1. < Joint Replacements

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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rennie | @rennie | Jul 5, 2022
In reply to @cheris "Hi I had total knee replacement 10 months ago. Lots of swelling. Went to PT had..." + (show)
@cheris

Hi I had total knee replacement 10 months ago. Lots of swelling. Went to PT had deep tissue massage. VERY painful I felt like I had a very tight band around my knee making it hard to move.. I used a recumbent cross trainer which helped a lot. Getting into the pool and walking had an immediate effect on bringing down the swelling. After 3 months I did fairly well. I was bothered for a long time with sciatic pain making it hard to sit and ride in a car. I had second knee replaced 8 weeks ago. Almost no swelling very good range of motion right after the operation. Doing exercises twice a day and icing 3 time a day. This time around so much better. Some stiffness in knee but nothing compared to last time. My only problem is the hip/butt pain is back but not as bad. Has anyone else had this problem???

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@cheris I find it encouraging that your second TKR went better. My first knee recovery has been terrible with pain and tightness. Lots of sitting pain too. Had to have a L5/S1 micro decompression which has helped some but after 15 months, buttock and knee pain still an issue. And, my body mechanics change contributed to a avulsion fracture of my heel where my Achilles inserts. But, I have no choice but to have second knee replaced. Very valgus knees and first TKR made opposite knee even worse. Any pre-surgery advice is welcome. I try to keep moving, but back surgery has limited me for now. Six week post op tomorrow. Just ready to get it done so I can start recovery! Thanks.

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Mentor
Chris Trout, Volunteer Mentor | @artscaping | Jul 6, 2022
In reply to @amcit340 "My problem may be a little different. Had first replacement (rt), in 2010. VERY dedicated to..." + (show)
@amcit340

My problem may be a little different. Had first replacement (rt), in 2010. VERY dedicated to PT and fabulous results! Danced at a concert and traveled to a reunion, at 6 weeks. Current issue is I was told to "wait", by PA, though he had told me I was eligible 2 years before, for TKR. Told him my lt. knee would "give out", with no warning. 6 weeks later, fell directly on that knee (gave out) and broke my patella. Had to wait 5 months, to have replacement. Patella had to heal, with wires wrapped around. Again, very dedicated to PT. Now, 15 months after TKR, returned to ortho and told I have scar tissue from patella repair. Using the "roller" device but MUST live on Advil, also. Even with that, very painful to walk and navigate stairs. Any other suggestions? Just use Advil (400 mg) twice a day, to barely function?

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Hi there @amcit340. I just read your post......before turning in for the night. Everyone has some scar tissue.....it is part of the healing process. The only way I got rid of it was MFR, myofascial release therapy. Because the tissue is wrapped in layers of fascia and the fascia becomes restrictive, it can be quite annoying and even painful.

I am going to ask @jenniferhunter to come over to say hello to you and explain just how this works. In the meantime, here is a video that will show you how the fascia moves within your body. When you watch it you will understand how it can build up in a restrictive way around the scar tissue.
https://www.youtube.com/watch?v=eW0lvOVKDxE&t=86s. You can skip the Ad im the beginning.
Let me know what you think.
Chris

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1 reply
Mentor
Jennifer, Volunteer Mentor | @jenniferhunter | Jul 6, 2022
In reply to @amcit340 "My problem may be a little different. Had first replacement (rt), in 2010. VERY dedicated to..." + (show)
@amcit340

My problem may be a little different. Had first replacement (rt), in 2010. VERY dedicated to PT and fabulous results! Danced at a concert and traveled to a reunion, at 6 weeks. Current issue is I was told to "wait", by PA, though he had told me I was eligible 2 years before, for TKR. Told him my lt. knee would "give out", with no warning. 6 weeks later, fell directly on that knee (gave out) and broke my patella. Had to wait 5 months, to have replacement. Patella had to heal, with wires wrapped around. Again, very dedicated to PT. Now, 15 months after TKR, returned to ortho and told I have scar tissue from patella repair. Using the "roller" device but MUST live on Advil, also. Even with that, very painful to walk and navigate stairs. Any other suggestions? Just use Advil (400 mg) twice a day, to barely function?

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@amcit340 Thanks, Chris, for inviting me to this discussion. I think it would be worthwhile to try myofascial release as Chris suggests. The patella is the only bone in the body embedded inside a tendon which connects to muscle. All of that is connective tissue. When connective tissue which includes fascia has scar tissue and gets too tight, it pulls the body out of alignment which can cause pain or extra wear and tear on something. With a knee, there is also the possibility that there could be an alignment problem in the pelvis or the foot/ankle than can affect the knee alignment or put stress on it. Even though the knee has been replaced, the patella is still functioning independently. It's like a system of pulleys and levers from the spine through the pelvis and down the leg, so if any of that is "off" it can change the dynamics.

