How do you treat excess scarring after TKR?

Posted by Jmacvol @jmacvol, Jul 29, 2016

I had TKR on my left knee Dec 2013. Had poor ROM performance with PT and had MUA after 3 months. Recovery from MUA was most painful experience ever and totally ineffective. As time went on ROM got worse as scar tissue took over knee. Sep 2014 I had left knee revision to remove scar tissue and had right kne TKR. 3 more months of PT and right knee recovered much better than left as left knee once again grew excessive scar tissue. Dec 2015 I had a 2nd revision on left knee to remove scar tissue and surgeon said if this didn't work he may have to replace remove appliance and start over. 3 more months of PT and ROM got worse with PT as scar tissue grew back again. ROM in left knee is about 70. As each day goes on pain increases with no improvement in site. Surgeon says that appliance is fine and there is no more he can do. Is there any solution to my problem. Contacted Mayo for help.

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@artscaping

Good evening @ezas123 There are some pretty standard recuperative exercises. Here is a link to some on-line
options:
https://orthoinfo.aaos.org/en/recovery/total-knee-replacement-exercise-guide/.
Perhaps Maria can help you select the best ones to improve your ROM. Also, you want to straighten your knee and make your extension a zero. The ones that helped me the most were the ones you hold for 5 or 10 minutes.

The one that helped my ROM is the one where you slide your foot on the carpet or a towel on a hard floor.....from straight to bent and hold for 5 seconds.

There is also a Youtube program with a couple of gentlemen. Here are their names and you can select videos for post-surgery.
3 Simple Things Everyone with Knee Pain Should Do Daily - YouTube
Physical Therapists Bob Schrupp and Brad Heineck have over 50 years of combined. We try to add a twist of our humor into each video in our quest ...

Please let me know how it goes. I am sure you can master this. Tell me about the exercises you choose. If there is discomfort.....that is to be expected. You can always ice and elevate to reward yourself for good effort.

I am thinking about you......wish we had a 2-way camera so I could cheer you on.

May you be physically well
May you be mentally well.

Chris

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Thank you Chris I will be checking out the you tube video ….. I have full extension now which feels great I am continually working to keep it …. Now is the bend need to work on today maybe 65 I let you know next week how it’s going ….. thank you for all your help god does put the people i need in my path….. thank you Chris have a wonderful weekend

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@ezas123

Thank you Chris I will be checking out the you tube video ….. I have full extension now which feels great I am continually working to keep it …. Now is the bend need to work on today maybe 65 I let you know next week how it’s going ….. thank you for all your help god does put the people i need in my path….. thank you Chris have a wonderful weekend

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Hi Chris well watched video checked out exercises….. I think the slide be most helpful I started yesterday doing for 10 min twice my leg does not go very far nor can I assist it to …. But I know if I keep it up will come this morning along with slide I included another I sat buy my table and put my foot up against the leg this was so painful at first my granddaughter and I sang the abc lol it helped so much I did for 5 min my leg was more bent than I can possibly get with slides right now….once again thank you everyone for your support means a lot and Chris special thanks for pointing me in right direction …..have a great weekend everyone

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@ezas123

Hi Chris well watched video checked out exercises….. I think the slide be most helpful I started yesterday doing for 10 min twice my leg does not go very far nor can I assist it to …. But I know if I keep it up will come this morning along with slide I included another I sat buy my table and put my foot up against the leg this was so painful at first my granddaughter and I sang the abc lol it helped so much I did for 5 min my leg was more bent than I can possibly get with slides right now….once again thank you everyone for your support means a lot and Chris special thanks for pointing me in right direction …..have a great weekend everyone

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Good evening @ezas123. I loved seeing your response and learning about the beginning progress you have made. It is also nice that you have your granddaughter to help you "sing the blues".

I liked the looks of the slide also.....I made my own and use it on the thick rug in the living room. I am trying to visualize how you put your foot up against the table leg. You may have to draw me a picture.

How about your extension......can you get the space between the back of your surgery knee and the floor to be zero? That sure took me a while.

May you have peace and contentment.
Chris

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@artscaping

Good evening @ezas123. I loved seeing your response and learning about the beginning progress you have made. It is also nice that you have your granddaughter to help you "sing the blues".

I liked the looks of the slide also.....I made my own and use it on the thick rug in the living room. I am trying to visualize how you put your foot up against the table leg. You may have to draw me a picture.

How about your extension......can you get the space between the back of your surgery knee and the floor to be zero? That sure took me a while.

