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Scar tissue after knee replacement
Joint Replacements | Last Active: Oct 10 8:31am | Replies (1550)Comment receiving replies
Good morning (again) JK, Gator, DDuke, and all -
There were some statements that arthroscopy as a treatment for arthrofibrosis was somewhat of a "new concept" - it isn't.
Neither is arthro or "open" lysis. There was a question on what this "arthrolysis" actually is. Here are the answers from NIH
(and invaluable source). Please note that when surgeons are generally aware of a problem but don't actually know what to
do - there is invariably comments about how "this is controversial" (which is another way of them saying - they don't actually
know what to do... which they seem to have a hard time saying). The same way that it is with MUA's and standard arthoscopies -
surgeons know how to do these procedures, but the actual efficacy (in other words - did it "work" for the patient) is at best
"questionable".
Depending on which report you read - you get extremely low numbers (like 3-6% in this one) but then more realistic numbers
like "one in five" (20%) who have long term problems with their TKR surgeries - the most common complaint being "a stiff and
painful knee" (and if that ain't a layman's description of an arthrofibrotic knee - don't know what is). I have heard higher numbers -
and who knows ? The one thing we do know for sure is that this is a VERY large number of people - and if it was ONLY 6% of
the people who were taking a medication (instead of having a surgical procedure reccommended) and THEN became disabled and chronic pain patients, do you think that medication would continue to be on the market without comment (or lawsuits) ?
Anyway... here's the NIH article on arthrolysis (and it's pretty detailed - as all NIH stuff is):
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4246397/
Best all,
John
PS - Maybe I wasn't listening/reading carefully, but did anyone out there say they experienced long term relief from
having had an arthrolysis (when they previously suffered from arthrofibrosis) ? Thanks for letting me know.
Replies to "Good morning (again) JK, Gator, DDuke, and all - There were some statements that arthroscopy as..."
John: thank you for all of the valuable information you provide on this forum—you are definitely several steps ahead of me in your research of this problem. I agree that no one seems to know how many TKR patients suffer from arthrofibrous following their procedures. My surgeon says it is about 1 percent, but my physical therapist says in his experience it is closer to 10 percent. The irony for me is that prior to my surgery everyone I knew who had undergone TKRs had very positive outcomes, but after my procedure about 50 percent of the people I know have had problems and are not happy with their outcomes.
My initial recovery on my first knee went by the textbook, so I opted to do the second knee six weeks later. It was not until a few months after the procedures that I started losing ROM on the first knee and several months after that before the second knee started to lose its range of motion. Two different surgeons have now advised me against additional surgeries because they feel the problem will simply return a few months post-op. I sure hope we start to see some long term success stories from others on this forum!
Will
@gutthookd this is interesting. My problem is simply one of flex, no pain. I am thinking maybe I should just let it be. I think I will purchase a goniometer to see just how bad it is now. That would be simpler than going to a PT or the doctor to find out.
JK
@gutthookd @gatorgirl @dduke @exflyer
While I wouldn’t call it successful “long-term” relief from arthrofibrosis yet- I am now 10.5 weeks out from arthroscopic lysis of adhesions and still have the range of motion I left the surgery with and significant better function and dramatically less pain.
I have read my surgery report and a “significant” Amount of scar tissue was removed from both gutters, the superpatella pouch and some “notch” that was pulling down my kneecap. Basically, as near as I can tell - the new knee was encased in scar tissue and there was no way it was going to move on it’s own. I had the arthroscopic procedure 8 months after my TKR.
Mine normally shows up at about 6 weeks. I have an issue at one portal - but we have been able to minimize it so far.
This hasn’t been without a tremendous amount of effort in PT and I am doing 2 hours plus of active PT a day still. I only did the surgery because of the pain. If my ROM was limited but I had no pain - I would not have
This is my third round of battling arthrofibrosis in 3 different body parts. The knee is by far the worse pain wise. The abdominal one was far the scariest.
Anyway. -it can be successful. But you, your PT and your surgeon all need to be educated about it and on the same page about treatment.
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No the only benefit is that I can bend my knee to 96 degrees, which means I can drive, and have returned back to work.
I have a lot of pain , and am taking baclofen and amitriptyline for neuropathic pain. I feel as though my leg from my knee downwards has been repeatedly kicked.