MFR works by stretching out the kinks in the overly tight fascia and lets the body move normally again, or closer to normal. When tissue stops moving correctly, it gets compressed and dehydrated. Tight fascia can also restrict the muscles too because they are encased in it and it weaves through them. That can cause muscles to shorten and pull harder on something causing pain. The key to success is finding the right therapist who has been trained in the John Barnes methods of MFR. There is a provider search at http://mfrtherapists.com/

You can find a lot of information in this discussion on MFR, and the beginning pages have lots of links and information.

Myofascial Release Therapy (MFR) for treating compression and pain: https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/

I and Chris have both had good results with MFR. Do you think you would like to try it?

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amcit340 | @amcit340 | Jul 6, 2022
In reply to @artscaping "Hi there @amcit340. I just read your post......before turning in for the night. Everyone has some..." + (show)
@artscaping

Hi there @amcit340. I just read your post......before turning in for the night. Everyone has some scar tissue.....it is part of the healing process. The only way I got rid of it was MFR, myofascial release therapy. Because the tissue is wrapped in layers of fascia and the fascia becomes restrictive, it can be quite annoying and even painful.

I am going to ask @jenniferhunter to come over to say hello to you and explain just how this works. In the meantime, here is a video that will show you how the fascia moves within your body. When you watch it you will understand how it can build up in a restrictive way around the scar tissue.
https://www.youtube.com/watch?v=eW0lvOVKDxE&t=86s. You can skip the Ad im the beginning.
Let me know what you think.
Chris

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Thanks anyway.

In a message dated 7/6/2022 1:37:20 AM Eastern Standard Time,

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bill5 | @bill5 | Jul 8, 2022
In reply to @gailfaith "gaIlfaith here responding: Yes I had both knees replaced in 2004 and 2006 but I did..." + (show)
@gailfaith

gaIlfaith here responding: Yes I had both knees replaced in 2004 and 2006 but I did not have ANY problems with the recovery. After my first, before I left the hospital I was on the passive bending machine but off hand I don't remember how much bend I got but by the time I left there, but it was above 90 degrees. At the nursing home, the doctor there didn't know what she was doing !!! and she got very upset with me if I turned the machine there to anything over 90 degrees. When I got home, I lowered the seat on my stationary bike and stretched it more that way. I eventually end up with 124 degrees and my current therapist (for my monotonic dystrophy) measured it recently and now I have even more, something near 129. After my second one, I left the hospital with 123 and when I got to a DIFFERENT nursing home, they said I didn't need the machine with that much bend already , and by the time I left there I had 132 with just PT. Now I have even more like maybe 135. I don't think even before the surgery that it was much if anything above that naturally! Sorry to make you all jealous but should I have to get revisions on either knee in the future, I will be apprehensive that I might have problems in the future. The surgeon I had for both just had surgery on one of HIS knees (not TKR) and on the internet they showed his surgery. Not many people get to the see the inside of their surgeon's knee! My visit last summer to the surgeon, the X-rays showed no wear at that time! I will be 81 next month and hopefully the original TKR's will last me for the rest of my life, but as I have mentioned previously, right now I am doing a lot of walking for the Dystrophy . I am now up to 45 miles since Aug 13, '06 (that only includes measured walks, not day to day walking where-ever). And yes, I am thanking the Lord for that!

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I requested knee motion machine from my surgeon and he would not prescribe or recommend it. Have had replacement a month and after therapy it swells so bad it takes majorly of time between there and next therapy to reduce swelling. Range of motion at therapy is 110% with very painful force. I try my best to exercise and stretch at home but cannot get that degree of motion without extreme pain, any thoughts?

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1 reply
Mentor
John, Volunteer Mentor | @johnbishop | Jul 8, 2022
In reply to @bill5 "I requested knee motion machine from my surgeon and he would not prescribe or recommend it...." + (show)
@bill5

I requested knee motion machine from my surgeon and he would not prescribe or recommend it. Have had replacement a month and after therapy it swells so bad it takes majorly of time between there and next therapy to reduce swelling. Range of motion at therapy is 110% with very painful force. I try my best to exercise and stretch at home but cannot get that degree of motion without extreme pain, any thoughts?

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Hi @bill5, I see in your earlier post you mentioned you had your knee replacement done on 6/7/2022. I think it's still early in your recovery process for the TKR. I did all of my recovery at home with the walking, knee exercises and stretches along with the 2 most important things my surgeon told me to focus on - icing and elevating the leg to control the swelling. I found out at my 1 month or so followup with the surgeon that I was not elevating my leg enough. I was doing it after the exercises several times a day while icing it. My surgeon told me I should be elevating the leg when I was not doing exercises or walking. He basically wanted me to keep the leg elevated as much as possible.

I think the swelling comes with the exercises while your knee and leg are recovering. The exercises probably add to it a little which is why the icing and elevating are so important. Are you doing a lot of icing and elevating?

