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Jmacvol
@jmacvol

Posts: 25
Joined: Jul 29, 2016

How do you treat excess scarring after TKR?

Posted by @jmacvol, Jul 29, 2016

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.

REPLY

Hi @jmacvol, welcome to connect.
I am not a doctor but understand your situation. I injured my right knee. Tore my meniscus & ACL & broke a bone off my thigh (fell of silly tedmill) 6 years ago. I learned that the key to slowing down the process of scar tissue is continous exercise & stretching, even when therapy discharges. You may need to revisit therapy for some help breaking up some of that scar tissue. I actually still see therapy to keep mine feeling great, a maintenance program. This might be a great option for you.

Hope this helps.
Dawn

@dawn_giacabazi

Hi @jmacvol, welcome to connect.
I am not a doctor but understand your situation. I injured my right knee. Tore my meniscus & ACL & broke a bone off my thigh (fell of silly tedmill) 6 years ago. I learned that the key to slowing down the process of scar tissue is continous exercise & stretching, even when therapy discharges. You may need to revisit therapy for some help breaking up some of that scar tissue. I actually still see therapy to keep mine feeling great, a maintenance program. This might be a great option for you.

Hope this helps.
Dawn

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Thank you Dawn for your quick reply. I hadn’t thought of physical therapy again because I thought it was general knowledge that you were going to get as much as you could in the 1st few weeks of therapy. After three 3 month therapy sessions (1 for each surgery) I was a little turned of on therapy being the solution anymore.

I thought the same thing. I had part of my sternum remove 2003 and had therapy 4 different times to specifically break up the scar tissue. Part of my therapy now is the left knee, right pectoral minor and shoulder. When they removed my sternal manubrium joint the pectoral muscle had to get reattached. It has now atrophied and we are now working on thining the scar tissue for mobility and pain control.

Insurance covers for acute and any exacerbations. Just ask your doc for a physical therapy re evaluation order or referral.

Good Luck
Dawn

I am sorry you have had so much trouble. I had my a RTH 5 years ago. I had my left hip done 1 year ago. I continue to have pain in both hips, even have both Total Hip Replacement. Had Bursitis in Right Hip and now I have Bursitis in my Left Hip. I. Pray your Knees get better. These types of surgeries are very painful and having to go thru physical therapy can be very hard.

To Jmacvol: You’ve been thru the war and I am sorry to hear of your
continuing problems post TKR. I’ve had both knees done with no post-surgery
problems at all. Maybe time to change Drs????????? I’ll be praying for
you. gailfaith

@gailfaith

To Jmacvol: You’ve been thru the war and I am sorry to hear of your
continuing problems post TKR. I’ve had both knees done with no post-surgery
problems at all. Maybe time to change Drs????????? I’ll be praying for
you. gailfaith

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Thank you Gail. I’m trying to get an appointment at the Mayo to see what
can be done. You know that the definition of insanity is to keep doing the
same thing and expect a different result. Time for a change.

@gailfaith

To Jmacvol: You’ve been thru the war and I am sorry to hear of your
continuing problems post TKR. I’ve had both knees done with no post-surgery
problems at all. Maybe time to change Drs????????? I’ll be praying for
you. gailfaith

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Hi Jmacvol…..Do you live close to Mayo (which one?). I’ve been there twice for 2 different issues and for me it takes 3 flights each way to get there. Well worth the effort. Not to make you jealsous but after my first TKR, when I went back to see the surgeon in 2 weeks for a check, I needed no cane, etc. The gal asked where my cane was and she said they were going to put me on a pedistal in the waiting room! However I went to a nursing home for post care for the first one as I live alone. The physiatrist there was nuts. This was back when they still used ths passive motion machine, and she got upset when I raised the angle to bend my knee over 90 degrees. That is what you go there for, to get as much bend as possible. When she wasn’t around I’d raise it again, but the best I ever got to was about 124 degress of bend but after I got home and used my stationionary bike to help me with the bending by lowering the bike seat as much as possile. My second one is an even better story. gailfaith

