Scar Tissue Around Knee After TKR

Posted by flaredhead @flaredhead, Sep 29, 2022

I have a question. I had a total knee replacement on my right knee 13 weeks ago. I have achieved 120% ROM and 100% extension. Still in PT for strengthening muscles to master going up and down stairs. BUT -- there is a tightness around my knee that seems to move and shift around the knee when I'm exercising or walking. Is that scar tissue? It's a weird sensation. If not scar tissue, what? Should I be concerned? I have mentioned it to my physical therapist and he just said "maybe, not sure." Does it warrant a visit to my surgeon?
Melinda

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I am no expert just reading and research and my own experience…. By the way great work that’s awesome you have full range of motion …. You may be experiencing the tight band you will hear prefer to …. But fortunately for you did not stop your range … did you always have that feeling or is it something new ?…the tight band usually people describe having it right from surgery or shortly after …. My first knee surgery I had tight band from time I awoke from surgery it went away in few months … good luck keep up the good work

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Are you doing any stretching exercises, like for the illio tibial band (ITB)? I could explain some stretches but it's easier of you ask your PT. I have similar numbers as far as ROM and extension but no tightness - I stretch before I exercise. Something to look into. All the best!

Joe

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Yes, see surgeon. They will check for infection. Also X-ray and bone scan. Also see about a pain specialist. I had genicular nerve ablation at a year but hasn’t helped much. Also recommend myofascial release therapy and shock wave therapy. Both are noninvasive and could help especially since you are not that far out from surgery. I am 14 months out and still have tightness and some sharp pain almost all the time. Swimming, biking and walking are all very unpleasant! But I do them because they are good for the rest of my body. I also was diagnosed with breast cancer recently so can’t try anything for my knee until next year. Will have radiation but chemo possibly. Waiting on lymph node pathology. Want to try focused shock wave therapy as it goes deeper into soft tissue than regular. Doctors don’t know problem. Therapists should. Good luck.

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Hi Melinda,
I feel your discomfort. 8 weeks out from a total knee on the right and I have that tight, binding feeling in my knee that changes depending upon what I am doing. Also had a previous knee surgery involving my IT band and a screw that had to be removed when they did my TKR. I have 0-130 Passive ROM, 0-123 active. Adhesions in my quad, IT band, and around my patella and incision were restricting my motion. My PT has done IASTM—Graston technique—scraping to the skin using a tool, to my distal quads, IT band, and gently around my incision. Feels like gravel, causes some bruising, but seemed to be very therapeutic. I also had cupping done where the skin is suctioned into a cup, then leave it in place and you can even do some gentle exercise, remove after 5-7 minutes. It initially is red with with an indentation and later may turn into a round bruise. For me, function before aesthetics…but know you will have some marks on your body should you choose to get either of these done. Both have helped me. I posted some pics below; have my silicone tape over my incision in most of them.
I am told it just takes time … but I am wanting to get back in action. The spin bike, kicking in the lap pool, and doing the stretching with a noodle in the hot pool have definitely helped me as well.
Hoping you have a good recovery and the tightness eases up!

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@swimmergirl

Hi Melinda,
I feel your discomfort. 8 weeks out from a total knee on the right and I have that tight, binding feeling in my knee that changes depending upon what I am doing. Also had a previous knee surgery involving my IT band and a screw that had to be removed when they did my TKR. I have 0-130 Passive ROM, 0-123 active. Adhesions in my quad, IT band, and around my patella and incision were restricting my motion. My PT has done IASTM—Graston technique—scraping to the skin using a tool, to my distal quads, IT band, and gently around my incision. Feels like gravel, causes some bruising, but seemed to be very therapeutic. I also had cupping done where the skin is suctioned into a cup, then leave it in place and you can even do some gentle exercise, remove after 5-7 minutes. It initially is red with with an indentation and later may turn into a round bruise. For me, function before aesthetics…but know you will have some marks on your body should you choose to get either of these done. Both have helped me. I posted some pics below; have my silicone tape over my incision in most of them.
I am told it just takes time … but I am wanting to get back in action. The spin bike, kicking in the lap pool, and doing the stretching with a noodle in the hot pool have definitely helped me as well.
Hoping you have a good recovery and the tightness eases up!

