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?

I had damage to my right knee as a child then my Nursing career working on concrete floors for long hours made it worse. In May of 2017 at the age of 54 I had a Right TKR, I had a very rough recovery swelling, stiffness and severe scar tissue developed around my knee and behind my knee which prevented me from bending my right leg more than 85 degrees. I agreed to have a manipulation under general anesthesia but unfortunately my orthopedic surgeon accidentally fractured my Femur I was in a Velcro brace for three months with no weight bearing now my quad muscle to like jell-o very weak. He suggested removing the scar tissue in 2018 but my Nursing knowledge kicked in and I asked him if I start this procedure when do I stop if my scar tissue comes back possibly worse than it us now. Fast forward 4 years since I had my knee replacement and femur fracture and I’m in severe pain my pain doctor has given me Tramadol helps some I also had a Spinal Cord Stimulator place in 2018 helps some but not a whole lot. I’m 61 now and I debating if I should bite the bullet and have the surgery to remove my scar tissue. I think to myself I don’t know if I can live like this for the next 20-30 years. I’m glad I found this discussion group. Has anyone had the arthroscopic surgery to remove severe scar tissue after a TKR and Femur if so could you please let me how it went, was it worth it? Any information would be greatly appreciated. Thank you

REPLY
@kneeproblem

I am in the same boat as you guys are . A surgery that has gone bad after the replacement (partial),then injections, then a knee manipulation, then a scope and still no relief along with a surgeon who doesnt care at all sort of laughs when you tell him of the pain and how your life changed I don't believe there is any help

Jump to this post

Can you tell me what type of injections you had? That might me in my future. I'm off to see a 4th doctor. One that specializes in pain management. I have good ROM 0-125.

REPLY
@anniesnaps

@erikas I wrote a very long answer to your question, but then I thought about it more and didn’t post it because I realized I could not possibly have done anything differently. I think that I did all that I could.

Unfortunately, I felt like I was really at the mercy of the surgeon, and he is the kind of doctor that does one knee surgery after another. If you don’t fit into his cookie cutter mold as a patient he doesn’t care or respond. I tried to get appointments with other orthopedists recommended by my PCP, but none would see me because I had already had a TKA by my surgeon. (That made me really want to give up, but I didn’t. I think my anger fueled my will to keep going.)

On all the nights that I couldn’t sleep due to pain I researched everything I could find and understand about my symptoms. I tried to find the answer myself because the surgeon was done with me. I tried alternate therapies like acupuncture and other manual modalities done by doctors at the same university as the surgeon. One of them contacted my surgeon several
times about my case, and the surgeon wouldn’t even respond to him. That doctor finally sent me to pain management where I am now, getting physical therapy from a PT who understands the problem and treats it appropriately.

During this ongoing journey I discovered that I am not alone. There are so many people out there “like us,” and I take comfort in that. There is not yet an end in sight for me, but I am not ruined. I learned to listen to myself and to not give my power away.

So I would tell people in my situation:

1. Doctors are not gods.
2. You are not a victim.
3. Educate yourself as much as you can.
4. Advocate for yourself. If you reach one dead end, keep searching for alternate ways. Think outside the box.
5. Find and reach out to others who are in similar situations.
6. Follow your gut. (When my original PT pushed me to the breaking point and caused more damage, I should have sought out a different one. I didn’t listen to myself.)
7. Find one medical professional who is willing to be in your corner and help advocate for you or at least journey with you. My PCP has not given up on me, so I can’t give up on me.
8. Be mindful of your thoughts. I catastrophized and, especially in the middle of sleepless nights, I pictured my pain never ending and my life being over because of it. Doing that just caused more suffering.
9. Take things one step at a time (pun intended!) Don’t get ahead of yourself.
10. Be gentle with yourself. This is not your fault. You are not a lost cause. You are not your pain.

I hope this helps someone.

Jump to this post

Good evening @anniesnaps and others who have read your post or need to read it. This was quite a thoughtful recording of your genuine and authentic thoughts and an evaluation of your attempts to find a solution for scar tissue after a TKR.

