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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@bonzobear72

It can take a full year for a TKA to fully heal and just as long for the swelling to go down. As long as you can fully straighten your knee and get at least 90 degrees Physicians (everywhere) consider that a great outcome. You really have to do the work. Stretching, heel slides with a sheet, having somebody push that knee back for you when you hit your own plateau. Hold that stretch for up to 10 minutes and do sets of 5 up to 3 times per day. Roll on an exercise ball. Sit on a porch swing and slowly keep bending your knee and increase your time. Google exercises. There are 2 PT guys that do YouTube videos showing advanced stretching. Are people going to the gym and riding a bike? Forward/back increasing and holding the stretch until a full revolution forward or backward can be done. Lower the seat, move the seat forward to increase the stretch. Stretch the hamstrings, soleus and gastronomic muscles (these all prevent a full ROM if they are tight). I think doing a MUA within that first 3-mths is extreme unless there is a medical condition that warrants it. Nobody knows scar tissue is solely the problem. We all get it after surgery and injury. You can loosen it on one part and have it sticking on another. It comes loose in pieces and sometimes not all of it ever loosens. Just keep doing aggressive therapy on your own and you'll get there.

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I like the advice provided (by bonzobear72) in that I too feel that continuing with your own aggressive therapy will eventually gain results, if only by small increments.

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@sraley1

Had a TKR in Nov 2017. Went through a very vigorous PT, able to straighten my knee and bend it. My challenge is that after about 4 months, my knee was not feeling any better. I gave up walking because it walking makes my knee swell and tight. I went back to see my surgeon at both 6 months and after a year. He said everything is looking good and some people just take longer to heal. He said if I wanted to walk, take walks but don't overdo it.
I do believe my issues are with scar tissue that has developed above my knee cap. Again my surgeon did not clearly state that was my issue or not. He said it could be one of a few issues. Also, I know they cut through nerves with TKP surgery. Anyone else feel extensive numbness still in the knee after a year?
I'm now taking a more aggressive approach and manually with my fingers and knuckles applying pressure to areas I feel scar issue build up.
I'm now reading that several people have had arthroscopic removal of scar tissue which has helped some of you. I'm also hesitant about this surgery. Open to suggestion for relief without using medications.

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Had my TKR in 2017 too. I have scar tissue and my mobility after a manipulation 2 or 3 months after the TKR was only at 65. I did feel numbness for a long time, probably at least for a year. The numbness eventually dissipated but I do still have scar tissue. I have most recently been applying pressure to my knee while using magnesium oil topically. I do this on my bus commute to and from work (which is about 100 miles each way) as well as when I am reclining at home before bed. I have also been sitting in a jetted tub with Epsom salts (magnesium) for about 12 to 15 minutes 1 or 2 times a week and sitting in a hot tub for 30 minute sessions, while flexing and bending my knees about twice a week. After the hot tub, I find my knees more flexible so push myself into squats. Initially this caused a lot of pain and discomfort but I am currently experiencing some minor improvement in terms of slightly less stiffness in the TKR knee and miniscule improvement in mobility (putting on socks and shoes). For the last several days I have been taking one 500 mg Bayer aspirin daily so have not really felt any pain in either knee (I also massage both knees), and the left knee is bone-on-bone. The movement of warm/hot water around the knee joint seems to facilitate being more flexible but you can ask your doctor. My surgeon said the rehab facility where I was for about 15 days did not do the aggressive therapy, so go figure. I have decided no more surgery for me and I stopped physical therapy some time ago. If you can do water aerobics and swim, they are also helpful.

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@damewocane

Heat and a cbd oil+ massaged around knee front and back gives some relief. I swim and paddle around on a floaty in the pool every other day weather permitting. Waiting to see what comes next.

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A friend of mine resides in Las Vegas. She says CBD oil has helped her condition substantially but the CBD oil may contain another ingredient. Don't know for sure at this time. However, I don't think I can readily purchase CBD oil in NYC or PA but am conferring with my friend about how to get some. I think different states have different laws.

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@dkapustin

How does one know that it's scar tissue causing a struggle with ROM and not something else? I'm 7 weeks out today and was measured on Monday. My extension is zero but my natural ROM is 105-106 and my self assist ROM is 112-115 depending on how sore I am. No-one has mentioned scar tissue to me but that seems to be the big reason why people struggle. Is that ALWAYS the case with ROM or COULD it be other things? Thanks, everyone!

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Your ROM and extension after only 7 weeks out are good. If you are not feeling unusual discomfort there may be some scar tissue. Your surgeon would be able to advise you on this better than anyone else, in that he can obtain images, etc. If you have a physical therapist, then a therapist would likely be able to make a suggestion as to whether it could be scar tissue.

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How does one know that it's scar tissue causing a struggle with ROM and not something else? I'm 7 weeks out today and was measured on Monday. My extension is zero but my natural ROM is 105-106 and my self assist ROM is 112-115 depending on how sore I am. No-one has mentioned scar tissue to me but that seems to be the big reason why people struggle. Is that ALWAYS the case with ROM or COULD it be other things? Thanks, everyone!

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Has any one ever been concerned about your surgery being the last one of the day? It sounds and feels ominous. My revision is scheduled for 3pm and I've been told that its the best they could do as more urgent procedures are being performed by the OS that day starting at 7 am- No water or food after midnight .- Seems pretty rough. Any one with this experience -please relate!

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@damewocane

Has any one ever been concerned about your surgery being the last one of the day? It sounds and feels ominous. My revision is scheduled for 3pm and I've been told that its the best they could do as more urgent procedures are being performed by the OS that day starting at 7 am- No water or food after midnight .- Seems pretty rough. Any one with this experience -please relate!

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Hi
I had my total knee replacement in April last year. My surgery was scheduled for 1730. I was advised that the surgeon preferred to complete quick procedures first.
I was allowed to eat up to 5 hours before the admission time, and 1 hour before admission time was my last drink (water).

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@dkapustin

How does one know that it's scar tissue causing a struggle with ROM and not something else? I'm 7 weeks out today and was measured on Monday. My extension is zero but my natural ROM is 105-106 and my self assist ROM is 112-115 depending on how sore I am. No-one has mentioned scar tissue to me but that seems to be the big reason why people struggle. Is that ALWAYS the case with ROM or COULD it be other things? Thanks, everyone!

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I am 4 months post op from TKR and extension is real good but only 70-80 degrees ROM! They won’t scope to remove scar tissue as there is other issues similar to CRPS keeping me from surgery. I have been tested negative for CRPS and they have their hands on the air on don’t know what I have. I tried to get into Mayos in Scottsdale and Rochester for testing both Orthopedic and Neurological....but got denied. I tried 3 other Ortho groups and have been denied. Can’t get into a specialist Ortho Doc till July 10th!! In the meantime I walk around like a peg legged 56 year old frustrated Nebraskan!!!

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@kneeproblem

What is crps please

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Complex Regional Pain Syndrome also known as RSD, Reflex Sympathetic Dystrophy. This is not the reason for my poor ROM.

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