Scar tissue removal - is it the right thing to do?

Posted by krenn @krenn, Jun 8, 2023

61 yr old active female - my story in a short summary
Right Knee 2019 Meniscus repair surgery - fail
2020 Partial Knee Replacement - fail
2021 Oct TKR
2022 Oct - was schedule for scar tissue removal, surgeon attempted MUA before opening up knee again, seemed successful, but went backwards due to scar tissues.
Currently my knee is stuck at 75 - 80 degrees flexion, extension is 100% (full extension). Cannot do stairs, cannot ride bike at all, cannot kayak (something I love- we live on a river in NC) In constant pain daily. My knee feels like it has cement sitting on top of it.
I am scheduled in 2 weeks 6/22/23 to have scar tissue removal.
I have read success stories and failure stories. I was so active, I am not willing to settle with my knee the way it currently is, I may have to but I want to try anything I can go get it moving. I have done Myofascial release therapy, cupping, needling.... I am at a loss.
Any thoughts would be welcomed and appreciated.

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@krenn

Thank you for your insight and input. I did do exercises etc. I was very active prior to surgery, in the gym, road biking, walking daily, kayaking etc. I went into PT immediately after surgery and worked hard. When scar tissue began reforming is when the restrictions started. I did many sessions of PT after that only to have my knee blow up with fluid. I have been on this journey for 4 years, all during that time, I have done the work. My last session of PT, my surgeon ceased PT due to my knee swelling to the point of me not being able to walk. I have spent the last 3 months letting it "settle down" so he could perform the scar tissue removal surgery. I am doing my best to remain positive throughout this process. I have good days and bad days. Living with the ongoing pain daily with every step I take is wrenching. It can put you in a bad dark place. I am ready to see the light.
Again, thank you for all you insight.

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So sorry krenn. Damn you have done all the right things. I don't understand how the scar tissue can be so pervasive in someone so active.

Has the surgeon given you any ideas on how to keep the scar tissue from coming back? It can't be due to lack of activity.

I wish you the best.

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@krenn

Thank you for your insight and input. I did do exercises etc. I was very active prior to surgery, in the gym, road biking, walking daily, kayaking etc. I went into PT immediately after surgery and worked hard. When scar tissue began reforming is when the restrictions started. I did many sessions of PT after that only to have my knee blow up with fluid. I have been on this journey for 4 years, all during that time, I have done the work. My last session of PT, my surgeon ceased PT due to my knee swelling to the point of me not being able to walk. I have spent the last 3 months letting it "settle down" so he could perform the scar tissue removal surgery. I am doing my best to remain positive throughout this process. I have good days and bad days. Living with the ongoing pain daily with every step I take is wrenching. It can put you in a bad dark place. I am ready to see the light.
Again, thank you for all you insight.

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I hear you …. Some of us we do everything and then some and still get scar tissue …. I am like you …. I develop scar tissue very quickly even my incision from tkr healed very quickly that was dr first sign I healed quicker …most people who have tkr they can do exercise and go to the gym and break through scar tissue , unfortunately for me was not like that still fighting the fight 10 1/2 month’s revision finally breaking the scar tissue wall lol well I hope it continues I like you and others I get swollen and have to stop everything and go backwards a little….. it’s frustrating but I am still doing mfr, Graston technique, massage , recently I tried reiki form of energy healing…. Well I think was more of a massage but my knee did not like the massage I won’t do that again ….. but I want to try reiki again with someone else…. I also am going to try acupuncture can’t hurt right …I find and try different alternatives but I am nowhere where you are right now, I am 61 been dealing with this almost 2 years but I actually getting somewhere right now…. Hope it continues….. but I understand you wanting to go for surgery to remove scar tissue …… but I would also have a plan in place to focus on trying to break down scar tissue as it develops … there are some new techniques…. Some are pricy …. I pay out of pocket for everything …. But it is worth it most of the time I feel lol…. Good luck to you speedy recovery….