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ammaw52 | @ammaw52 | Jul 10, 2022
In reply to @JustinMcClanahan "Hello @leithlane, welcome to Connect. This is an experience very close to my own. I had..." + (show)
@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 was just told yesterday I would be sent this to use to help straighten my leg and help my bend. I had tkr 5 months ago. Had manipulation June 17th it did not help. I have been in agony. I have had home health for 3 weeks and go back to outpatient thearpy next week. Now I am dealing with back pain from so much working on my knee. Wow. I have had 2 back surgeries. I hope this machine works. I am - 15 on straighten leg. I can't walk good at all. I use a cane.

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mladinichh | @mladinichh | Jul 10, 2022
In reply to @johnbishop "Hi @bill54321 - You are not dumb! Sometimes it is easy for a discussion to be..." + (show)
@johnbishop

Hi @bill54321 - You are not dumb! Sometimes it is easy for a discussion to be misinterpreted. I was just commenting on the movie poster in the post that you mentioned you didn't get it. If you are not having any problems or pain with your knees then it is not likely that you need a knee ablation. Here is some information that explains a knee ablation.

Could Radiofrequency Ablation Provide Relief for Painful Osteoarthritis in Your Knees?
--https://health.clevelandclinic.org/could-radiofrequency-ablation-provide-relief-for-painful-osteoarthritis-in-your-knees/

Sorry if I added some confusion with my post.

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that was lame

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krenn | @krenn | Jul 11, 2022
In reply to @rmeddings "I'm afraid a second opinion will only lead to the same results for me also. As..." + (show)
@rmeddings

I'm afraid a second opinion will only lead to the same results for me also. As my joints look perfect on X-ray. I suppose I just keep hanging on to the hope that there is someone out there that will have the knowledge to help me. As I sit and write this at 4:00 am , I wonder if my Dr's even have any idea, or really believe what an ordeal this has been , or what it's like to go to bed each night, and wake each morning, with the same old pain !!
I really hate that anyone else is going thru this, but at he same time, it strengths me know that there is someone else in the world that does understand my pain.. I have the gabapentin route, I was on Percocet for nine months ( as you say it only dulls the pain) I have tried nerve blocks,also. All to to avail..
I'm still holding on to the hope that someday this nightmare will end for me, and all of you ,who are going thru this.

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Hi, I am in the same spot you are. 3 surgeries on my right knee, been dealing with since 2018
1st... Meniscus Repair.... found out after the fact that it was an "experimental" surgery. Spring 2019 2nd... PKR Spring 2020
3rd... TKR Oct 2021
Now I have large thick scar tissue... that my surgeon is going to do a 4th surgery to take out.
I am scheduled for him to reassess Sept 7, 2022. If inflammation has "settled down" he will schedule to take out the scar tissues. Not arthroscopically he is going to open my knee back up.
He says it is too large that it would take too long to do arthroscopic surgery. I am hopeful.
I have bee so frustrated and depressed. I am a strong woman and want to push through this but I am growing very weary.
Has anyone ever had scar tissue removed other than arthroscopically?

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2 replies
Mentor
Chris Trout, Volunteer Mentor | @artscaping | Jul 12, 2022
In reply to @krenn "Hi, I am in the same spot you are. 3 surgeries on my right knee, been..." + (show)
@krenn

Hi, I am in the same spot you are. 3 surgeries on my right knee, been dealing with since 2018
1st... Meniscus Repair.... found out after the fact that it was an "experimental" surgery. Spring 2019 2nd... PKR Spring 2020
3rd... TKR Oct 2021
Now I have large thick scar tissue... that my surgeon is going to do a 4th surgery to take out.
I am scheduled for him to reassess Sept 7, 2022. If inflammation has "settled down" he will schedule to take out the scar tissues. Not arthroscopically he is going to open my knee back up.
He says it is too large that it would take too long to do arthroscopic surgery. I am hopeful.
I have bee so frustrated and depressed. I am a strong woman and want to push through this but I am growing very weary.
Has anyone ever had scar tissue removed other than arthroscopically?

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Good evening @krenn. It is great to be able to welcome you to Connect. Our purpose here is to help each other by sharing. And to support that mission, I will now cut to the chase about scar tissue post-TKR. I have had two of those surgeries. After the first one, I developed excessive scar tissue and all my great exercise and strengthening efforts went right out the window.

Imagine how thrilled I was to be introduced to MFR, Myofascial Release Therapy. It took about six weeks to get the restrictive fascia and scar tissue released and then it was over.

And then came TKR #2 and I was ready. My PT, worked closely with my MFR therapist from day one after the surgery. The result.........this time I did not have scar tissue build up. It didn't have a chance with those two ladies being on top of it.

Are you familiar with MFR? Here are two links to get you started. One explains what fascia does and how it can become restrictive. The second one is written by a fellow mentor @jenniferhunter. She and I are both huge supporters of MFR and this is an introduction.
https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/


Would you be willing to try MFR?
Chris

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