How do you treat excess scarring after TKR?

Posted by Jmacvol @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.

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@ezas123

Hi I can relate I am 3 months out had issues from the beginning….I am at 70 degrees I exercise every 3 hours at home and knee feels stiff all the time Thank god I found this support group …. I went to my first water therapy last week which I know will help …. But most important thing I have done for my recovery I reached out to Maria Gennetti she was very nice made me feel comfortable she does mfr release I found through this link …. I seen her for first time yesterday yes it was somewhat painful but bare able…. Right after our session I felt it my knee was not so stiff and tight it was incredible ….. another important thing is this morning not as stiff as usual….. i slept on my side for first time since tkr was great best night sleep in months …. So I am feeling so good about mfr is going to work ……so if you have not tried I would …I know it is expensive but if it get me back to work we’ll than I pay off my credit card. Lol no seriously my knee has not felt this good sine tkr I hope it stays I let you know….. feeling good having hope been a while thank you for putting the people I need in front of me God and I do the foot work

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Nothing helps me but rest.

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@ezas123

Hi I can relate I am 3 months out had issues from the beginning….I am at 70 degrees I exercise every 3 hours at home and knee feels stiff all the time Thank god I found this support group …. I went to my first water therapy last week which I know will help …. But most important thing I have done for my recovery I reached out to Maria Gennetti she was very nice made me feel comfortable she does mfr release I found through this link …. I seen her for first time yesterday yes it was somewhat painful but bare able…. Right after our session I felt it my knee was not so stiff and tight it was incredible ….. another important thing is this morning not as stiff as usual….. i slept on my side for first time since tkr was great best night sleep in months …. So I am feeling so good about mfr is going to work ……so if you have not tried I would …I know it is expensive but if it get me back to work we’ll than I pay off my credit card. Lol no seriously my knee has not felt this good sine tkr I hope it stays I let you know….. feeling good having hope been a while thank you for putting the people I need in front of me God and I do the foot work

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Hi there @ezas123 Congratulations on your success with MFR. Actually, I am on my way to my MFR therapist in a few minutes. You will not suffer from excess scar tissue because the MFR process will make sure the fascia is not holding on and creating restrictions. Yes, it is expensive unless insurance will cover it. Are you working? Is Maria a certified OT? Insurance will help with the cost if your intention is to return to work.

When is your next session? You need to make sure you don't build up more scar tissue. That should also help you increase your ROM. Do you do the exercise where you hold a flat-out position for 5 or 10 minutes? That one helped me the most.

May you be content and at peace today.
Chris

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@artscaping

Hi there @ezas123 Congratulations on your success with MFR. Actually, I am on my way to my MFR therapist in a few minutes. You will not suffer from excess scar tissue because the MFR process will make sure the fascia is not holding on and creating restrictions. Yes, it is expensive unless insurance will cover it. Are you working? Is Maria a certified OT? Insurance will help with the cost if your intention is to return to work.

When is your next session? You need to make sure you don't build up more scar tissue. That should also help you increase your ROM. Do you do the exercise where you hold a flat-out position for 5 or 10 minutes? That one helped me the most.

May you be content and at peace today.
Chris

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I pay out of pocket my insurance does not cover …. No I am not working right now yes very expensive but like I said when I run out of cash I will charge as long as it is helping worth it …. The next day still feeling ok my leg I am able to get straight during exercise …. Once more scar tissue breaks down hope to bend better that is one thing feels new every time …I walked around store my gait I noticed much better…. I see Maria again Wednesday being a little more aggressive at first …..I am going to take in my exercise see what she suggest ….,,I have the worst time with bending only 70 if you have an exercise that helped I would be grateful if you shared thank you for your interest help god bless

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@genespanos

Nothing helps me but rest.

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How along ago did you have your surgery

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@ezas123

How along ago did you have your surgery

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Suggest you stop any form of PT besides walking.

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@genespanos

Suggest you stop any form of PT besides walking.

