and complete. Only difficult time occurred after too aggressive PT session.
This time i was asked to fill prescriptions for anti inflamatory sulidec and purchase omeprezole and asprin, gabapentin and cymbalta for pain management. I cant take cymbalta so nixed that one.

This time also: partial block (useless)and 2 percoset q 4 hrs with oxycodone once in a while. Pain was excruciating. PT excessively aggressive. Miserable upon discharge. Current pain management useless as prescribed. They are trying to tell me that current protocol is due to new State regulations regarding opiates. I have a copy of the law and they are either lying or stupid. An acquaintance was discharged yesterday on the good old 1 or 2 percoset q 4 hrs prn. Also prior to surgery there were multiple errors in preparation. And Im told not to take the meds purchased prior to surgery and am taking xeralto instead. The practice has become an assembly line and no longer sees the human being.

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So sorry to hear of all your pain-I got 2nd opinion regarding scar tissue overgrowth , btw, only 1% of tkr patients have this problem, Not around 5 % as my ortho surgeon told me when he discharged me in December!... The new Ortho Drr. suggestion is to wait another 6 months-feels there was likely a miscalculation of part sizes used in the tkr titanium replacement ...sleepless nights, stabbing pain is a sad way of life. On a waiting list to see pain management specialist but from what I'm reading here... Doesn't look promising.

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@contentandwell

@gutthookd Please do keep us updated. Does insurance cover the X10 at all? If you have to use it for long that's a pretty high per diem. How long do they recommend using it?
JK

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Good morning, JK, Dame Wocane, and all -

First on the X10 - This item is ONLY covered by Blue Cross/Blue Shield in Michigan (the original surgeon/inventor
has strong links to Unniversity of Michigan Dr. Haller - also his CEO and several of his corp people are grads).
U of M has a lot of influence in that state. When you go to their website - you see the limits on the areas you can
get access to this. If you anywhere other than the mid-west (or Florida) you're making a 3-4 week pilgramage
that will NOT be covered by your insurance.

Dame Wocane - My first TKR was severely complicated by an obviously oversized upper (femoral) portion of the prosthetic.'
They don't say much about this (or anything), but these are "shelf components" stocked in these surgical centers. Yes, they
take xrays and MRI's but on the day of surgery I am told they "eyeball" the joint cavity when it is opened up and select what
they think will fit. This process is literally called (and I'm not making this up) "stuffing the joint cavity" (like a Christmas turkey
maybe). The prosthetic joint consists of three pieces - an upper, lower, and middle insert (usually polyethelyne). These are
"sized" like shoes. What isn't commonly known is that - it's common for someone to receive a size #6 upper portion and then
a 6-1/2 or #7 lower portion based on their individual physiology (and what should ideally fit best). When you understand that
most of these surgical centers are in a literal race to see how many of these they can do in a day... it's easy to see how these
mistakes (which are usually never admitted by theoriginal surgeon - deemed "close enough") happen frequently. In my own case,
foe the partial revison I got two opinions from respected local surgeons who both commented that the upper portion was clearly
oversized. The one who said this "the loudest" is the one I chose. Writing up the recommendation to my insurance for the necessity
of the procedure, he significantly "soft-pedaled" this as "a possible explanation and something that might work to solve the problem"
although this was drastically stated to me as "the knee can NEVER recover properly if you don't do this". Sometime after the revison
surgery I learned that a sizeable amount of his business came from doing surgical TKR revisions from this surgeon mainly as well
as other local surgeons (all of course "highly respected" but mostly by each other). Typically... you can expect surgeons to never admit
that there ever was a problem with the surgery they themselves performed - and they assume no responsibility (financial or otherwise).
These people are being very well paid as "guardians" of our best health interests. At some point we must ask the question:
Quis custodiet ipsos custodes?

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@gutthookd

Good morning, JK, Dame Wocane, and all -

First on the X10 - This item is ONLY covered by Blue Cross/Blue Shield in Michigan (the original surgeon/inventor
has strong links to Unniversity of Michigan Dr. Haller - also his CEO and several of his corp people are grads).
U of M has a lot of influence in that state. When you go to their website - you see the limits on the areas you can
get access to this. If you anywhere other than the mid-west (or Florida) you're making a 3-4 week pilgramage
that will NOT be covered by your insurance.

