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?

@katp

Of course, it’s an unknown territory and most dispensaries have very understanding docs and salespeople. The menus are incredibly large. I have not wanted to smoke anything so I began with tinctures. I recommend getting a strong thc content. That allows you to use less (and save money-it’s not cheap!). Problem, however, is that I must take it at 8pm in order for me to be sleepy by 10pm. Any MM taken by mouth takes awhile to kick in but then last longer. I’ve tried lotions (forget them), transdermal creams (don’t work really). After more than a year I have created a tolerance and just bought a disposable vape pen. I haven’t really used it except for an experimental trial yesterday. I don’t really want to get high, but I did on one strong draw, and yes, I coughed. 😆. I will only use it if I can’t fall asleep after 10pm. If I didn’t sleep every night there is no way I could get thru days of pain. I tried ambien, and it works, but that, too, comes with tolerance after awhile. I use MM for a distinct purpose. I am not a drug abuser. No haters need reply. Hope you can find some relief.

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Good evening @katp, I am not a hater, I am a supporter. I have been using MM for Small Fiber Neuropathy and its determination to keep me in pain 7/24. After 4 or 5 years and with amazing improvements in products and options, I can finally control my pain with tinctures of different dosages and content from 3:1 CBD/THC to 1:3 CBD/THC. My favorite get-up and get going is a 1:1 CBD/THC. And nighttime……a little more calming 1:1 CBD/THC.

I was pleasantly surprised that the nurses and physicians openly discussed my use of MM during my hospital stay. At my follow-up today, the topic was on the table again in a positive and helpful way. Things are looking up.

I have a new goal for my pain. I used to want to be pain-free. Now I will realistically accept pain under control…….not totally gone….just tolerable.

May you be healthy and whole.
Chris

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Thank you. I guess the social stigma of MM is still alive and well in me. So far all I have been able to do use it to sleep. By about 7 pm my knee seems to swell, tighten, and nothing I try seems to calm it down. It’s good to know that others live with tough chronic pain. Some days I want to quit. Most days I live in acceptance, doing what I can, resting, reading, and taking care of myself. I realize that many have it worse than I do. I may try cbd for daytime use. Why not, I’ve tried so many things.

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My story is so similar to yours. I knew I had scar tissue at 6 weeks also. Docs and pt told me I was ‘guarding’, like it was my fault for not working hard enough. I did not give up. Scar tissue is a very real complication. Don’t let anyone tell you that you are just weak!

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Hello everyone. My story is.like everyone else's. I had TKR going on 9 weeks and my knee is worse than before the surgery with scar tissue build up all around the knee that has limited my mobility. I'm at 88 degrees flex and 11 degrees straight. My PT can get it to 105 and 5 with me screaming in agony. I had a manipulation done going on 3 weeks ago and it did nothing. I've had 13 knee surgeries on this knee in my lifetime starting nwith an ACL replacement back when I was 18. I'm 46 now. O had an osteotomy with a left wedge 7 years ago. The other surgeries were scopes to clean up arthritis and torn meniscus.

Im.writing looking for help and advice. I still go to PT 3x/week. The 2 weeks just after the manipulation I went 5x/week. Other then stretching, what can I do to help combat this? I feel I'm capped with PT as I havent seen improvement there. I'm so nervous and losing faith that this TKR was the right decision.

Thank.you

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@reelin

Me too.. I want to take walks so bad and I can’t or I’ll be in excruciating pain the next day.. I’m in pain and so stiff .. I can’t stand being inactive like this..my dr recommended a Dynasplint.. I’m at 90..not straight enough..I would like to know if anybody else had one? Diana

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My doctor recommended the dynosplint as well. I would need both types of splints for bending and straightening as there isn't 1 splint that does both. I'm curious as well of this has worked for others.

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Hello @briankoz and welcome to Mayo Clinic Connect. I am sorry to hear about your limited range of motion following this last and surgery. It sounds like you are working so diligently to regain your motion but things just aren't working as you had hoped.

You mention dynosplint so wanted to connect you with members @mwatts91757 and @reelin who have both shared about it in other discussions and may have information they can share with you as you consider it.

I found some information that you might find helpful on range of motion timelines and what you can do if you fall within the 5-7% of people who experience stiffness after surgery (as quoted by this article) and what things you can do at home and in addition to your PT.

-Range of Motion After Joint Replacement Surgery:
https://www.peerwell.co/blog/2017/01/13/range-of-motion-after-joint-replacement-surgery/
Have you tried these suggestions already?