I just wanted to add one option that might have value and that is MFR, Myofascial Release Therapy. Fascia, the connective tissue in our bodies, can become restricted and painful. Removing the restriction takes gentle hands and specially trained therapists.

May I ask another question? Have you experienced Baker's Cysts? They also can be an indicator of the presence of a cyst-like vessel that has filled with fluid. Here is a link to the foremost expert in this field, John Barnes.
http://www.myofascialrelease.com.

Give it a look and ask any questions that come up for you.
May you be free of suffering and the causes of suffering.
Chris

REPLY
@artscaping

Good evening @anniesnaps and others who have read your post or need to read it. This was quite a thoughtful recording of your genuine and authentic thoughts and an evaluation of your attempts to find a solution for scar tissue after a TKR.

I just wanted to add one option that might have value and that is MFR, Myofascial Release Therapy. Fascia, the connective tissue in our bodies, can become restricted and painful. Removing the restriction takes gentle hands and specially trained therapists.

May I ask another question? Have you experienced Baker's Cysts? They also can be an indicator of the presence of a cyst-like vessel that has filled with fluid. Here is a link to the foremost expert in this field, John Barnes.
http://www.myofascialrelease.com.

Give it a look and ask any questions that come up for you.
May you be free of suffering and the causes of suffering.
Chris

Jump to this post

@artscaping Hi Chris, Thank you for the information about MFR. I’ll ask my physical therapist about it and also talk to the pain management doctor, and I’ll let you know if I have any questions.

I did have a few large Baker’s Cysts and also some smaller ones. My old PT mentioned once that she wondered if I might have developed more since my surgeries. The orthopedic surgeon never responded when she reached out to him about this. What test would I need to get to see if I have this problem? (My pain management doctor only did an ultrasound on my thigh right above my knee, and based on that test she decided that scar tissue is the cause of my problem.) Do you know of any additional diagnostic tests that might benefit me?

I’m currently getting iASTM to help with the scar tissue. My pain management doctor says that the iASTM and strengthening exercises should help. My PT has me do modified strengthening exercises so I don’t put weight on my bent knee and cause more inflammation and scar tissue.

My husband works 60 plus hours a week and for the last few years has had to do the laundry and other chores because I’m still not able to do stairs. I can’t walk more than 1/4 mile without additional pain and swelling. Many of my friends are very active, so I’m left out a lot. It’s been a lonely road, but I’m thankful for people like you and the others who have replied to my post. During the past seven months I’ve had a cancer diagnosis, radiation, two non-orthopedic surgeries, plus the chronic knee pain. I have been a survivor my whole life, and I won’t give up!

REPLY
@anniesnaps

@artscaping Hi Chris, Thank you for the information about MFR. I’ll ask my physical therapist about it and also talk to the pain management doctor, and I’ll let you know if I have any questions.

I did have a few large Baker’s Cysts and also some smaller ones. My old PT mentioned once that she wondered if I might have developed more since my surgeries. The orthopedic surgeon never responded when she reached out to him about this. What test would I need to get to see if I have this problem? (My pain management doctor only did an ultrasound on my thigh right above my knee, and based on that test she decided that scar tissue is the cause of my problem.) Do you know of any additional diagnostic tests that might benefit me?

I’m currently getting iASTM to help with the scar tissue. My pain management doctor says that the iASTM and strengthening exercises should help. My PT has me do modified strengthening exercises so I don’t put weight on my bent knee and cause more inflammation and scar tissue.

My husband works 60 plus hours a week and for the last few years has had to do the laundry and other chores because I’m still not able to do stairs. I can’t walk more than 1/4 mile without additional pain and swelling. Many of my friends are very active, so I’m left out a lot. It’s been a lonely road, but I’m thankful for people like you and the others who have replied to my post. During the past seven months I’ve had a cancer diagnosis, radiation, two non-orthopedic surgeries, plus the chronic knee pain. I have been a survivor my whole life, and I won’t give up!