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Thank you for getting back to me seems you had surgery while ago and twice ….. I won’t do the other knee everyone saying maybe different well may not…. I am still trying to get my first knee on track …. You are right I am focusing on my walking my leg bent and stiff and in one session with mfr my leg is pretty straight I mean I have been working on straightening exercises at home also…..next is trying to get more bend in my knee … I know good luck with that it has been impossible …. Thank you I am sorry you still having tuff time….. Theresa

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@ezas123

I pay out of pocket my insurance does not cover …. No I am not working right now yes very expensive but like I said when I run out of cash I will charge as long as it is helping worth it …. The next day still feeling ok my leg I am able to get straight during exercise …. Once more scar tissue breaks down hope to bend better that is one thing feels new every time …I walked around store my gait I noticed much better…. I see Maria again Wednesday being a little more aggressive at first …..I am going to take in my exercise see what she suggest ….,,I have the worst time with bending only 70 if you have an exercise that helped I would be grateful if you shared thank you for your interest help god bless

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Good evening @ezas123 There are some pretty standard recuperative exercises. Here is a link to some on-line
options:
https://orthoinfo.aaos.org/en/recovery/total-knee-replacement-exercise-guide/.

Perhaps Maria can help you select the best ones to improve your ROM. Also, you want to straighten your knee and make your extension a zero. The ones that helped me the most were the ones you hold for 5 or 10 minutes.

The one that helped my ROM is the one where you slide your foot on the carpet or a towel on a hard floor.....from straight to bent and hold for 5 seconds.

There is also a Youtube program with a couple of gentlemen. Here are their names and you can select videos for post-surgery.
3 Simple Things Everyone with Knee Pain Should Do Daily - YouTube
Physical Therapists Bob Schrupp and Brad Heineck have over 50 years of combined. We try to add a twist of our humor into each video in our quest ...

Please let me know how it goes. I am sure you can master this. Tell me about the exercises you choose. If there is discomfort.....that is to be expected. You can always ice and elevate to reward yourself for good effort.

I am thinking about you......wish we had a 2-way camera so I could cheer you on.

May you be physically well
May you be mentally well.

Chris

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Fortunate I am to have an exceptional young physical therapist who has addressed every single issue with my reverse total shoulder 2019 and now my TKR 201. These are not easy . Takes a knowledgeable therapist, and a great surgeon that has done their job. My therapist starts massage right from the start and has taught me how to do it on my knee. It is definitely unpleasant to go through but outcome is so positive. Insurance pays for all while in therapy. I have had to use muscle stimulator, dry needling, massage, and of course a daily exercise regimen to include balance exercises not just for a few months but for a lifetime. Still do occasional dry needling on shoulder because I tend to overuse it, my bad. I also do water aerobics. My surgeon is young too and told me from the start it takes a great deal of work on my part. Am so pleased to not be in the pain I was in prior to these surgeries.
Best wishes to all. It’s a life long journey.

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@dmk

Fortunate I am to have an exceptional young physical therapist who has addressed every single issue with my reverse total shoulder 2019 and now my TKR 201. These are not easy . Takes a knowledgeable therapist, and a great surgeon that has done their job. My therapist starts massage right from the start and has taught me how to do it on my knee. It is definitely unpleasant to go through but outcome is so positive. Insurance pays for all while in therapy. I have had to use muscle stimulator, dry needling, massage, and of course a daily exercise regimen to include balance exercises not just for a few months but for a lifetime. Still do occasional dry needling on shoulder because I tend to overuse it, my bad. I also do water aerobics. My surgeon is young too and told me from the start it takes a great deal of work on my part. Am so pleased to not be in the pain I was in prior to these surgeries.
Best wishes to all. It’s a life long journey.

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Absolutely true that "My surgeon is young too and told me from the start it takes a great deal of work on my part." It is obvious that you are doing the work - congratulations!

I think often the issue with post surgery recovery (but certainly not all of it) is either that the doctor forgets to tell the patient that the largest part of the equation is to do the rehab OR the patient chooses not to hear it in their excitement to get relief from pain. People also get the "glazed over" look when the doctor or his PA try to explain that every body is different, the procedure may be different "once I am in there", there are risks and that perfect results are not guaranteed.

When I share with people that I have had - and rehabbed from - a dozen ortho surgeries - the most usual response is "You're lucky". My reply is "No, I'm stubborn" - I don't give up. They weren't there at 5 am and 9 pm, when I was doing PT after ACL replacement/MCL repair before & after work and raising kids. Or when I was going between 2 PT appointments, one to work on my back & neck, the other to work on my surgically repaired wrist.

Keep up the good work - and hang on to the name of your PT - the good ones are golden.
Sue

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