May you have peace and contentment.
Chris

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Good morning Chris I have not had my knee measured the only way I can judge is on massage table and I am pretty close to flat on and during exercises I can hyper extend well look like that to me……the only back step I had yesterday was I got pretty swollen ..,whenever I start new activity or exercise this happens even though I ice after I exercise……so I was on ice most of night I wake to put on and off but I will push through today and do slides because I do believe they are the one that I have to get that bend I so desperately need ……i like you made a homemade slide you can use in living room I seen what they are charging for one i like to see picture of it make I can make one ….I am going to take picture of how I am using the table leg to hold the bend and add it here so thank you for all your encouragement and help Chris …,, have an awesome Saturday

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@ezas123

Good morning Chris I have not had my knee measured the only way I can judge is on massage table and I am pretty close to flat on and during exercises I can hyper extend well look like that to me……the only back step I had yesterday was I got pretty swollen ..,whenever I start new activity or exercise this happens even though I ice after I exercise……so I was on ice most of night I wake to put on and off but I will push through today and do slides because I do believe they are the one that I have to get that bend I so desperately need ……i like you made a homemade slide you can use in living room I seen what they are charging for one i like to see picture of it make I can make one ….I am going to take picture of how I am using the table leg to hold the bend and add it here so thank you for all your encouragement and help Chris …,, have an awesome Saturday

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Hey there @ezas123 . Thank you again for the update. Can't wait to see your picture. And thanks for remembering to ice, ice, ice, especially at this point in your recovery. Just a word about the swelling. The swelling happens when your body releases fluid to the area. There are all kinds of tissue, bone, ligaments in the middle of recovery. When they have all totally recovered and or accepted the prosthesis, the swelling should be better to control. If you want to try to control it now, you have to move the fluid back up your leg so it can be released with your urine.

My MFR therapist really worked on that situation especially when I went there right after PT. Legs up the wall can also help. If you notice that your surgery leg is smaller than the other leg, that is an indication of atrophied muscles from lack of use. Your exercises will help there also......

May you have happiness and the causes of happiness......
Chris

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Good evening this will give you ideal what I am trying to do if pics go through that is I hold my foot against the corner and fit my leg in there ….. I know not much of a bend but I find that so painful to do. I feel the pain in my knee in my thigh and hip even my bottom which makes so difficult to even sit normal when I first start ….. I starting to think is this normal…. Or I guess I am just that tight ….. thank you for your advice about being swollen I will try sitting with my legs up the wall for some time tonight ….. this will get better I know each day I do my body getting use to ….another day down lol thank you for your help it’s so nice to open my phone and see answer to something I was thinking about …..

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@ezas123

Good evening this will give you ideal what I am trying to do if pics go through that is I hold my foot against the corner and fit my leg in there ….. I know not much of a bend but I find that so painful to do. I feel the pain in my knee in my thigh and hip even my bottom which makes so difficult to even sit normal when I first start ….. I starting to think is this normal…. Or I guess I am just that tight ….. thank you for your advice about being swollen I will try sitting with my legs up the wall for some time tonight ….. this will get better I know each day I do my body getting use to ….another day down lol thank you for your help it’s so nice to open my phone and see answer to something I was thinking about …..

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@ezas123

There are easy ways to make a slide rather than spending money on one. If you are on a carpet, just put a plastic bag over your foot for the slide exercises. If you have hard flooring, wear an extra fuzzy sock that will slide well.

In the beginning when I was doing slides while on my back in bed, I had a long piece of 2 ft wide cardboard that I used. The cardboard also worked well to flip crosswise on the bed to do side leg extensions, just angled up a bit to keep the heel on it throughout the whole wing motion.

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@ddsack

@ezas123

There are easy ways to make a slide rather than spending money on one. If you are on a carpet, just put a plastic bag over your foot for the slide exercises. If you have hard flooring, wear an extra fuzzy sock that will slide well.

In the beginning when I was doing slides while on my back in bed, I had a long piece of 2 ft wide cardboard that I used. The cardboard also worked well to flip crosswise on the bed to do side leg extensions, just angled up a bit to keep the heel on it throughout the whole wing motion.

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Thank you good ideal with bag in living room …. I have been doing in between rooms where hardwood is and is doable but I think the bag be more comfortable … this definitely the most challenging exercise I have thank you I will use your suggestion today have a wonderful day

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@ezas123

Thank you good ideal with bag in living room …. I have been doing in between rooms where hardwood is and is doable but I think the bag be more comfortable … this definitely the most challenging exercise I have thank you I will use your suggestion today have a wonderful day

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Update your suggestion worked great I was able to set timer watch a show while i exercised…,many thanks

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I had my knee replaced before retirement hoping for a great retirement. 3 mos when suppose to go back to work, I still had issues. Knee replacement went well but scar tissue limited my range. I didnt know it was scar tissue, panicked and had the other replaced as it too needed it. I figured my first one just needed more time to rehab. Boy was I wrong. One knee rom 85 and other only 80 and always hurtful, i hold a pulsing vibrator on them most of the day for some relief, tens unit, cbd and gels, just miserable. Had one manipulated but no real benefit. PT wasnt progressing me. Went to new surgeon who wants my A1C to drop and me to lose some weight, trim up gut in hopes to improve outcome of surgery. Talked about arthrosiopic lysis of adhesions but he feels it is better to open up my knee again. But no guarantees. One Dr said scar tissue can grow back. It has really ruined my life. I had to buy a new lift chair ladt week because my other cheap one was failing and I need the lift to stand. Im 63 and always active before this and now to go to gym to trim up sucks when it is discomforting just to walk and limited on machines I can use. Hard to be motivated when you know surgery may not go well.

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