Knee replacement revision

Posted by sgp1949 @sgp1949, Nov 20, 2018

I am looking at a third knee replacement on the same knee in six years. This time is due to aggressive scar tissue. My doctor has used physical therapy which sent me back to the doctor last year. This year he has used braces that crank to try to break up the scar tissue. He won’t do a manipulation this time around. My range of motion has gone from 118 to the present 70 degrees. I am afraid if I don’t have the surgery it will continue to get worse but am really dreading it. Not sure about getting a second opinion since mine is one of the best in the area. Anyone else had troubles or any advise?

Hello @sgp1949, welcome to Connect. I'd like to share the following discussion with you titled, "Scar tissue after knee replacement." It is a long, ongoing discussion on the exact topic of aggressive scar tissue.

Personally, I had the same experience with aggressive scar tissue after my replacement in 2006. I had two manipulations that did not work and I also had a brace that had cranks on it to try and break it up. Eventually, I had a full leg cast put on that had hand cranks on it to try and aggressively break up the scar tissue. None worked, but I kept at it and eventually broke the scar tissue loose on my own. Still, I only have 0-105ish. A second opinion can never hurt, even if you are currently seeing an expert, especially since it involves major surgery.

I'd also like to invite @amberpep, @r2martin, @melcpa86, @rhetorica, @liza, who have all talked about having a revision, scar tissue surgery, or are also considering a revision surgery as well.

@sgp1949, while we wait for other members to share their experience, has surgery to remove the scar tissue been discussed? In my own case, they did not want to do so because they did not want to risk infection.

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@JustinMcClanahan

Hello @sgp1949, welcome to Connect. I'd like to share the following discussion with you titled, "Scar tissue after knee replacement." It is a long, ongoing discussion on the exact topic of aggressive scar tissue.

Personally, I had the same experience with aggressive scar tissue after my replacement in 2006. I had two manipulations that did not work and I also had a brace that had cranks on it to try and break it up. Eventually, I had a full leg cast put on that had hand cranks on it to try and aggressively break up the scar tissue. None worked, but I kept at it and eventually broke the scar tissue loose on my own. Still, I only have 0-105ish. A second opinion can never hurt, even if you are currently seeing an expert, especially since it involves major surgery.

I'd also like to invite @amberpep, @r2martin, @melcpa86, @rhetorica, @liza, who have all talked about having a revision, scar tissue surgery, or are also considering a revision surgery as well.

@sgp1949, while we wait for other members to share their experience, has surgery to remove the scar tissue been discussed? In my own case, they did not want to do so because they did not want to risk infection.

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I have surgery scheduled for February to remove the scar tissue. He really doesn’t want to do it nor do I want to have it done but as of now no other option except to live with the pain and impairment

Liked by katp

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I have a scope surgery to remove scar tissue scheduled on 11/28 with my original surgeon. Infection has been ruled out. The bone scan had increased uptake, but at barely 9 months after surgery, the doc said that could be normal or it could be loose. The metal allergy test came back that I’m allergic to nickel, but none of the four surgeons that have looked at the result can tell me if the implant I have contains nickel as of yet. I was advised by two of them that even if it does – at my age (54) they would advise AGAINST a revision as I would have larger issues in the future when the implant wore out.

The scar tissue scope is the least invasive option to try and address the pain and increase my ROM which has slipped from 120 to 105 in the last 6 months.

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@sgp1949

I have surgery scheduled for February to remove the scar tissue. He really doesn’t want to do it nor do I want to have it done but as of now no other option except to live with the pain and impairment

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@sgp1949, what sort of procedure is involved with removing the scar tissue? @melcpa86, mentioned that they are having a scope surgery to remove scar tissue on 11/28. If you feel like sharing, is this the procedure you will be having in February?

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@JustinMcClanahan

@sgp1949, what sort of procedure is involved with removing the scar tissue? @melcpa86, mentioned that they are having a scope surgery to remove scar tissue on 11/28. If you feel like sharing, is this the procedure you will be having in February?

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He is talking about a third knee replacement if February. It will the third in 6 years on the same knee. I have tried physical therapy, manipulation, and braces with cranks. Nothing broke up the scar tissue. I am now down to 70% range of motion. It decreased by 20% in the last year.

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@sgp1949–that's tough. I have a lot of scar tissue too, and am going in on Thursday for a needle aspiration to see if any of the fluid in my knee is from an infection. After that, I do have a second opinion scheduled for next week to see what my options are. I have also talked with a massage therapist who has recommended some specific massages designed to break up scar tissue. I wish you luck.

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Thank you

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Hello All. I'm new to the group. I'm scheduled for revision of TKR on May 2, 2019. I understand the first operation will entail taking out the prothesis and putting in an antibiotic emitting spacer. Does anyone know how long the spacer will stay in and how long before the 2nd surgery to take out the spacer and put in a new knee? And during the time the spacer is in place, how much mobility will I have? Thanks for any feedback. Jean

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Hello @jeansugg, welcome to Connect. You may notice I moved your discussion and combined it with another discussion titled, "Knee replacement revision." I did this so you could see some of the posts already made on this topic and so you could meet members like @sgp1949, @barbwire, @szqyoung, @amberpep, @maryann1753, @jmacvol, @franciesusan, who have all talked about having a knee revision.

@jeansugg, this is the first I have heard of an antibiotic spacer being needed for a revision as part of the normal routine of things. If you are comfortable sharing, does your provider have infection concerns or have you had issues with infections in the past?

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@JustinMcClanahan

Hello @jeansugg, welcome to Connect. You may notice I moved your discussion and combined it with another discussion titled, "Knee replacement revision." I did this so you could see some of the posts already made on this topic and so you could meet members like @sgp1949, @barbwire, @szqyoung, @amberpep, @maryann1753, @jmacvol, @franciesusan, who have all talked about having a knee revision.

@jeansugg, this is the first I have heard of an antibiotic spacer being needed for a revision as part of the normal routine of things. If you are comfortable sharing, does your provider have infection concerns or have you had issues with infections in the past?

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This is what I know. The device attached to my tibia is loose or loosened. And I had an aspiration and the fluid from that showed infection. My bone scan showed loss of bone so I just assumed I had infection in the bone as well.

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Hi there, I am 3.5 yrs post TKR and have dealt with enormous scar tissue issues. The best ROM I could ever get was 120 degrees under extreme pain. Best advice I can offer is keep moving, stretch every day and ride a good quality excercise bike. I am facing revision surgery, the last couple of days I have experienced sharp pain on weight bearing. In your case your ROM is severely limited, I would most definitely get a second opinion from an unrelated surgical group- even if just for peace of mind! I wish you all the best, please keep us posted

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I’m one year post op TKR my knee replacement clicks every time I move and I have scar tissue does any one else have that problem.

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Hi @memeblair – Welcome to Connect! Glad you found this forum. I've had 2 TKR's and did not experience that noise although my orthopedic surgeon told me it was one of the three biggest complaints he usually got from patients regarding their knee replacements. I have heard other people on this forum speak of it. Here are a couple of threads that might interest you:
https://connect.mayoclinic.org/discussion/i-had-a-partial-knee-replacement-in-january-all-was-fine-until/?utm_campaign=search
https://connect.mayoclinic.org/discussion/scar-tissue-after-knee-replacement/?pg=10#comment-109702
Meantime, have you had your 12 month re-check appointment yet? If so, I'm wondering what you OS says? Also, other than the noise, are you feeling comfortable with your TKR?

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