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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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timb | @timb | May 21, 2019
In reply to @debbraw "No @timb - you don't sound like a fatalist. You do sound fed up with what..." + (show)
@debbraw

No @timb - you don't sound like a fatalist. You do sound fed up with what you are going through and I can't blame you. I don't know how to begin to weigh the pros and cons of having arthroscopic scar tissue removal. If you don't mind sharing, did the same doctor do the original TKR and the replacement to get the right size implant in? I'm wondering if there is some value in getting another opinion before you have an additional surgery - especially since you sound kind of conflicted about it anyway.

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No. The second doc is a TKR specialist and the first one is the defendant in a lawsuit. I am more worried about the chance of success in getting scar tissue removal surgery. I guess my thought is that if he gets rid of 70% of the scar tissue and 30% comes back.....it's a win

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JK | @contentandwell | May 26, 2019
In reply to @timb "Hi. New to group. I had TKR 18 months ago. Doc put wrong sized implant in..." + (show)
@timb

Hi. New to group. I had TKR 18 months ago. Doc put wrong sized implant in and new doc did revision. Correct sized implant in now, but 6 months post op and lots of scar tissue. Knee is constantly swollen and stiff. ROM is good, 125 and 0 degrees on extension. But the scar tissue is causing the swelling. It's rubbing on tissue and causing bleeding. Most is above the knee and caused by the quad tendon being cut and repaired numerous times. Had 40cc's drained off and it was red, fresh bleeding. Knee still looks terrible. Cannot see kneecap or any definition. New doc says only hope is arthroscopic scar tissue removal surgery. This will be my 7th surgery on that knee. Can't decide if the risk of scar tissue returning is worth it. Any similar stories????

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Hi @timb and welcome to the group. I am sorry to hear of all the problems you have had with your knee. Your ROM is great but being in pain with a stiff and swollen knee is not good.
I have not had to have scar tissue removed, but I may have some there. My ROM is not what I would like it to be. I am in no pain though and getting along fine with about 115 flex so I am planning to leave it alone. Have you discussed the probability of scar tissue returning with your new doctor? Of course if the probability is high it would definitely have a negative impact on your decision.
I am interested in hearing what the new doctor says about the scar tissue and if it will probably return. I would think if the probability is high that they would not bother removing it at all.
JK

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gator1965 | @gator1965 | Jun 13, 2019
In reply to @rayreich3 "I also had the same surgery January 30 of this year and it has helped reduce..." + (show)
@rayreich3

I also had the same surgery January 30 of this year and it has helped reduce my problem and my knee with scar tissue but scar tissue did develop and I had to go to PT and break it down it’s still there I guess I’m just huge scar producer I should go into Ripley’s believe it or not for how much scar tissue I can produce

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I also had arthroscopic arthrolysis and debridment of left knee last September. I am glad to say my knee flexion is now 120 degrees. It has been hard work.
However I still have awful pain and stiffness.... paying for physio .....again

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1 reply
JK | @contentandwell | Jun 13, 2019
In reply to @gator1965 "I also had arthroscopic arthrolysis and debridment of left knee last September. I am glad to..." + (show)
@gator1965

I also had arthroscopic arthrolysis and debridment of left knee last September. I am glad to say my knee flexion is now 120 degrees. It has been hard work.
However I still have awful pain and stiffness.... paying for physio .....again

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@gator1965 This is what I was considering, but I’m afraid that I could end up worse off after it. What was your flex before lysis?

I really do not want to go through PT again.
JK

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1 reply
gator1965 | @gator1965 | Jun 13, 2019
In reply to @contentandwell "@gator1965 This is what I was considering, but I’m afraid that I could end up worse..." + (show)
@contentandwell

@gator1965 This is what I was considering, but I’m afraid that I could end up worse off after it. What was your flex before lysis?

I really do not want to go through PT again.
JK

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My knee flexion was 70 degrees in September pre arthrolysis , 5 months after TKreplacement. It is worth while having the surgery, I am back at work full time as a nurse, but I do still have neuropathic pain.
I have had several physiotherapists, my current one seems to understand arthrofibrosis, he is now working on my muscle weakness

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1 reply
damewocane | @damewocane | Jun 13, 2019
In reply to @timb "It definitely effects my daily duties. It is "stiff" and painful. Between my two knees, I..." + (show)
@timb

It definitely effects my daily duties. It is "stiff" and painful. Between my two knees, I have had 12 surgeries and 19 overall. I'm becoming immune to the pain and have learned to live with it. I have degenerative joint disease. I'm very dissapointed with results of "correct" replaced knee. It feels quite hopeless. Sorry to sound like a fatalist....