Dame Wocane - My first TKR was severely complicated by an obviously oversized upper (femoral) portion of the prosthetic.'
They don't say much about this (or anything), but these are "shelf components" stocked in these surgical centers. Yes, they
take xrays and MRI's but on the day of surgery I am told they "eyeball" the joint cavity when it is opened up and select what
they think will fit. This process is literally called (and I'm not making this up) "stuffing the joint cavity" (like a Christmas turkey
maybe). The prosthetic joint consists of three pieces - an upper, lower, and middle insert (usually polyethelyne). These are
"sized" like shoes. What isn't commonly known is that - it's common for someone to receive a size #6 upper portion and then
a 6-1/2 or #7 lower portion based on their individual physiology (and what should ideally fit best). When you understand that
most of these surgical centers are in a literal race to see how many of these they can do in a day... it's easy to see how these
mistakes (which are usually never admitted by theoriginal surgeon - deemed "close enough") happen frequently. In my own case,
foe the partial revison I got two opinions from respected local surgeons who both commented that the upper portion was clearly
oversized. The one who said this "the loudest" is the one I chose. Writing up the recommendation to my insurance for the necessity
of the procedure, he significantly "soft-pedaled" this as "a possible explanation and something that might work to solve the problem"
although this was drastically stated to me as "the knee can NEVER recover properly if you don't do this". Sometime after the revison
surgery I learned that a sizeable amount of his business came from doing surgical TKR revisions from this surgeon mainly as well
as other local surgeons (all of course "highly respected" but mostly by each other). Typically... you can expect surgeons to never admit
that there ever was a problem with the surgery they themselves performed - and they assume no responsibility (financial or otherwise).
These people are being very well paid as "guardians" of our best health interests. At some point we must ask the question:
Quis custodiet ipsos custodes?

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The above describes exactly what happened to me. Six weeks post op from revision and so happy I sought out a second opinion as my original surgeon was treating me for scar tissue and never mentioned another possibility. Said he did his part well and it was now up to me to break the scar tissue. I know it can be hard to find someone who will take you as a patient but what I learned is there are doctors who specialize in revisions. I just got lucky I know as I was turned down by two doctors but don’t give up and know what this person above explained that the fit can be the culprit.

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@registerednurse

Oh Jeez--I feel for all you knee people on here. I am a 65 year old retired oncology nurse. I had a TKR in 2010 and a MUA about 3 weeks after that. In the past 17 years, not the greatest ROM but I learned to live with it. I found if I rode my bike religiously--and I wired my left foot onto the pedal--since it wanted to slip off due to stiffness--if I rode my bike daily, I could keep my ROM. But I found it utterly AMAZING that if I didn't ride my bike every day, that by the next day of riding, my knee was very stiff again. Wow--that is some kind of tissue/adhesion growth rate!! So basically, I rode my bike 10-15 miles a day out of utter fear. In 2017, I got an ugly debilitating infection in the TKR and ended up going to the hospital via 911 and having it immediately debrided. I was on antibiotics for 7 months and was told by my infectious disease doc that ultimately, I would need to have it re-done since the infection would always be in there--silently smoldering. I have taken a chance by stopping the antibiotics and not having the surgery. So far so good. But I am kinda waiting for the other shoe to drop. In the meantime--THE DEBRIDEMENT HAS INCREASED MY ROM HUGELY!!! While my knee is ugly and swollen and criss-crossed with suture lines, I feel unbelievably lucky to have been able to have the emergency debridement and the subsequent increase in ROM. I have been to 3 different ortho people and they all say--"Don't mess with it. Leave it alone." The 4th one said "You will really regret not having this new TKR done now--when you are still 65 and fairly mobile. It's gonna be a lot tougher on you with each year that passes--when the infection flares up and you get back in serious trouble." Well, that may be the case--but in the meantime, I am enjoying my mobility and will cross the bridge when I come to it. I have a question about the stem cell ads I see in the newspaper. Can someone kindly tell me about it, if it could work for me, and what its goals are? Thank you. Love, Mary Ann

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Here's what i've learned about the stem cell theory from asking 3 different Ortho M.D's in my area, (Fl.) -anyone else please lets hear what your experience is- It is my understanding that as far as using stem cells for knee replacement healing- there are no good results yet- for other things, yes. My new MD explained that if I go in for round two after 6-9 months, there is a technology which is still Experimental, where they take your bone marrow and grow a compatible stem cell system- no promises, yet. Don't be taken in by scammers!

