Chronic knee pain after knee replacement with excessive scar tissue formation

Thank you for responding......now another question...What is knee revision ? My P.T. feels that I need a replacement of my TKR which took place almost 1 yr.ago.

A revision is taking out the first knee replacement and putting in a second<br />
one,but it is only done in cases of infection, improper selection of first<br />
prosthetic (too large) or the surgery was not done correctly. It is a last<br />
resort.<br />

Thank You for answering my question re:revision, sometimes I feel so silly asking a question that I think I should know the answer to!

My sister had metal allergy to her implant, which caused her constant pain; took forever for any doctor to figure out because no one wanted to believe that titanium can cause allergy, but once it was finally removed her pain disappeared almost immediately-might be worth looking into...

Wow! Do not think that is my situation but my heart goes out to her. I think and so does my doc that I have patella cluck whis is scare tissue built up and making my patella get stuck. When it finally releases it goes lunch...therefore the name.<br />
Rena<br />
<br />
Rena (Riki) Applebaum<br />

I had TKR on my left knee Dec 2013 at the Holston Valley Medical Center in Kingsport Tennessee followed by 3 months physical therapy. My surgeon was Dr. Jason Park. As PT went on, my ROM decreased and my pain from scar tissue increased. I had MUA April 2014 which was the most painful recovery experience I have ever had also with no improvement in ROM. I had revision surgery on my left knee to remove scar tissue Sept 2014 and had TKR on my right knee at the same time followed by 3 months PT. Pretty much the same impact as bi-lateral TKR. My right knee responded reasonably well but scar tissue grew back quickly in my left knee again. My 3rd major surgery to again remove scar tissue was in Dec 2015 followed by 3 more months of aggressive but unsuccessful PT as the scar tissue once again returned. I am almost 8 months out from my 3rd surgery on my left knee, my ROM is approximately 70/0, walking aggravates the scar tissue so at the end of each day I am in significant pain. My surgeon is highly experienced in TKR and very respected in the region. He said 4 things of note over this ordeal: 1) after the 1st surgery he said that I had the largest bones that he had ever operated on; 2) when trying to understand what was happening he said that he may have used too large an implant; 3) before the final surgery he said that if that didn't work he may have to replace the entire implant; and 4) after the last PT he said there was no more he could do. I am trying to get an appointment at the Mayo Clinic to see if anything can be done. This is pretty much my last resort. Has anyone heard of ASTYM therapy? I just saw some articles on it on the internet last night.

@jmacvol I have complete faith that Mayo Clinic will help you out. 🙂

Yes I do know what Astym is. It is very uncomfortable or painful for some patients during the procedure, but there is no pain after a therapy sessions. Astym treatments take place about twice a week over a period of four to six weeks. Because the procedure heals the dysfunctional tissue, the pain gradually diminishes. By the end of the treatment period, the tissue is healthy, and the pain is gone and will not return unless the area is reinjured. This is what we are doing to my shoulder and 3,4,5 ribs. Like all treatments, does not work for everyone. It can cause pain to be worse if it is not done correctly or the diagnosis is incorrect.

I have had four surgeries on my right knee, two full replacements and two partials. The first dr. I feel threw me under the bus because I saw his physician assistant the first two times after my first surgery not him. No one but the PT's touched my knee and they kept saying you are not getting your range. So the third month I went to my dr. I told him. Right away (apparently he had finally read PT notes), he said I needed a manipulation. Well it was over 3 months and they don't like to do a manipulation only in first 30/40 days because they can break your femur. I was so mad at him I said I was going elsewhere. I did I went to Duke in Raleigh where they did a manipulation to almost no avail. Scar tissue is very debilitating and hurts like the devil. My whole leg was awful. Then I went to Georgetown University Hospital in DC wherein Dr. Evans went in and cleaned up my knee. A year went by and it was awful, chronic pain. So he went back in and did another full replacement. Of course in the meantime I got an obstruction in my lower intestine and almost died from that. I was not able to bend my knee and was simply in pain all the time. Not able to do anything but work because I sit down. Finally a friend of mine gave me an article on Dr. Henry Finn at Weiss Memorial Hospital/The University of Chicago Bone and Joint Clinic. I went to see him. He does radiation before revision or even replacement. Well, he felt my last replacement was too long ago and it had grown into whatever place it was. He felt he would do more damage than good. Anyway, he did a revision and I had radiation before the revision and four manipulations a week apart. He put in the rotating hinge replacement. I must tell you I never before had the extension for this knee but I do now. I am still in pain but it has only been 4 1/2 months. I have done 3 months of PT this time and am working out at a gym. He is a wonderful doctor and did design his own knee - just did not put it in me. I am better than I have ever been, just want the pain to go away. This has all happened within less than four years.

Mine is a long story like yours. Left TKR December 2013, 3 months PT and MUA March or April 2014, poor ROM due to excess scar tissue. Right TKR and Left revision to remove scar tissue Sept 2014 followed by 3 more months PT. Range of motion on right knee about 105 but left knee still 70 - 80 degrees. 2nd revision to remove scar tissue on left knee Dec 2015 followed by 3 more months of intensive PT. As PT went on my range of motion decreased due to growing scar tissue. My surgeon said there was no more they could do. Had my records sent to The Mayo Clinic late this Summer and they agreed to see me but I am on a waiting list. Since then my doctor has said that i have sufficient bone on my tibia to remove the lower implant, remove some tibia and loosen the joint and that might improve range of motion regardless of scar tissue. He came up with that idea after i had my records sent to The Mayo 🙂 Needless to say I'm not excited about that option and want to see the surgeon at The Mayo to see what option he has and ask if my surgeon's suggestion makes sense. I am now trying acupuncture to see if that will help with the constant pain. It's my last resort short of surgery.

Yes Dr. Finn is arrogant. He did radiation before my 4th knee surgery. He does all the football players and famous people. He designed his own knee. Unfortunately he could not put that knee in my leg because it was too long after my third surgery. He did put a hinge in my knee and my extension is great and my range also. But I still have lots of pain. I would at least give them a call. He saw me almost within two weeks and two weeks later I had surgery. The only thing I had to stay in Chicago for 6 weeks for PT. But I would call him at least. Weiss Memorial Hospital