Scar tissue after knee replacement

I had TKR on my right knee in early 2017. Had all kinds of physical therapy, home, in and out patient; also had a personal trainer which seemed to help more at the time and did some lap swimming once a week or so but not enough to brag about. Still have a stiff knee but a little less. I use a cane but more for balance because of the lack of flexion in the knee. I do walk every day for about 40 minutes (however, not conscious walking; have to walk to and from my office to transportation). I had some pain off and on - also different types of pain - until several weeks ago. The pain was not enough to take pain killers beyond the occasional aspirin though, although it did wake me up at night at times pulsating. During the last 12 months I've lost a large amount of weight; I am still in a medically supervised weight loss program at NYU Medical Center in NYC. I do think losing weight helps. About one year ago I invested in a hot tub which is outdoors and runs 24-7 continuously ($30,000 plus with all that I had to do to support it -- concrete patio, exterior lights, 22 Kw generator, etc.); did squats in the hot tub (which sometimes resulted in pain afterwards because I probably squatted too far). I try to get in the tub daily either early in the A.M. (like 3:30 A.M. or after 10:00 P.M. - I commute). i have not returned to surgeon in over 2 years. It is still difficult to put on shoes/boots because of my lack of bend but it is slightly better. On the commuter bus (90+ minutes each way) I try to sit in the rear seat in the aisle whenever I can get it or in an aisle seat so that I can stretch my leg out. I now stand on the subway (easier than having people inadvertently knocking against or stepping on the foot that is swung out for my 15 minute subway ride). I cannot say definitively why the pain has disappeared but will tell you what I've been doing now. Started mixing organic Moringa oleifera leaf powder (1 tiny scoop, about a teaspoon) in my meal replacement protein shakes twice a day. It does not taste great but the vanilla shake masks the taste to a great degree. Since I started taking this (have not discussed this with my medical team yet though) I started noticing less discomfort and actually no pain, and feel I am walking more freely. I just started forcing myself to walk around at home and in my office without the cane. I believe that the Moringa leaf powder is reducing the inflammation. Yes I do have scar tissue but I am sure there was more inflammation before (sometimes my knee appeared swollen to others). You can read up on this on line but the important thing is to purchase it from a good source. I also started drinking matcha green tea (purchased the powder and make it myself). You can also include the powder in cereal, shakes, etc. I eat one or two healthy meals a day (small amount of poultry, fish or meat, broccoli, cautiflower, kale, spinach greens, etc.). However you can read up on this too. I do believe, however, that the Moringa leaf powder has most to do with my feeling better.

I had a TKR in both knees almost four years ago and have been suffering from persistent pain and stiffness for at least three years and was diagnosed with arthritis fibrosis. A good friend of mine is a physical therapist and she has been researching this condition. She recently discovered a trial that dealt with persistent pain following TKR:
Arthroplasty
Persistent pain after total knee arthroplasty (TKA) has been speculated to be a result of central sensitization5. The authors of 1 randomized controlled trial (RCT) found that, of 464 patients with primary osteoarthritis scheduled for elective TKA, 80 demonstrated signs of central sensitization6. These 80 patients were randomized to treatment with duloxetine (30 mg daily for 6 weeks) or no duloxetine (control group). The duloxetine group demonstrated significantly greater improvement from 2 to 12 weeks in all pain outcome measures assessed (p < 0.05). The 2 groups did not differ significantly with respect to adverse events6.

I presented this information to my family doctor and he has given me a prescription of duloxetine (Cymbalta) to try. Has anyone else tried this approach?

I had a TKR in both knees almost four years ago and have been suffering from persistent pain and stiffness for at least three years and was diagnosed with arthritis fibrosis. A good friend of mine is a physical therapist and she has been researching this condition. She recently discovered a trial that dealt with persistent pain following TKR:
Arthroplasty
Persistent pain after total knee arthroplasty (TKA) has been speculated to be a result of central sensitization5. The authors of 1 randomized controlled trial (RCT) found that, of 464 patients with primary osteoarthritis scheduled for elective TKA, 80 demonstrated signs of central sensitization6. These 80 patients were randomized to treatment with duloxetine (30 mg daily for 6 weeks) or no duloxetine (control group). The duloxetine group demonstrated significantly greater improvement from 2 to 12 weeks in all pain outcome measures assessed (p < 0.05). The 2 groups did not differ significantly with respect to adverse events6.

I presented this information to my family doctor and he has given me a prescription of duloxetine (Cymbalta) to try. Has anyone else tried this approach?

I appreciate your input dixiedog -This is my fear- So much of a gamble... what other options have you pursued?

I appreciate your input dixiedog -This is my fear- So much of a gamble... what other options have you pursued?

Quite a bit of therapy, dry needling, massage therapy (who has been great) foam roller. I’m trying cupping and this is something one can do on your own so that cost is low. I’m going to ask about something called ASTYM - there are other names for it (ISTYM, rock blade) but it involves using a blunted instrument and working the soft tissue. I feel I need to work my iliotibial band and distal rectus femoris muscle (one of the front knee muscles). No clue if it will help my rubber band tightness issue but I know both are tight still despite all the stretching I do.

Quite a bit of therapy, dry needling, massage therapy (who has been great) foam roller. I’m trying cupping and this is something one can do on your own so that cost is low. I’m going to ask about something called ASTYM - there are other names for it (ISTYM, rock blade) but it involves using a blunted instrument and working the soft tissue. I feel I need to work my iliotibial band and distal rectus femoris muscle (one of the front knee muscles). No clue if it will help my rubber band tightness issue but I know both are tight still despite all the stretching I do.

I should have also mentioned I did CBD oil (Drops, roll on, balm that you rub on the knee) with THC, high grade, for three months with no change thus did not continue. This was most disappointing as a few of my coworkers got good results with CBD. But there is no clear evidence to support it despite the current market and popularity. Prior to this, I did turmeric supplement, both pill and liquid forms, with no change in pain after 2-3 months (but not at the same time as CBD). Like CBD, others got great results. So for some reason my body doesn’t even respond. And for me to keep taking all these products without any results, is too costly and wasteful.