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Alas, I feel that this may be what may happen to me- i am So sorry to hear of your pain- the thing is -to me-how much can you take? When will it end ? Do you accept or give up...

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libertyusa | @libertyusa | Jun 13, 2019

CHANGE OF TOPIC: GALLBLADDER SITUATION ALL DAY TODAY - ATTACK - PAIN - SYMPTOMS - POSSIBLE SURGERY? I have had gallstones for 6 months - started right before TKR. I have managed the few episodes "attacks" by eating smaller meals, few fats, recommended diet. HOWEVER, TODAY MY ATTACK HAS LASTED 8 HOURS. NOT GETTING BETTER. SOME CHILLS. A TINY BIT OF NAUSEA. NO APPETITE. TRIED TEA, TUMERIC, VEGGIES, CRACKERS. HAD SOME CHILLS. A LITTLE DISCOMFORT IN SHOULDERS. Every attack has seemed different - but they were ok. HOWEVER, THIS ONE IS NOT O.K. More intense; more symptoms. I do not fear surgery. But I have read many complications and problems in the Mayo Clinic forums. It is not as easy as people think. There can be complications post surgery. I am furious about losing a body part; especially when I am basically healthy and active. I do "admit" to being over 70 yrs. old, but let's not dwell on that as to me it is not an issue. I have seen 2 gastroenterologists. Both say "HAVE IT REMOVED". I am doing last-minute research on lining up potential surgeons. I found one, recommended by my TKR Dr., who, among other things, has Advanced Laparoscopic skills according to his Bio. He is young-ish (maybe 40???). Another is much older - has 30+ yrs. of related experience. Now, I am the last person to be age biased, but sorry to say, I am looking for middle aged - although experience is crucial I realize. Sorry to go on and on - but no surgeons I find on internet list "gallbladder" as a specialty. They list "abdominal or laparoscopic or pediatrics or other specialties. Any suggestions?
I would try to withstand the pain if there wasn't the threat of waiting too long when laparoscopic is no longer an option. (This is a crazy way to do medical research I know - all sort of last minute.) Not my style. (I have had 2 successful recent TKRs. Also abdominal surgery 35 years ago.) As you can see, I am not prepared for this.....

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1 reply
ellerbracke | @ellerbracke | Jun 13, 2019

Sounds very serious and scary, but I doubt that the average person posting on this forum can be of much help. Hope you expanded your urgent message to other relevant Mayo sub-sites. Best wishes to you.

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Debbra Williams, Alumna Mentor | @debbraw | Jun 13, 2019

Hi @tennisgolf - It must be so discouraging to have this kind of problem in parallel with your TKR recovery. I feel for you. I'm going to agree with @ellerbracke - I'm afraid you might not get good responses here in the Joint Replacement Group. I would suggest you check out the Digestive Health Group.

Here is good place to start:
https://connect.mayoclinic.org/discussion/gallbladder-surgery/?orderby=DESC#chv4-comment-stream-header

Wishing you the best of luck AND good insight and support from the folks over in the Digestive Health Group!

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JK | @contentandwell | Jun 13, 2019
In reply to @gator1965 "My knee flexion was 70 degrees in September pre arthrolysis , 5 months after TKreplacement. It..." + (show)
@gator1965

My knee flexion was 70 degrees in September pre arthrolysis , 5 months after TKreplacement. It is worth while having the surgery, I am back at work full time as a nurse, but I do still have neuropathic pain.
I have had several physiotherapists, my current one seems to understand arthrofibrosis, he is now working on my muscle weakness

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@gator1965 My flex is about 115 so I have a lot less to gain than you did, which is why I hesitate to do lysis. Also, unlike you with neuropathic pain, I do not have any pain most of the time. Last weekend I did have some minor pain after walking a lot all over NYC.

I am glad that your physiotherapist is helping, it seems as if some help very little. I hope with that help you will be able to get rid of the pain. I have had a couple of good physical therapists over the year, but more that were not very helpful.
JK

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