Scar tissue after knee replacement

I had total knee replacement March 15 and after one week started physical therapy which ended up being aggressive. Started at 56 degrees and got up to 95 degrees but was brutally painful and when PT bent my knee to try and get it further I was always ending up screaming and in tears. Finally went back to my surgeon who was the best and he took me off PT and has me doing three exercises every hour hoping more frequent movements will help. I know there is scar tissue and it doesn’t seem to be getting any more flexible and still very painful. I go back this Friday to see him again. Manual manipulation has been discussed. Pain pills don’t even phase it. Nurse told me manipulation is like starting over! Very down in the dumps! All I do every day is exercise and set and ice! Don’t think I’ll ever consider doing other knee...not worth the pain!

I had total knee replacement March 15 and after one week started physical therapy which ended up being aggressive. Started at 56 degrees and got up to 95 degrees but was brutally painful and when PT bent my knee to try and get it further I was always ending up screaming and in tears. Finally went back to my surgeon who was the best and he took me off PT and has me doing three exercises every hour hoping more frequent movements will help. I know there is scar tissue and it doesn’t seem to be getting any more flexible and still very painful. I go back this Friday to see him again. Manual manipulation has been discussed. Pain pills don’t even phase it. Nurse told me manipulation is like starting over! Very down in the dumps! All I do every day is exercise and set and ice! Don’t think I’ll ever consider doing other knee...not worth the pain!

I had total knee replacement March 15 and after one week started physical therapy which ended up being aggressive. Started at 56 degrees and got up to 95 degrees but was brutally painful and when PT bent my knee to try and get it further I was always ending up screaming and in tears. Finally went back to my surgeon who was the best and he took me off PT and has me doing three exercises every hour hoping more frequent movements will help. I know there is scar tissue and it doesn’t seem to be getting any more flexible and still very painful. I go back this Friday to see him again. Manual manipulation has been discussed. Pain pills don’t even phase it. Nurse told me manipulation is like starting over! Very down in the dumps! All I do every day is exercise and set and ice! Don’t think I’ll ever consider doing other knee...not worth the pain!

Hi @sparky233 - First of all, welcome to Connect. I know you are going to find many kindred souls here who have had similar experiences. I am so sorry to hear about your pain and difficulty with the recent knee replacement. It must be awfully frustrating. I'm glad the surgeon took you off that terribly aggressive PT. I know that there are people who really benefited from manipulation to remove the scar tissue. Will your doctor explain more about the options tomorrow? I'm wishing you the best.

I see the surgeon again Friday and we’re going to talk about options and manual manipulation. I’m just disappointed that it hasn’t gone like I expected! I forgot I tend to get scar tissue or I’d have brought that up before surgery! Thanks for the kind words...I’ll keep you posted!

Sorry to hear you are going through this @sparky233 . I had bilateral (both knees) done on Jan 7th. My first 4 weeks of pt I was a rock star! Then week five nothing past 90 degrees, week 6 no progress on both knees. I had the visit with surgeon and we decided to do the manipulation under anesthesia (MUA). It is not fun. But when you wake up there is not a lot of pain. Even that first pt session, which immediately followed, was not too awful. Actually to hear that my bend was at 117 and 112 after struggling at 90 gives you a boost to keep fighting. And you'll need that for the rigorous pt that follows an MUA. Mine was 2 weeks straight for 80 min a session. There were tears on both me and my therapist! I had to go back on the Oxycodone for the following month. Heads up for active scar tissue growers: it does want to come back because you are dealing with inflammation once again. Keep doing your pt and home exercises. Yes my life was pt, ice, home pt, ice and rest repeat, repeat. Because an MUA does lengthen your recovery it's very easy to be overcome with depression. Have someone or something to fall back on. Whether it's your faith or a significant other. Don't let it win. Keep fighting for that outcome you want.Good luck for a good recovery.

welcome to my world. i had my cane beside me and the therapist thought i was going to hit her. the drs office next door sent 2 nurses to investigate the screams . i got to 119 and quit. 5 years later i am not close to that. now it may be lose but i will put up with pain as long as i can. that is why i did stem cells for the other knee.

Sorry to hear you are going through this @sparky233 . I had bilateral (both knees) done on Jan 7th. My first 4 weeks of pt I was a rock star! Then week five nothing past 90 degrees, week 6 no progress on both knees. I had the visit with surgeon and we decided to do the manipulation under anesthesia (MUA). It is not fun. But when you wake up there is not a lot of pain. Even that first pt session, which immediately followed, was not too awful. Actually to hear that my bend was at 117 and 112 after struggling at 90 gives you a boost to keep fighting. And you'll need that for the rigorous pt that follows an MUA. Mine was 2 weeks straight for 80 min a session. There were tears on both me and my therapist! I had to go back on the Oxycodone for the following month. Heads up for active scar tissue growers: it does want to come back because you are dealing with inflammation once again. Keep doing your pt and home exercises. Yes my life was pt, ice, home pt, ice and rest repeat, repeat. Because an MUA does lengthen your recovery it's very easy to be overcome with depression. Have someone or something to fall back on. Whether it's your faith or a significant other. Don't let it win. Keep fighting for that outcome you want.Good luck for a good recovery.

@doodles418 had asked about my experience with a second manipulation - what was my experience like, was it painful, did it help, and how did I know if it was scar tissue, when did it occur during my recovery?

My recall on the exact details may be a bit fuzzy because I had my knee replacement in 2006 (can't believe it has been that long already). I had end-stage arthritis in my right knee caused by a genetic bleeding disorder that prevents my blood from clotting on its own. When I was a child, the medication to help this disease (hemophilia) was not as good as it is now. Essentially, my blood wouldn't clot without injecting the clotting factor that I was missing. Most people think a cut is the issue, but the bigger issue was internal bleeding. My right knee was my "target joint" meaning I continually had internal bleeding in that joint as a kid which led to arthritis at age 8. By the time I was 19, my knee was completely arthritic and deformed - it was no longer a ball & socket joint, the bones had worn to squares. Because of this my knee - prior to surgery - had not been able to straighten to 0 degrees for almost a decade already. So I went in to surgery fighting all sorts of muscle and ligament atrophy as is.

My initial recovery from the replacement was awful. The ligaments were stretched straight upon waking up for the first time in 13+ years so the pain was intense. Scar tissue took hold almost immediately (likely due to my young age and immune system being much more active than waiting until later in life). Ultimately I had to have a manipulation - more painful to wake up from than the actual surgery. Scar tissue took hold again and I had to have another manipulation, I believe somewhere close to the 8 month mark from the original replacement (but could be closer to one year). Unfortunately, that still did not do the trick. I was told at that point that you cannot do additional manipulations because the scar tissue becomes strong enough to risk breaking your femur at that point.

To answer the question of how did they know, it was determined via x-ray to show the joint itself was not the issue and based on the mechanics they determined it was most likely scar tissue. I tried a full leg cast that had hand cranks built in to it to try and turn the knobs and bend the leg. That did not work. What ultimately ended up working was when I jumped up to catch a football one day and landed and felt a pop (no real pain as I remember). Within a week after that pop sensation, I was 0-90 or so. Over time, I gained additional ROM and landed somewhere between 0-110. I would have liked to get to that 130 range, but 0-110 is much better than my initial 15-50 ROM that basically equated to a frozen leg joint.

A bit long-winded, but it was quite the experience and a very long road to recovery. All said, I think it took somewhere close to 18 months for me to get to that 0-110 range.