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Melinda,

Considering your ROM, which is incredible, I'm surprised that you developed adhesions. But no two knee surgeries are alike. Thanks for the info. I'm 67 and had both knees replaced this year. I worked hard before and after surgery and recovery was fast. ROM is 130 and extension is 0 in both knees.

I never would have thought of cupping. I've had it done with massage but it does loosen anything under the skin that is messing with a muscle. Thanks!

Joe

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Thanks to everyone for their responses and insights on my question. I will give it some more time and keep doing stretches/exercises. And if it does not improve I will go back to my surgeon for guidance.
Melinda

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My body makes scar tissue rapidly. I have had my knee replaced twice manipulated once and scoped once with the same results. I have aggressively participated in physical therapy. After my last procedure I went directly to a swing bed to get Therapy two times a day for a week to get a good start. The 3 times a week for 3 months with the same results. 70 degrees is all I have. I am 6' 2" tall so being tall even makes it more difficult. I am looking for answers. I am 71 so I am to young just to accept this is it. Any advice is appreciated.

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@pupwud

My body makes scar tissue rapidly. I have had my knee replaced twice manipulated once and scoped once with the same results. I have aggressively participated in physical therapy. After my last procedure I went directly to a swing bed to get Therapy two times a day for a week to get a good start. The 3 times a week for 3 months with the same results. 70 degrees is all I have. I am 6' 2" tall so being tall even makes it more difficult. I am looking for answers. I am 71 so I am to young just to accept this is it. Any advice is appreciated.

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Welcome @pupwud, I moved your question about scar tissue after TKR to this existing discussion in the Joint Replacements support group (https://connect.mayoclinic.org/group/joint-replacements/)

See:
- Scar Tissue Around Knee After TKR: https://connect.mayoclinic.org/discussion/scar-tissue-around-knee-after-tkr/

I did this so you can read previous posts and connect with other members like @flaredhead @ezas123 @heyjoe415 @mpirruccel @swimmergirl @dmk @noethewja and many others.

You may also be interested in this older discussion with current posts:
- How do you treat excess scarring after TKR? https://connect.mayoclinic.org/discussion/how-do-you-treat-excess-scarring-after-tkr/

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@colleenyoung

Welcome @pupwud, I moved your question about scar tissue after TKR to this existing discussion in the Joint Replacements support group (https://connect.mayoclinic.org/group/joint-replacements/)

See:
- Scar Tissue Around Knee After TKR: https://connect.mayoclinic.org/discussion/scar-tissue-around-knee-after-tkr/

I did this so you can read previous posts and connect with other members like @flaredhead @ezas123 @heyjoe415 @mpirruccel @swimmergirl @dmk @noethewja and many others.

You may also be interested in this older discussion with current posts:
- How do you treat excess scarring after TKR? https://connect.mayoclinic.org/discussion/how-do-you-treat-excess-scarring-after-tkr/

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Thank you

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@pupwud

My body makes scar tissue rapidly. I have had my knee replaced twice manipulated once and scoped once with the same results. I have aggressively participated in physical therapy. After my last procedure I went directly to a swing bed to get Therapy two times a day for a week to get a good start. The 3 times a week for 3 months with the same results. 70 degrees is all I have. I am 6' 2" tall so being tall even makes it more difficult. I am looking for answers. I am 71 so I am to young just to accept this is it. Any advice is appreciated.

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I am searching for post TKR problems. My surgery was on 2-19-24 and I have been having PT ever since. My ROM is still only 75 degrees and I am very discouraged. I also had the manipulation done on 4-12-24. I went to my surgeon today and he suggested a "revision of the components" which means another knee surgery!!! He says I don't have scar tissue. How does he know that., my PT thinks I do!!

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