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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@nb16

.husband just went to our ortho about the hip/sciatica pain and he said it was the ischial tuberosity where the hamstrings connect, bone right under the glutes. Doc is sending him to pt. Also discovered some curvature of spine which would also cause an imbalance of muscles. He has pain when driving long distances as well.

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@nb16 I hope your husband will get some help from PT. Does the doctor think he has always had spine curvature?

Sciatica typically is worse after sitting for long. In July of 2019 I was sitting for about 8 hours - we drove 3 hours to get somewhere, spent two hours there sitting, and then drove 3 more hours coming home. The pain the next day was the worst pain I have ever had, it was worse than childbirth. As I was walking through the kitchen I suddenly felt very light-headed from the intense pain. I was trying to get to the family room to sit down but I didn't make it. I had a pre-syncope and fell on the tile floor in the kitchen and had a minor trochanteric femur fracture. The only good thing was that led to the discovery that I had somewhat advanced osteoporosis, my PCP had somehow not thought to send me for a DEXA before that. This week I finally started mediation for my osteoporosis. A fall of that type, from basically just standing, would not usually cause a fracture if your bones are not weak.
JK

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@nb16

.husband just went to our ortho about the hip/sciatica pain and he said it was the ischial tuberosity where the hamstrings connect, bone right under the glutes. Doc is sending him to pt. Also discovered some curvature of spine which would also cause an imbalance of muscles. He has pain when driving long distances as well.

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I sympathize with your husbands condition. I had second TKR 12 /28 and sciatic nerve is causing problems just as it did with first TKR. This time muscles are spasming in keg periodically. Have been put on muscle relaxers and meds.for restless leg. Have been going to pt and they are working with stretching and gentle massage. Going to a spine doc also for last 2 years since other TKR. Each 6 months he burns nerves to give them a chance to grow back differently. In between burning, I receive injections that do help with pain. I typically get approximately 4/-6 months of relief. Chiropractor helps in between also. Long car rides are difficult as leg needs to be stretched out. I find sitting in the back seat behind driver and stretching out leg across seat or stretching out on floor works well. At pt if he can exercise and stretch in a warm pool (94 degrees), it will help as well . Get to a therapist that’s familiar with technique of getting sciatic nerve back in position. It’s painful for sure. It’s hard for others to understand. He needs someone to just listen to him. I hope he finds relief.

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You could be one of those people that grows scar tissue very quickly! I had similar issue with my first TKR. Had to have manual manipulation by doctor under anesthesia at hospital and then work hard exercising and stretching in warm pool and spent hours on a continuous passive motion machines. Find a therapy with this machine and a pool. Keep up with massage and exercising. It takes time and yes, it’s uncomfortable.

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Maybe start with orthopedist doing a manual manipulation under anesthesia to break up scar tissue. Then therapy in warm pool, it works wonders. After knee loose and warmed up after an hour of pool exercise, get in a continuous passive motion machine and let it move you knee back and forth. Not one of these horrible home models, but is large machine at pt. If your pt doesn’t have this machine or a pool.... find one that dies! Still need to work hard like 3-4 days a week but it will get better.

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@charliez22

Hello all, I had a TKR of my left knee 4 months ago. I am stuck at about 95 degrees flexion. I have very sharp pain behind the knee when trying to bend past that. The MRI shows a very swollen Popiteal muscle, but my doctor says this is unusual and isn't quite sure what is causing this sharp pain. I was taken out of p.t. and just resumed it again. The pain sometimes is on the outer side of the knee as well. Has anyone experienced this sharp pain behind the Knee? This is really prohibiting the ability to bend the stupid knee! I have crazy tightness across the knee as well. I'm guessing scar tissue is the cause? Unfortunately, I have a bad ankle/foot on the opposite side too, it makes walking a challenge. I knew the recovery would be harder due to my limitations, I'm just frustrated, upset and hoping for a positive turn around. This site is great, the info I've read from everyone is so helpful. So, anyone with this behind the knee pain PLEASE...id love any info you have. Thank you

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Hi, I'm having the same problem as you have, just went for a CT scan. Pain behind my knee everytime I stand up. I have to wait before I can put my full weight on my leg so I can walk, than I limp for a while and than I can finally walk "normal". This is also why I had a very hard time in PT when they pushed my leg to get it to bend, the pain was unbearable. So what have they done for you? Hoping your answer will give light to my same problem.

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@grafic2

Hi, I'm having the same problem as you have, just went for a CT scan. Pain behind my knee everytime I stand up. I have to wait before I can put my full weight on my leg so I can walk, than I limp for a while and than I can finally walk "normal". This is also why I had a very hard time in PT when they pushed my leg to get it to bend, the pain was unbearable. So what have they done for you? Hoping your answer will give light to my same problem.

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@grafic2, @charliez22, Good evening, and welcome to Connect. You may know that our group is dedicated to sharing our experiences so that you may see that others have walked down your path. We are unable to diagnose or prescribe. However, I am going to reach out a little bit and introduce you both to MFR.