@gailfaith

To Jmacvol: You’ve been thru the war and I am sorry to hear of your
continuing problems post TKR. I’ve had both knees done with no post-surgery
problems at all. Maybe time to change Drs????????? I’ll be praying for
you. gailfaith

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I live in SW Virginia and it takes 2 flights and a 90 minute drive to get to the Mayo. Believe me, I’ve heard more stories like yours than mine. I’m really happy for you. I had no trouble walking right out of surgery and ROM was pretty good. As time went on things deteriorated. I’m hoping that Mayo has the experience to help me overcome my proclivity to scar. Statistics show I’m less than 1/10 of 1% of population. Lucky me.

Liked by hjlucchi

Do I understand you correctly, that outside of the scarring, the rest of the TKR results were good? If so, I am happy for you. After my second TKR also on the machine before I left the hospital, I went to a different nursing home. I expected to use the machine there, but when the she saw my ROM already, she didn’t order it. However on day 1 there, they measured my ROM at something in the mid 120’s. But I was having calf pain and to be sure I didn’t have a clot, I did no PT over the weekend until they could confirm there was no clot. So after lying in bed for 3 days, I was concerned that I had lost some of my good 120+ degrees of bend. So when I started PT again on Tuesday, I joking asked how much did I lose. His response: you’re now up to 132 degrees! As far as I can ascertain, that is about where I was pre-surgery! Now that I have monotonic dystophy, I need that 132 degrees to get up from the floor though I still need help as the legs are weak, but I can at least get my R leg under me and get ready to stand.
When you fly to Mayo, where do you fly from and where is your plane change? I fly out of Lancaster airport which is just down the street (2 miles) to Dulles, then to Minneapolis and then Rochester. But coming home the last time, they cancelled the last flight back to Lancaster as they never told us that airline had changed hands and the FAA had not yet approved them flying into Lancaster. ! So instead of a 45 minute flight, they DROVE me and another passenger right to our front doors! But that was an hour wait at first then a 3 hr drive.

No, the scarring is internal to the knee joint and restricts my ROM to less than 70 degrees. It is preventing me from normal activities and is quite painful. I fly from Tri Cities Tennessee to Atlanta to Minneapolis. I stay with my son and his family in a suburb of Minneapolis and drive to Rochester.

Wow, getting to Mayo is a real effort for you. My hat off to you. Sounds like your knee hopefully is something Mayo can solve. Again, my prayers.
gailfaith,

@apportee

I am sorry you have had so much trouble. I had my a RTH 5 years ago. I had my left hip done 1 year ago. I continue to have pain in both hips, even have both Total Hip Replacement. Had Bursitis in Right Hip and now I have Bursitis in my Left Hip. I. Pray your Knees get better. These types of surgeries are very painful and having to go thru physical therapy can be very hard.

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As you know, most of the outcomes of these surgeries are improved quality of life and total recovery. And then there are those of us that never stop suffering. I’m hoping there is a solution out there somewhere for us.

@gailfaith

Do I understand you correctly, that outside of the scarring, the rest of the TKR results were good? If so, I am happy for you. After my second TKR also on the machine before I left the hospital, I went to a different nursing home. I expected to use the machine there, but when the she saw my ROM already, she didn’t order it. However on day 1 there, they measured my ROM at something in the mid 120’s. But I was having calf pain and to be sure I didn’t have a clot, I did no PT over the weekend until they could confirm there was no clot. So after lying in bed for 3 days, I was concerned that I had lost some of my good 120+ degrees of bend. So when I started PT again on Tuesday, I joking asked how much did I lose. His response: you’re now up to 132 degrees! As far as I can ascertain, that is about where I was pre-surgery! Now that I have monotonic dystophy, I need that 132 degrees to get up from the floor though I still need help as the legs are weak, but I can at least get my R leg under me and get ready to stand.
When you fly to Mayo, where do you fly from and where is your plane change? I fly out of Lancaster airport which is just down the street (2 miles) to Dulles, then to Minneapolis and then Rochester. But coming home the last time, they cancelled the last flight back to Lancaster as they never told us that airline had changed hands and the FAA had not yet approved them flying into Lancaster. ! So instead of a 45 minute flight, they DROVE me and another passenger right to our front doors! But that was an hour wait at first then a 3 hr drive.

