Hi! I want to share what I have learned about my own scar tissue issue. I had a TKR 7 months ago; an MUA 5 months ago. This was accompanied by aggressive ROM work in PT. For more than 5 months my knee was totally inflamed and swollen and not functional. My quads totally shut down. Still, my PT tried to force it to move. There was NO progress in ROM but constant pain, inflammation and swelling and little sleep until I was diagnosed with Complex Regional Pain Syndrome and stopped this treatment. A subsequent MRI showed that the whole joint was full of inflamed/infected scar tissue and the synovial membrane was thickened and inflamed as well. A biopsy showed no bacterial infection as a cause.
I have since learned that the untreated inflammation combined with the aggressive PT was at least part of the cause! A soon as I stopped this treatment and got help from acupuncture the inflammation, pain and swelling began to go down.
Now, two months later, I am pain free; my knee does hardly swell anymore; the knee is more functional in its ROM; and more resilient: I can do my daily exercises without pain; my extension is almost at 0 degrees ( it had been -15); my flexion is still at the 105 degrees I had achieved after the MUA probably due to the amount of scar tissue still inside the joint; but the scar tissue is actually slowly getting less.
This is what worked for me so far: I started (at first twice weekly now once weekly) acupuncture treatments; several times a day I elevate my leg by resting it vertically against the wall as close as possible and rolling a rolling pin down my thigh at intervals; I started to massage the knee and thigh in this vertical position and as often as I can remember to and that brings instant relief; I started to take Arnica 30c homeopathic pellets because by now I was seriously traumatized by the maltreatment I had been subjected to; I changed my orthopedic surgeon and PT; my new doctor is much more knowledgeable and engaged with my rehab and gave me clear goals and exercises to pursue as well as an appropriate time table to work with; my new PT is performing ASTYM treatments, a tool based treatment method that helps the scar tissue to be re absorbed over time; she also employs two different taping techniques that work wonders to keep the swelling down; she has me do very gentle exercises which already have brought more improvements within weeks than the months of aggressive PT had done; I stopped icing and purchased a far infrared (FIR) knee device which supports deep healing; (my husband loves it too; he says it was the only thing that took his pain away after badly bruising a rib.) I really recommend it! It also helps with sleeping : ).
Being a German native I also learned a lot from German online sites about scar tissue issues with TKR and how they treat it; they recommend only gentle PT; they see the excessive scar tissue formation as a result of stress (from the surgery and pain alone but also emotional and circumstantial stress), overexercise, and too much pressure to perform as well as a psychological sense that the knee is in an unprotected (!) vulnerable position which as a result sends it into overdrive to try and heal itself by forming excessive scar tissue. They have good results with early detection, gentle PT, far infrared treatments; lymph draining methods; different massaging techniques; PEMF; and general relaxation techniques. With early detection they claim to have gotten rid of excessive scar tissue issues in TKR within 6 to 8 weeks. No MUA needed.
I am 7 months out from surgery and still have a lot of scar tissue in my knee; however with the above treatments I have no pain, no swelling, less stiffness and better mobility and I am gaining trust and confidence in my knee to heal. I now hope to slowly gain a functional knee without further surgery that will allow me to do what I aim for: ease of walking; no pain or swelling when not overly straining it; gentle hiking; biking; swimming. I will continue my treatment plan until then and hope not to have to have another knee surgery ever again! Already after 5 weeks I can walk stairs and my quad strength is improving. I feel very encouraged. I know it will take time and a lot of discipline and patience but I really sense it will get me what I need! Good luck to all of you who are struggling. Keep on working at it. You and your knee deserve it!