Scar tissue after knee replacement

Posted by leithlane @leithlane, Jan 31, 2017

I had knee replacement surgery 6 weeks ago . Through PT I have been working on breaking up the scar tissue only for it to regrow by the time I get back to PT two days later. I have been massaging at home, using a hand held massager and roller. It is painful and swollen. I am getting very disheartened. Any suggestions as to what else I can do. Has anyone had laser treatments to break up scar tissue? Were they effective?

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@dduke

There is something wrong. Arthrofibrosis. You have massive scar tissue surrounding your knee. You need arthroscopic lysis. I had the procedure as did several on this site. It made all the difference.
Arthrofibrosis
From Wikipedia, the free encyclopedia
Arthrofibrosis (from Greek: arthro- joint, fibr- fibrous and -osis abnormality) is a complication of injury or trauma where an excessive scar tissue response leads to painful restriction of joint motion, with scar tissue forming within the joint and surrounding soft tissue spaces and persisting despite rehabilitation exercises and stretches. Scarring adhesions has been described in most major joints, including knees, shoulders, hips, ankles, and wrists as well as spinal vertebrae.[1][2]
Arthrofibrosis of the knee[edit]
Arthrofibrosis of the knee has been one of the more studied joints as a result of its frequency of occurrence.[3][4] Beyond origins such as knee injury and trauma, arthrofibrosis of the knee has been associated with degenerative arthritis.[5] Scar tissues can cause structures of the knee to become contracted, restricting normal motion. Depending on the site of scarring, knee cap mobility and/or joint range of motion (i.e. flexion, extension, or both) may be affected.[6] Symptoms experienced as a result of arthrofibrosis of the knee include stiffness, pain, limping, heat, swelling, crepitus, and/or weakness.[4] Clinical diagnosis may also include the use of magnetic resonance imaging (or MRI) to visualize the knee compartments affected.[7]
The consequent pain may lead to the cascade of quadriceps weakness, patellar tendon adaptive shortening and scarring in the tissues around the knee cap—with an end stage of permanent patella infera—where the knee cap is pulled down into an abnormal position where it becomes vulnerable to joint surface damage.[8]
Patients who are recognized as developing arthrofibrosis may improve motion with appropriately directed physical therapy, corticosteroid injections, non-steroidal anti-inflammatory drugs, and cryotherapy. In many instances, however, as fibrosis has set in, surgical intervention is necessary.
Specialized arthroscopic lysis of adhesions knee procedures such as anterior interval releases may be indicated and utilized to great success, in the hands of an appropriately trained specialist.[5]

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This is an old post so hopefully you get this. My TKR surgery was as 2 years ago and my ROM is still only 105/4 extension. I am in a lot of pain and believe it is from scar tissue. Dr says scar tissue removal doesn’t work and is now referring me for nerve ablation. Surgeons in my area don’t perform surgery for scar tissue removal. I am willing to travel, live in Louisiana, any suggestions on how to find a reputable surgeon??

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