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@cheris

Hi I had total knee replacement 10 months ago. Lots of swelling. Went to PT had deep tissue massage. VERY painful I felt like I had a very tight band around my knee making it hard to move.. I used a recumbent cross trainer which helped a lot. Getting into the pool and walking had an immediate effect on bringing down the swelling. After 3 months I did fairly well. I was bothered for a long time with sciatic pain making it hard to sit and ride in a car. I had second knee replaced 8 weeks ago. Almost no swelling very good range of motion right after the operation. Doing exercises twice a day and icing 3 time a day. This time around so much better. Some stiffness in knee but nothing compared to last time. My only problem is the hip/butt pain is back but not as bad. Has anyone else had this problem???

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I’m 9 weeks in and I also have terrible sciatica pain, hip, SI joint pain from the TKR surgery. Had the pain the minute I came out of recovery and has just got worst over time. I’ve had PT for knee and the above problems. I just found a new chiropractor that is finally helping me. Find out if you have periformis syndrome because I was just diagnosed with that from all the problems that were created during the surgery and now that I’m being treated for that I finally am getting so much better. Periformis syndrome doesn’t get diagnosed as much as it should on people and it can greatly affect everything in the butt and hip area. I’m finally getting better. It’s been a tough and painful road.

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@scarletrose

I’m 9 weeks in and I also have terrible sciatica pain, hip, SI joint pain from the TKR surgery. Had the pain the minute I came out of recovery and has just got worst over time. I’ve had PT for knee and the above problems. I just found a new chiropractor that is finally helping me. Find out if you have periformis syndrome because I was just diagnosed with that from all the problems that were created during the surgery and now that I’m being treated for that I finally am getting so much better. Periformis syndrome doesn’t get diagnosed as much as it should on people and it can greatly affect everything in the butt and hip area. I’m finally getting better. It’s been a tough and painful road.

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I am so glad you found the cause and are getting better! I agree that often piriformis and sciatic inflammation, which can cause pain and referred pain throughout the back and lower extremities, can be overlooked, especially after surgery or an injury.

On my soapbox now – There is almost always pain and discomfort after surgery, but it should lessen over time. Unless there is a defect or infection, new, worsening pain after surgery is not "normal" and needs to be evaluated & treated – it often leads back to joints, muscles and tendons that have been compensating for the bad joint for years. You will need physical therapy and exercise to get to your new normal.

You need to be your own best advocate, and keep pushing for a real answer and needed therapy to correct the situation. Then you need to do the therapy – which may be uncomfortable, boring or time-consuming – for as often and as long as recommended in order to make a complete recovery. (PT can be done on your own with a few sessions with a therapist to get & keep you on track – it doesn't need to be a costly matter of going to the clinic 3 times a week…)

Sue

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@briankoz

Hello everyone. My story is.like everyone else's. I had TKR going on 9 weeks and my knee is worse than before the surgery with scar tissue build up all around the knee that has limited my mobility. I'm at 88 degrees flex and 11 degrees straight. My PT can get it to 105 and 5 with me screaming in agony. I had a manipulation done going on 3 weeks ago and it did nothing. I've had 13 knee surgeries on this knee in my lifetime starting nwith an ACL replacement back when I was 18. I'm 46 now. O had an osteotomy with a left wedge 7 years ago. The other surgeries were scopes to clean up arthritis and torn meniscus.

Im.writing looking for help and advice. I still go to PT 3x/week. The 2 weeks just after the manipulation I went 5x/week. Other then stretching, what can I do to help combat this? I feel I'm capped with PT as I havent seen improvement there. I'm so nervous and losing faith that this TKR was the right decision.

Thank.you

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Hi, I don’t know if someone mentioned this already, but if you are on Facebook there is a group called “Arthrofibrosis Support”. Members of the group share information about treatments for scar tissue and arthrofibrosis after knee surgery. The group is a great resource, and I’ve learned a lot.

I have been in PT on and off (mostly on!) for almost four years for three knee surgeries (including 2 TKA’s.) I’m a scar tissue generator. Despite my intense pain upon bending my left leg, swelling, burning, etc. my orthopedic surgeon kept telling me that my knee was fine. I was able to get into a Pain Management program at a local university. Due to allergies and drug interactions I’m not able to take any pain medication except Tylenol. It has been a very bad few years. I’m in PT once again getting ASTYM treatments and new strengthening exercises that don’t cause additional pain. My new physical therapist said that it’s not good for me to have more intense pain and inflammation because that causes additional problems. My surgeon previously said PT means Pain and Torture, and my old PT was extremely brutal. It just caused more scar tissue to form.

Please don’t give up. I am now 52 and have developed other health issues due to these four years of pain. Keep fighting for your health. It can be frustrating, depressing, and draining, but there is help. Try that FB group. It has given me hope and the reassurance that I’m not the only one. There are answers.