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You are correct about scammers. The scammer buy stem cells from sales people and the cells are dead. I worked with a dr who was trained by Regenexx and i had knee and my back done. I had great success. My TKR was a disaster. Work out in water the knee swells. Been 6 years and my TKR is twice the size of my stem cell knee. I wish i had a do over. My stem cell knee was one of following directions. The cells were taken from my hip and mixed with my blood for 3 hours. Then injected in the knee. Took 10 days of lying around reading and watching TV. Never took any pain pills. It took time but i can do everything but play tennis. Golf, gardening, down on my stem cell knee, biking etc. No swelling. I am still seeing my ortho dr about the TKR swelling and pain and i get a good shoulder shrug. The orthos who work in same hospital as stem cell dr continue to bad mouth it, but now Promedica is now covering all their employees for stem cells with Regenexx. Other insurance companies are also covering it. I wish i had a do over on the TKR . I know many have success but judging by what i read many do not. I was told , yes tennis and all the activity you did before. I now walk down my steps backwards to avoid the pain. Pretty good at it. I learned about stem cells from Mayo and its use on arthritis. I found out about DR Kruse in Toledo and i am happy with my results. I would recommend people interested to go Regenexx web site. They keep all the data on their success and failure rates. My friend had his hip done and was told it was a 50 50 chance. They were honest with him. He is happy with the results.
My back had an L4 and a L5 rubbing on the nerve. 2 friends had the same and had operations twice and did not work. I had the injection and within weeks i noticed the difference,
Bottom line, do your homework. Do not go to drs who buy stem cells. Chances are they are dead. Use your own and stay away from meds and pills that kill your stem cells and their are many. Good luck

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@cobweb

You are correct about scammers. The scammer buy stem cells from sales people and the cells are dead. I worked with a dr who was trained by Regenexx and i had knee and my back done. I had great success. My TKR was a disaster. Work out in water the knee swells. Been 6 years and my TKR is twice the size of my stem cell knee. I wish i had a do over. My stem cell knee was one of following directions. The cells were taken from my hip and mixed with my blood for 3 hours. Then injected in the knee. Took 10 days of lying around reading and watching TV. Never took any pain pills. It took time but i can do everything but play tennis. Golf, gardening, down on my stem cell knee, biking etc. No swelling. I am still seeing my ortho dr about the TKR swelling and pain and i get a good shoulder shrug. The orthos who work in same hospital as stem cell dr continue to bad mouth it, but now Promedica is now covering all their employees for stem cells with Regenexx. Other insurance companies are also covering it. I wish i had a do over on the TKR . I know many have success but judging by what i read many do not. I was told , yes tennis and all the activity you did before. I now walk down my steps backwards to avoid the pain. Pretty good at it. I learned about stem cells from Mayo and its use on arthritis. I found out about DR Kruse in Toledo and i am happy with my results. I would recommend people interested to go Regenexx web site. They keep all the data on their success and failure rates. My friend had his hip done and was told it was a 50 50 chance. They were honest with him. He is happy with the results.
My back had an L4 and a L5 rubbing on the nerve. 2 friends had the same and had operations twice and did not work. I had the injection and within weeks i noticed the difference,
Bottom line, do your homework. Do not go to drs who buy stem cells. Chances are they are dead. Use your own and stay away from meds and pills that kill your stem cells and their are many. Good luck

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So did the stem cell help your knee. I would like to start it but very expensive my insurance will not pay for it. But with that being said if it help with this partial knee replacement that isn't getting any better I would surely do it

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@kneeproblem

So did the stem cell help your knee. I would like to start it but very expensive my insurance will not pay for it. But with that being said if it help with this partial knee replacement that isn't getting any better I would surely do it

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Look at Regenexx and mayo clinic and find Drs who know what they are doing. My Dr examined my MRI and said its doable. My TKR dr said no way. I called him and told him to look for another job. We kid a lot even though my knee is a total flop.
I keep saying regenexx because i have not found out who else to trust. You can get on their newsletter once a week. They do train the drs. My back dr was trained on back with stem cells and id now being trained on the neck etc.
It is sad to see unqualified people taking advantage of people and tgen the word is spread that it does not work. One item is unknow. How long does it work. I keep working out and working on strength of my legs. I did that before the TKR and what a disaster.
I talked to one company in Toledo whose CEO worked with Regenexx and now there company will pay for stem cells only wth them. Hate to keep blowing their horn but not sure who else to talk about. We have nurses doing it and other drs who are not qualified. Where is the FBI and FDA?

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@bevinauburn

The above describes exactly what happened to me. Six weeks post op from revision and so happy I sought out a second opinion as my original surgeon was treating me for scar tissue and never mentioned another possibility. Said he did his part well and it was now up to me to break the scar tissue. I know it can be hard to find someone who will take you as a patient but what I learned is there are doctors who specialize in revisions. I just got lucky I know as I was turned down by two doctors but don’t give up and know what this person above explained that the fit can be the culprit.

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@gutthookes

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