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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In reply to @debbie64131 "What is lysis?" + (show)
@debbie64131

What is lysis?

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It is an arthroscopic procedure in which they cut out much of the scar tissue. They will usually do a manipulation at the same time as you are already under anesthesia. I had a manipulation planned and my Dr. wanted to scope me while I was out. He said there was so much scar tissue that I would not have been able to overcome it with P.T. So he performed the lysis procedure and it helped quite a bit.

https://www.arthroscopytechniques.org/article/S2212-6287(17)30061-0/fulltext
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@debbie64131

My knee replacement was in January. I’m still having issues with scar tissue. I had a total manipulation done & that helped for only 2 days. I’ve been going thru months of therapy. Looking for suggestions or input from others.

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Oh Dear- There is quite a pattern of sad repetition here-Not for everyone but wow - I'm looking at a 2nd manipulation after a revision after... blah blah- Is there an answer? This is frightening, Expensive and painful- how long can you go on?

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@dduke

I had lysis and it helped quite a bit. I still have to exercise all the time, but I can do about anything I want now.

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That is very encouraging! How long ago did you have the lysis procedure done?

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@debbie64131

Does acupuncture help? If so, can someone recommend a clinic in Kansas City?

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Hi Debbie64131 Since the bands between my knee and my hip were virtually "locked" and nothing worked to relieve it, I went to my accupunturist and he put the "needles" into each of the pain points on the bands that I knew were there, he also found 3 that were moderate and treated them as well. He "cups" the needled areas to bring the bloodflow to the point of pain, (which for me, usually has a huge nodule that defines them). He also treats the areas on my body that he knows need management treatment. Within 4 treatments to my left leg (TKR leg) the bands relaxed and I finally got relief. Because I can still feel some of the nodules, altho they're now small, I continue to have him treat them with management once a month. Accupunture has always been an excellent source of pain relief for me if done correctly. If you can find a "Community Accupunture"therapist, they are dedicated to make the treatments affordable for everyone and have sliding scales. In my city, they change $15-$35 and people pay what they can afford.

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@debbie64131

My knee replacement was in January. I’m still having issues with scar tissue. I had a total manipulation done & that helped for only 2 days. I’ve been going thru months of therapy. Looking for suggestions or input from others.

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I had bilateral knees in January also, and a manipulation in Feb. I'm also still in therapy. What are you dealing with in regards to movement and pain? And who is saying its scar tissue? Just curious since we would have similar time lines.

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Hi Doodles...My PT, who is excellent, and has been working with me for the last 5 months. Also, other Pt's who I know and trust their opinion, have agreed as well as my extemely knowledgeable IMed doc. For movement, I walk, stretch, use the weight machines doing the strenth training my PT gives me, accupunture (really helped with the painful bands), I do the recumbant bike (warm up on Airodyne first), water exercises and continue to push my knee for full ROM. For pain, Tylenol 500 (two) every 6 hrs as needed, Skelaxin (muscle relaxant) for spasms and for extreme pain Vicodin 5/325, one to two tablets. Also, I ice, ice ice and go to accupunture for management of pain. Honestly, knowing my body very well, having a very high pain threshold and having excellent mobility, I try to remain hopeful, yet I am going for second opinion and think I will need a replacement again. Also, because I am petite, the implant is huge compared to my right knee, and since my surgeon said he lets the rep chose the size implant for his pts, I'm wondering if the rep just stocked med, lge and extra large! Hope this helps. Good luck to you.

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@damewocane

Oh Dear- There is quite a pattern of sad repetition here-Not for everyone but wow - I'm looking at a 2nd manipulation after a revision after... blah blah- Is there an answer? This is frightening, Expensive and painful- how long can you go on?

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IT STARTED 2002 AND THE LAST SURGERY WAS 2018 AND I STILL HAVE PAIN

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@exflyer

That is very encouraging! How long ago did you have the lysis procedure done?

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I had the lysis procedure done about eight months after TKR. About 10 months ago.

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@killerbees

Hi Doodles...My PT, who is excellent, and has been working with me for the last 5 months. Also, other Pt's who I know and trust their opinion, have agreed as well as my extemely knowledgeable IMed doc. For movement, I walk, stretch, use the weight machines doing the strenth training my PT gives me, accupunture (really helped with the painful bands), I do the recumbant bike (warm up on Airodyne first), water exercises and continue to push my knee for full ROM. For pain, Tylenol 500 (two) every 6 hrs as needed, Skelaxin (muscle relaxant) for spasms and for extreme pain Vicodin 5/325, one to two tablets. Also, I ice, ice ice and go to accupunture for management of pain. Honestly, knowing my body very well, having a very high pain threshold and having excellent mobility, I try to remain hopeful, yet I am going for second opinion and think I will need a replacement again. Also, because I am petite, the implant is huge compared to my right knee, and since my surgeon said he lets the rep chose the size implant for his pts, I'm wondering if the rep just stocked med, lge and extra large! Hope this helps. Good luck to you.

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@killerbees Thanks for your reply. We also have similar timelines in regards to recovery. I also have an excellent PT out of the group I used for surgery. The PT's connected to the group I had surgery with only addressed ROM and the continued aggressive pushing aggravated my hips and back to the point it was limiting my sessions. My new PT uses myofacial release, massage and "dry needling" which is acupuncture needles inserted in to the scar tissue and then she turns them. I have my home routine every morning too. 15 min upright stationary bike and 15 on stationary recumbent. Then on to the stretching and bending exercises. My pain and limited ROM was concerning my PT. She strongly urged me to get a second opinion. I had that on June 6th and the surgeon examined my knees and xrays and determined both knee implants are too large for me. I too am petite and small boned. He has said revision on right is a must to ever feel better. I will want to know how your second opinion goes. Keep me posted and good luck!

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@kneeproblem

I also have had months of therapy, acupuncture knee manipulation cortisone shots water therapy nothing g is helping me either I am suppose to get a knee scope done tomorrow but unsure if I want to

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@debbie64131 I hope you do go through with the scope, it can't hurt and it might shed some light on exactly what the problem is and what can be done to help with it.
If you do have I hope to hear the results.
JK

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