How do you treat excess scarring after TKR?
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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124 degrees of bend after a TKR is very good. 120 degrees is the target after most surgeries, so good for you. You must have done all that was recommended re: PT post-op.
I worked to get my whole body in shape for a year before my first TKR this March. It could nor have gone better and I? followed all post-op therapy instructions and still do some of them, and more, at the gym.
I had my other knee replaced this July. Pretty much the same results but it took two weeks longer (around 6 weeks) before I could use stairs. Still have some minor swelling 8 weeks out. No two operations are the same.
Joe
Speaking for the people who STILL have pain and scar tissue, I can only wonder why people come on here and tell their success stories other than for attention and brag! Also, we are glad for you but frankly do NOT want to hear it. Just valuable insight and information to help.
Dawn,
I think you're right. The best way to avoid scar tissue after a TKR is to be diligent about stretches and then strengthening. It's too late once the scar tissue is there and it has to be removed surgically, I think, or the TKR needs to be done over. Neither option is good.
For those reading who are pondering TKR, strengthen your quads and hamstring as much as possible before the surgery, and be diligent about post-op exercises. And continue to make stretching and strengthening exercises part of your life.
Joe
I’m in Florida and need any recommendations for doctors or methods to remove scar tissue after TKR. Three years later and still have swelling, stiffness and pain
Hi,
I am posting here to see if I am in an exclusive club with my ongoing issues following knee replacement. My initial total replacement was a little over 3 years ago. Other than the typical PT experience with getting to full extension and 120 plus degree bend, all went as expected for the initial 3-4 months. At that point I started experiencing increased pain in the joint especially climbing and descending stairs. My surgeon recommended different PT and other exercises but I continually went downhill getting progressively worse. He had me do a wide range of imaging, infection and allergy tests all inconclusive. Other that hope it would remedy itself, he had no plan of action. After a year or more of increasing pain, I went for another opinion.
After another series of testing it was concluded that my replacement was loose and needing a complete revision. I did that 14 months ago and the new surgeon said that among other items he would have done differently, the first prosthesis just about fell out with zero effort required to remove it. The new implant is much more aggressive. This time around I had no flexibility issues and was over 110 degrees by my first visit to the PT facility. All was great for the first few months and then again, I started experiencing increasing joint pain. I have great stability, no flexibility issues, can walk miles but I have constant pain with simple knee bending movements and stairs. The diagnosis is excessive scar tissue or sinovitis. After another range of tests I had an arthroscopic “clean-up” about 8 weeks ago. I had immediate pain relief but 2 weeks later the pain returned and continues. I am having PT to break up scar tissue but my therapist says he has never felt a knee grinding like mine does. To me it is almost like I have a bag of marbles in the joint. So much so that at times you can hear the grinding.
Last part of my story is my older brother is a retired knee and hip replacement specialist. Both he and my current surgeon are somewhat stumped on why I continue to have excessive scar tissue. They are confident the scar tissue is the problem. I am considering a 4th procedure to inspect and remove the scar tissue but there is no promise that this would not happen all over again.
I am curious if anyone in this group has experienced anything similar and what you did or are doing. Although few, there must be others with an experience similar to mine as I am hoping to get ahead of the problem and start to experience life as I expected it to be when I had the initial replacement over 3 years ago. Any replies are greatly appreciated.
JW
I have excessive scar tissue. Had TKR Jan 2022. Had two manipulations to force scar tissue to break up. Feb 2022 and Apr 2022. Lot of PT. Still no good. Aug 2022 had scar tissue removal. Scar was 1 1/2 inches thick. Removed about 80% of scar tissue. 5-6 months later and extensive PT scar tissue has presumably grain back and preventing me from bending and straightening much. Very limited range of motion. Going to see a different surgeon next week for second opinion. I tried to get into Mayo and provided all my info reports X-rays. But received letter that they are experiencing appointment delays and put me on wait list. Feel I’m in limbo.
Hi @jw14450, I moved your question about removing scar tissue after TKR to this existing discussion in the Joint Replacements group:
– How do you treat excess scarring after TKR?: https://connect.mayoclinic.org/discussion/how-do-you-treat-excess-scarring-after-tkr/
I did this so that you can read previous helpful posts and connect with members like @heyjoe415 @lawman @ezas123 @xteach @artscaping and more. You may also be interested in these related discussions:
– Scar Tissue Around Knee After TKR https://connect.mayoclinic.org/discussion/scar-tissue-around-knee-after-tkr/
- Revision surgery because of scar tissue in knee https://connect.mayoclinic.org/discussion/knee-replacement-revision/
– Will MFR help with scar tissue build up? https://connect.mayoclinic.org/discussion/will-mfr-help-with-scar-tissue-build-up/
- 8 Months after TKR Serious Grinding: https://connect.mayoclinic.org/discussion/8-months-after-tkr-serious-grinding/
Good evening @jw14450, and welcome to Connect. I have read your discussion of the post-surgery situation you have found yourself in several years after your TKR. I also had a three-year gap between my first TKR and the day when it gave up acting appropriately, complete with pain and stiffness, and swelling. Here is how I handled it.
https://connect.mayoclinic.org/discussion/will-mfr-help-with-scar-tissue-build-up/
A TKR surgery is quite complex......complete with severe handling of bones, connective tissues, muscles and nerves. So you can tell that I probably wasn't excited about having to undergo a second TKR last year. However, this time I was able to have a robotic surgery and one that was minimally invasive. And this time I was instructed to participate in pre-surgery exercises for six weeks before the actual surgery. In retrospect, I think those two items made a huge difference. Of course, I started PT right away and pushed myself to 137 degrees bend with zero extension relatively quickly.
And the new item.....my MFR therapist and my orthopedic PT got together and discussed how they could handle the scaring issue. My PT managed the movement exercises and my MFR therapist handled pain and discomfort until there wasn't any. In doing so, the scar tissue was eradicated before it could become a problem.
My question is this, surgery by its nature creates scar tissue. If for some reason, you get more than your share of it and it doesn't find its way out maybe you would profit from having some MFR sessions. You can find out more about MFR on this Connect link.
https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/
May you be safe, protected, and free from inner and outer harm.
Chris
Hi DMK
Maybe you can share some details on your rolling pin therapy. I am trying to get ahead of my scar tissue issue to avoid a surgical tissue removal procedure. Even if I do Xbox ahead with it I want stay in front of the possibility of it returning.
Thanks
I have excessive scar tissue too. Had surgery to remove it Aug 2022. After months of PT scar tissue is back and very limiting my ROM. About 70 degrees. My surgeon is proposing a revision where remove implant, remove s at tissue again. On tibia and femur remove bone on both to make bigger gap for knee to bend. New implant. And more PT. Especially as scar reforms. He’s talked with several specialists around the country and all agree with this as next step. One of the places he talked to are two surgeons from Rothman Orthopedic institute in Philadelphia. Then others in LA, Chicago, Dallas. I’ll be meeting with another surgeon to discuss this procedure and go from there. . Sounds radical but could be option for you. Best wishes to you.
Wayne