Closed / arthroscopic Lysis of Adhesions after a TKR?

Posted by leroyb63 @leroyb63, Jan 18 6:28am

I am 62 years old and, thanks to a left TKR in 2019, I’m a FORMER marathon runner, downhill skier, cyclist and tennis player. (Now my fitness pursuits are limited to ruck sack hiking and strength training, which I do LOVE but miss the old days….) I followed my physical therapy program to the letter following the TKR, but serious range of motion issues and stiffness were evident 12 months post op. I could not use my mountain bike without installing an adaptive pedal to accommodate 95 degree ROM. Granted, the TKR removed daily pain I was experiencing but the physical activity limitations are terribly frustrating and curtailing my quality of life! Currently, I cannot cycle, cannot strengthen my quads or hamstrings unless I perform unilateral exercises (I.e single leg squats). Not to mention the obvious safety issues with a very limited ROM in a knee. I will not consider a MUA because of potential for femur fracture and because it’s been too long since initial TKR surgery. Wondering if anyone has any experience with closed/ arthroscopic lysis of adhesions?
Thanks for reading and responding!

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Tracy | @fwintracy | Jan 18 7:35am

First, I have no experience with closed/ arthroscopic lysis of adhesions. I’m now 68 yrs old and I did have two TKRs - Jan 23 and Jan 24 - performed by a long-time friend. In the lead-up to my first surgery he told me I’d get pain relief but I’d “never forget that’s not my real knee”. I get it….now.

I’m just now getting the ROM-related pain-free days. Every night when I go to bed I fold my lower legs under me while I work very hard to break the scar tissue. Yes, it hurts. He assured me that after 6 months or so, I can’t break anything he did for me, within reason of course.

I also started yoga and Tai Chi within the last couple of months (still maintaining 2-3 trips a week for cardio (recumbent bike and elliptical) and weights - including leg work) and have increased ROM as a result, I believe.

It’s imperative to continue to break the scar tissue - he told me it will keep forming for a year or so before my body will give up. I’m no surgeon, but based on my hours of conversation with my friend, at this point a MUA may be your best solution. Have you spoken with your surgeon about this? I understand the risk of a femur fracture is less than 2% and is almost always associated with complicating issues like poor bone quality.

Best of luck to you. Don’t give up. Life’s different but has to be better without the daily knee pain.