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I’m so sorry for your experience and sympathize with you. I know exactly what you mean. After a TKR of left knee in 2018’ my quality of life got worse not better. It never felt right to me in spite of X-rays showing “nothing wrong” according to the original surgeon. I went from 35 degrees flexion before manipulation to no more than 20 degrees afterwards! I was in pain & dragged that cement block around for years. After 4 years of self-rehabing while searching for answers, and talking with others surgeons, I finally found an ortho surgeon who had a diagnosis for my issues on my first consult with him. He ordered several tests including a scan that confirmed his diagnosis - that my implant was loose, and defective, and the wrong size on top of that. That was Oct of 22’…he did say since this was 3rd surgery on this same knee (I too had meniscus repair in 2017’) that he could not guarantee I’d get to 120 degrees of flexion. He performed revision TKR in Nov 22’ and noted that it took him an extra hour just to cut out/through the scar tissue. I had PT daily for a month, then 3 x week for 2 more months to keep scar tissue from developing again. Today I’m at 90 degrees and I consider that a win! I’m able to walk stairs normally, sit in a car normally, get on/off toilet normally, ride my exercise bike & walk 2.5 miles total to/from aquatic fitness class - 5 days a week. No more cement brick! So - there is hope. Don’t listen to those who had wonderful outcomes and insinuate you are not doing what your supposed to. Everybody is different, every outcome is different and there’s a reason for your issues. Don’t give up hope, keep the faith and best of luck with your upcoming procedure.

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@heyjoe415

So sorry krenn. Damn you have done all the right things. I don't understand how the scar tissue can be so pervasive in someone so active.

Has the surgeon given you any ideas on how to keep the scar tissue from coming back? It can't be due to lack of activity.

I wish you the best.

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Thank you.... movement, movement, movement. I have lined up a therapist that will be working with me daily for the first two weeks and then every other day after. I am determined.
I pray it works this time around.

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@ezas123

I hear you …. Some of us we do everything and then some and still get scar tissue …. I am like you …. I develop scar tissue very quickly even my incision from tkr healed very quickly that was dr first sign I healed quicker …most people who have tkr they can do exercise and go to the gym and break through scar tissue , unfortunately for me was not like that still fighting the fight 10 1/2 month’s revision finally breaking the scar tissue wall lol well I hope it continues I like you and others I get swollen and have to stop everything and go backwards a little….. it’s frustrating but I am still doing mfr, Graston technique, massage , recently I tried reiki form of energy healing…. Well I think was more of a massage but my knee did not like the massage I won’t do that again ….. but I want to try reiki again with someone else…. I also am going to try acupuncture can’t hurt right …I find and try different alternatives but I am nowhere where you are right now, I am 61 been dealing with this almost 2 years but I actually getting somewhere right now…. Hope it continues….. but I understand you wanting to go for surgery to remove scar tissue …… but I would also have a plan in place to focus on trying to break down scar tissue as it develops … there are some new techniques…. Some are pricy …. I pay out of pocket for everything …. But it is worth it most of the time I feel lol…. Good luck to you speedy recovery….

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Thank you. I is and can be very frustrating and so painful each and every moment in the day. If I can get my knee moving again, that will be priceless. 🙂

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@elaineva

I’m so sorry for your experience and sympathize with you. I know exactly what you mean. After a TKR of left knee in 2018’ my quality of life got worse not better. It never felt right to me in spite of X-rays showing “nothing wrong” according to the original surgeon. I went from 35 degrees flexion before manipulation to no more than 20 degrees afterwards! I was in pain & dragged that cement block around for years. After 4 years of self-rehabing while searching for answers, and talking with others surgeons, I finally found an ortho surgeon who had a diagnosis for my issues on my first consult with him. He ordered several tests including a scan that confirmed his diagnosis - that my implant was loose, and defective, and the wrong size on top of that. That was Oct of 22’…he did say since this was 3rd surgery on this same knee (I too had meniscus repair in 2017’) that he could not guarantee I’d get to 120 degrees of flexion. He performed revision TKR in Nov 22’ and noted that it took him an extra hour just to cut out/through the scar tissue. I had PT daily for a month, then 3 x week for 2 more months to keep scar tissue from developing again. Today I’m at 90 degrees and I consider that a win! I’m able to walk stairs normally, sit in a car normally, get on/off toilet normally, ride my exercise bike & walk 2.5 miles total to/from aquatic fitness class - 5 days a week. No more cement brick! So - there is hope. Don’t listen to those who had wonderful outcomes and insinuate you are not doing what your supposed to. Everybody is different, every outcome is different and there’s a reason for your issues. Don’t give up hope, keep the faith and best of luck with your upcoming procedure.