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I had both knees replaced. First one 11/99 second 2/20. Knees always hurtful and tight, still to this day. If I stand too long, my knees stiffen up and hurts to bend them. I had one manipulated 2 month ago which was about a year after replacement but didn't help although the dr got it to 120 degrees, I can barely get them to 90 degrees. Trying to live the rest of my life this way is going to be difficult. 2 different top notch doctors did my knees and said the knee is done well and correct size. Im considering the Iovera treatment to get nerves froze the see how much that may help. Most of the day I sit with vibrators on both knees alternating to help them loosen up and less uncomfortable. Went to therapy to the point of no improvement past the point I should have been better. Im 62. 1/2 now and on disability and hating life frankly

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@briankoz

Hello everyone. My story is.like everyone else's. I had TKR going on 9 weeks and my knee is worse than before the surgery with scar tissue build up all around the knee that has limited my mobility. I'm at 88 degrees flex and 11 degrees straight. My PT can get it to 105 and 5 with me screaming in agony. I had a manipulation done going on 3 weeks ago and it did nothing. I've had 13 knee surgeries on this knee in my lifetime starting nwith an ACL replacement back when I was 18. I'm 46 now. O had an osteotomy with a left wedge 7 years ago. The other surgeries were scopes to clean up arthritis and torn meniscus.

Im.writing looking for help and advice. I still go to PT 3x/week. The 2 weeks just after the manipulation I went 5x/week. Other then stretching, what can I do to help combat this? I feel I'm capped with PT as I havent seen improvement there. I'm so nervous and losing faith that this TKR was the right decision.

Thank.you

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Hello, Most people that I’ve been reading about sound just like me and after having TKR in Aug. 2019. Started out ok going to PT, but by Nov. ‘19 one day couldn’t get a full rotation. well….after 6 doctors, 2 from Charlotte and 4 from NYC, it took me14 mos. and my shoulder surgeon (torn rotator cuff) due to using my arms to push up to get out of sofa or ANY sitting position to ….he sends me to ONE MORE KNEE SURGEON….HE SENT ME FOR ALLERGY TESTING. I’ve never had an allergy all through my 70 yrs. well I tested positive to two out of the 3 areas. He had me test for metals, glues and antibiotics.
Yup..I AM ALLERGIC TO THE ANTIBIOTIC AND…THIS IS THE WORST…THE GLUE THAT HOLDS YOUR KNEE STABLE WHILE YOUR BONE GROWS OVER THE PROSTHETIC, This glue is also used in tooth fillings.
So many drs. NEVER THINK OF ALLERGIC REACTION. So ask your dr. to find allergist that tests for metal, antibiotic, and glues.
Well, I’m sol ($#*$)' ———— out of luck because I tested positive for antibiotic neyomicin AND THE GLUE NAMED METHYL
METHACRYLATE !! and there isn’t any other glue that’s out there! And he used form of neomycin called gentamicin? I realize this doesn’t give you the answer your looking for or want….but at least I know exactly what’s 😑 happen with me and I’m not crazy! My knee surgeon didn’t want to be bothered. It’s still swollen, and painful. It wakes me every jnightAnd PT only helped slightly.
Good luck 🍀. Irish823

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@anniesnaps

Hi, I don’t know if someone mentioned this already, but if you are on Facebook there is a group called “Arthrofibrosis Support”. Members of the group share information about treatments for scar tissue and arthrofibrosis after knee surgery. The group is a great resource, and I’ve learned a lot.

I have been in PT on and off (mostly on!) for almost four years for three knee surgeries (including 2 TKA’s.) I’m a scar tissue generator. Despite my intense pain upon bending my left leg, swelling, burning, etc. my orthopedic surgeon kept telling me that my knee was fine. I was able to get into a Pain Management program at a local university. Due to allergies and drug interactions I’m not able to take any pain medication except Tylenol. It has been a very bad few years. I’m in PT once again getting ASTYM treatments and new strengthening exercises that don’t cause additional pain. My new physical therapist said that it’s not good for me to have more intense pain and inflammation because that causes additional problems. My surgeon previously said PT means Pain and Torture, and my old PT was extremely brutal. It just caused more scar tissue to form.

Please don’t give up. I am now 52 and have developed other health issues due to these four years of pain. Keep fighting for your health. It can be frustrating, depressing, and draining, but there is help. Try that FB group. It has given me hope and the reassurance that I’m not the only one. There are answers.

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@anniesnaps Welcome to Mayo Clinic Connect, a place to give and get support.

"Don't give up,' that's such a great message. It sounds like you have been through the ringer. May I ask how you might have approached this situation differently, knowing what you know now? What can others take away from your experience?

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