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@gailfaith
I’m so amazed that you got up to 120 degrees and then 132 degrees so soon after your TKR. I’m now at 108 after 7 weeks of PT and it has been a struggle. My goal is 115. You are very fortunate to have such a great result. Beatricefay

@gailfaith

Do I understand you correctly, that outside of the scarring, the rest of the TKR results were good? If so, I am happy for you. After my second TKR also on the machine before I left the hospital, I went to a different nursing home. I expected to use the machine there, but when the she saw my ROM already, she didn’t order it. However on day 1 there, they measured my ROM at something in the mid 120’s. But I was having calf pain and to be sure I didn’t have a clot, I did no PT over the weekend until they could confirm there was no clot. So after lying in bed for 3 days, I was concerned that I had lost some of my good 120+ degrees of bend. So when I started PT again on Tuesday, I joking asked how much did I lose. His response: you’re now up to 132 degrees! As far as I can ascertain, that is about where I was pre-surgery! Now that I have monotonic dystophy, I need that 132 degrees to get up from the floor though I still need help as the legs are weak, but I can at least get my R leg under me and get ready to stand.
When you fly to Mayo, where do you fly from and where is your plane change? I fly out of Lancaster airport which is just down the street (2 miles) to Dulles, then to Minneapolis and then Rochester. But coming home the last time, they cancelled the last flight back to Lancaster as they never told us that airline had changed hands and the FAA had not yet approved them flying into Lancaster. ! So instead of a 45 minute flight, they DROVE me and another passenger right to our front doors! But that was an hour wait at first then a 3 hr drive.

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Thanks for you email. I attribute it to the passive motion machine which they have discontinued tits use. Reason they say is it is hard for the new replacements. I just had new xrays done by the surgeon. I had them done in 2004 and 2006 and in 2016 they show NO signs of wear. gailfaith

@gailfaith

Do I understand you correctly, that outside of the scarring, the rest of the TKR results were good? If so, I am happy for you. After my second TKR also on the machine before I left the hospital, I went to a different nursing home. I expected to use the machine there, but when the she saw my ROM already, she didn’t order it. However on day 1 there, they measured my ROM at something in the mid 120’s. But I was having calf pain and to be sure I didn’t have a clot, I did no PT over the weekend until they could confirm there was no clot. So after lying in bed for 3 days, I was concerned that I had lost some of my good 120+ degrees of bend. So when I started PT again on Tuesday, I joking asked how much did I lose. His response: you’re now up to 132 degrees! As far as I can ascertain, that is about where I was pre-surgery! Now that I have monotonic dystophy, I need that 132 degrees to get up from the floor though I still need help as the legs are weak, but I can at least get my R leg under me and get ready to stand.
When you fly to Mayo, where do you fly from and where is your plane change? I fly out of Lancaster airport which is just down the street (2 miles) to Dulles, then to Minneapolis and then Rochester. But coming home the last time, they cancelled the last flight back to Lancaster as they never told us that airline had changed hands and the FAA had not yet approved them flying into Lancaster. ! So instead of a 45 minute flight, they DROVE me and another passenger right to our front doors! But that was an hour wait at first then a 3 hr drive.

Jump to this post

I used the passive motion machine for my first knee two years ago but I had the same difficulty getting my ROM. This time I didn’t use the machine with same results. I’m just glad that most of the bad pain is gone except when I’m working on getting that ROM which I’m confident will come in time. I have to be thankful that I’m making progress because when I read about others needing further surgery I feel so sorry for them. It’s a great operation, but it has to work. Beatricefay

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