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It does feel like I have a brick sitting on my knee... the way I describe is that it feels like my knee is in a vice and someone is pushing on it all the time. You are the first person that has given me some sense of what could be going on inside my knee. From day one after the TKR in 2021, I have felt and even said out loud that something did not feel right. I discussed with my surgeon and also his PA. They take x-rays each time I go in, I asked for an MRI with no avail.
Under the circumstances, I would be okay with the flexion that I have but it is the intense pain and ache that I deal with. It is off the scale! I do get tired of those that insinuate that I did not put in the work, I did! I just pray that when he opens my knee back up that it is obvious what is going on. I want to come back and post the findings afterwards in hopes that it will help others. Again, THANK YOU!

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@krenn

It does feel like I have a brick sitting on my knee... the way I describe is that it feels like my knee is in a vice and someone is pushing on it all the time. You are the first person that has given me some sense of what could be going on inside my knee. From day one after the TKR in 2021, I have felt and even said out loud that something did not feel right. I discussed with my surgeon and also his PA. They take x-rays each time I go in, I asked for an MRI with no avail.
Under the circumstances, I would be okay with the flexion that I have but it is the intense pain and ache that I deal with. It is off the scale! I do get tired of those that insinuate that I did not put in the work, I did! I just pray that when he opens my knee back up that it is obvious what is going on. I want to come back and post the findings afterwards in hopes that it will help others. Again, THANK YOU!

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krenn - Your most welcome. For the longest I felt like I was the only person in the world who had a failed TKR!..This blog/support group opened my eyes! Two things I forgot to mention that I found helpful was that the surgeon ordered a 3 phase bone scan which revealed - everything; and he suggested a manipulation at just 4 weeks post-surgery because I couldn't get past 60 degrees rom in spite of daily PT and he was afraid the scar tissue was building up again. Instead of taking the "wait and see" approach and doing an MUA at the standard six weeks post-surgery, he did it at 4 weeks and I think this made a huge difference. Granted when he uttered the word "manipulation", I burst out crying. He completely understood why...but said it was completely up to me, that I wouldn't be starting over, but would keep the rom I had already worked so hard to gain, and this would allow me to gain even more. I did it of course, and with another 3 weeks of daily PT, (so-looking back, I had about 7 weeks straight of daily PT!), was able to get where I am today. Unfortunately, my newfound surgeon has left this area (Northern Virginia). My right knee needs to be replaced...and I won't let anyone touch it but him, so will have to hunt him down (ha-ha). He was a savior & is a rockstar! Best of luck to you and I look forward to seeing your success posted here too.

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elaineva - thank you again for all of the insight related to your journey. I forgot to mention that my surgeon had me scheduled this past October for this scar tissue removal surgery but told me in the preop room that he would attempt a MUA before cutting my knee again... he did, and was able to break it loose... he decided to not move forward with the surgery at that time . The MUA was exactly 1 year after my TKR.
My knee was good for a little while, then it started to regress, the pain, the non movement... very frustrating.
I am not giving up yet 🙂 I am praying this scar tissue removal works.

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@krenn

elaineva - thank you again for all of the insight related to your journey. I forgot to mention that my surgeon had me scheduled this past October for this scar tissue removal surgery but told me in the preop room that he would attempt a MUA before cutting my knee again... he did, and was able to break it loose... he decided to not move forward with the surgery at that time . The MUA was exactly 1 year after my TKR.
My knee was good for a little while, then it started to regress, the pain, the non movement... very frustrating.
I am not giving up yet 🙂 I am praying this scar tissue removal works.

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Hello, I also have a failed knee replacement. The surgeon did multiple tests and the bone scan revealed an occult fracture of my lateral tibial plateau which was inoperable. I could not walk more than 100 feet before I had to lean and take all weight off the affected leg. It would take me three separate trips to make it through the grocery store. Last fall I had a peripheral nerve stimulator placed in my affected leg which completely blocks the pain. I can walk my dog, walk to the grocery store and through the store. I’ve even returned to work

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@michelebar

Hello, I also have a failed knee replacement. The surgeon did multiple tests and the bone scan revealed an occult fracture of my lateral tibial plateau which was inoperable. I could not walk more than 100 feet before I had to lean and take all weight off the affected leg. It would take me three separate trips to make it through the grocery store. Last fall I had a peripheral nerve stimulator placed in my affected leg which completely blocks the pain. I can walk my dog, walk to the grocery store and through the store. I’ve even returned to work

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Where did you have the procedure done? It

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