But first...I want to make one observation. When I see that your surgery was just 4 mos ago....I am shocked. My surgeon told me to take my time and to count on up to 12 months for healing to take place pretty completely. The other good piece of information he gave me was this......if you want your new knee to last a lifetime, treat it gently, don't overdue. When I asked about my penchant for mountain climbing, he looked straight at me and said, "If you just climb uphill, your new knee will last your lifetime. If you choose to go downhill, you may get only 5 years." Guess that said it all. I now live where there are virtually no mountains......Minnesota.

And now to my recommendation of myofascial release therapy, (MFR) for keeping the scar tissue under control, removing any inflammation, and making sure that the Baker's cysts don't develop. I still have at least one MFR session a week devoted to legs and knees and other neuropathic-related issues.

Here is the link and I will also tag @jenniferhunter who is our resident expert for MFR. She has all the medical details.
connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/

May you be free of suffering and the causes of suffering.
Chris

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@JustinMcClanahan

Hello @leithlane, welcome to Connect.

This is an experience very close to my own. I had my right knee replaced in 2006. I also had aggressive scar tissue immediately after my knee replacement. Ultimately, I had to have two post-surgery knee manipulations where they put me back under and broke the scar tissue up by bending my knee manually. Even after those two manipulations I still had issues with scar tissue. It took almost a full year and a half until I ended up breaking the scar tissue loose on my own when I jumped and landed awkwardly. Although it may be frustrating, sticking with your PT is a must.

I would like to invite @mnpat, @basa, @winning, @joanney, @emme, @kerri123, @gailfaith, @cautiousoptimism, @cheris, @ronnie3716, and @amberpep, to this discussion as they have all had knee replacements and may be able to provide some thoughts on their experiences with scar tissue after surgery.

@leithlane, have you heard of or tried a brace with hand cranks on it that you use to help with straightening and bending your knee? What does your therapist/surgeon say about your scar tissue problems?

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I had a TKR 3 months ago (Dec 2020) & therapy 3x a week...after two months I needed manipulation for scar tissue.. and another month of therapy..still stiff and painful..no progress with Flex or extension ..still 90 degrees... I have an appt with the surgeon this Friday April 26, 2021... I don’t know what to expect... my knee still hurts even at rest.. Diana

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@reelin

I had a TKR 3 months ago (Dec 2020) & therapy 3x a week...after two months I needed manipulation for scar tissue.. and another month of therapy..still stiff and painful..no progress with Flex or extension ..still 90 degrees... I have an appt with the surgeon this Friday April 26, 2021... I don’t know what to expect... my knee still hurts even at rest.. Diana

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Hello there
I had my second TKR five months ago my first TKR was the summer of 2018.
And everything that you were describing happened with my first TKR.
Three months of physical therapy two manipulations, Dynasplint, and a heck of a lot of pain all the time. And I had an additional two months of physical therapy later in the year of 2018.
My second TKR (new surgeon)he used a completely different prosthesis which seems to agree with me much better.
The first prosthesis the plate had loosened so that’s why I had a brand new prosthesis.
In my case I feel that a lot of my concerns the first time around were dismissed.(“you’re not doing enough exercises”)
So I found a Doctor Who did a CAT scan and a bone scan who found that the plate was probably loose.
So I went into surgery the second time around with flexion at 75 extension at 10.
Now I am 116/1. As well as having a new prosthesis he removed a ton of scar tissue.
I haven’t reached my goal yet and I guess I would be happy if I was 120 and zero.

I still have a lot of work to do and have my good days and bad days.
I pray that your surgeon does a complete battery of tests for you.
There’s nothing more painful in my opinion than having thoughts of scar tissue and a prosthesis failure. And walking on this leg with a contracture is very very painful and exhausting.
I hope this helps

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@reelin

I had a TKR 3 months ago (Dec 2020) & therapy 3x a week...after two months I needed manipulation for scar tissue.. and another month of therapy..still stiff and painful..no progress with Flex or extension ..still 90 degrees... I have an appt with the surgeon this Friday April 26, 2021... I don’t know what to expect... my knee still hurts even at rest.. Diana

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Please let us know how you make out with Dr. appt. Unfortunately, I had the same experience you did - TKR, therapy 3x wk, manipulation, and still unable to control scar tissue. Consulted other Docs who would not do a revision because they believed the results would be the same. I am 2 years from original TKR and still experiencing pain and 70 degree limitation. Forced to use a walker as my other leg is weak . Still looking for an answer

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@grafic2

Hi, I'm having the same problem as you have, just went for a CT scan. Pain behind my knee everytime I stand up. I have to wait before I can put my full weight on my leg so I can walk, than I limp for a while and than I can finally walk "normal". This is also why I had a very hard time in PT when they pushed my leg to get it to bend, the pain was unbearable. So what have they done for you? Hoping your answer will give light to my same problem.

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Forget to add that I did have a MUA, the Dr. said he could bend it. Went for 2 weeks straight of therapy, and was still at only 90 to bend because of the continue pain behind my knee I would get when it was pushed.

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