Jump to this post

Good evening @anniesnaps That is a wonderful reply. You are first of all a fighter. That's why you end up as a survivor. Congratulations…..your attitude does not reflect fear or anger at the anguish you have had working with pain every day.. I can see how lonely that road is.

I prefer that my friends and colleagues don't have to deal with my pain and suffering. I try hard to be strong and grateful for the joy I find in every day.

When you write about baker's cysts are you referring to the one behind your knee? I only have one bag-like vessel that fills up with fluid. Our bodies create the fluid in an attempt to help heal the knee. You can have them drained but they tend to fill up again. And the task is usually too much for them unless you have an MFR therapist who can help relieve the cyst of its contents. The other thing that can happen is that you get cysts around the meniscus.

My only other message to you is one that is currently helping me, myself, and I. Do not set expectations for pain control so high that you never are satisfied with the outcome. I have given up on reaching pain-free. I am going for pain reduction or what I call tolerable pain that permits me to have some joy in my life every single day.

And that is what I wish for you……freedom to live with only what you can control.
May you be safe and protected from inner and outer harm.
Chris

REPLY
@artscaping

Good evening @anniesnaps That is a wonderful reply. You are first of all a fighter. That's why you end up as a survivor. Congratulations…..your attitude does not reflect fear or anger at the anguish you have had working with pain every day.. I can see how lonely that road is.

I prefer that my friends and colleagues don't have to deal with my pain and suffering. I try hard to be strong and grateful for the joy I find in every day.

When you write about baker's cysts are you referring to the one behind your knee? I only have one bag-like vessel that fills up with fluid. Our bodies create the fluid in an attempt to help heal the knee. You can have them drained but they tend to fill up again. And the task is usually too much for them unless you have an MFR therapist who can help relieve the cyst of its contents. The other thing that can happen is that you get cysts around the meniscus.

My only other message to you is one that is currently helping me, myself, and I. Do not set expectations for pain control so high that you never are satisfied with the outcome. I have given up on reaching pain-free. I am going for pain reduction or what I call tolerable pain that permits me to have some joy in my life every single day.

And that is what I wish for you……freedom to live with only what you can control.
May you be safe and protected from inner and outer harm.
Chris

Jump to this post

@artscaping Hi Chris, I’m sorry for the delayed response. I’m thinking that I must have had multiple (non Baker’s) cysts removed as part of one of my surgeries. I think later on the PT thought I might have developed a Baker’s Cyst because I remember she said something about the back of my knee. It’s been several years, and so much has happened that I can’t remember.

I have expectations of eventually being able to go up and down stairs, but I know I will never be pain-free. Sometimes I actually do get angry, but I don’t let myself stay that way for long because I don’t want to become bitter. And I have had clinical depression since I was a teenager, so I do get down and my physical pain is very much a part of it. When I was young my mom taught me to “always utilize your resources,” so I advocate for myself and have a good amount of support from people around me. There’s always some sort of help out there… It’s frustrating and discouraging, but a person just has to keep looking until he or she finds the right kind.

REPLY
@anniesnaps

@artscaping Hi Chris, I’m sorry for the delayed response. I’m thinking that I must have had multiple (non Baker’s) cysts removed as part of one of my surgeries. I think later on the PT thought I might have developed a Baker’s Cyst because I remember she said something about the back of my knee. It’s been several years, and so much has happened that I can’t remember.

I have expectations of eventually being able to go up and down stairs, but I know I will never be pain-free. Sometimes I actually do get angry, but I don’t let myself stay that way for long because I don’t want to become bitter. And I have had clinical depression since I was a teenager, so I do get down and my physical pain is very much a part of it. When I was young my mom taught me to “always utilize your resources,” so I advocate for myself and have a good amount of support from people around me. There’s always some sort of help out there… It’s frustrating and discouraging, but a person just has to keep looking until he or she finds the right kind.

Jump to this post

Good evening, I liked your post especially your efforts to understand and control the mental and emotional aspects of coping with chronic pain and discomfort. Acceptance of the conditions and pain you are living with is a positive step.

Just this year I finally stopped the hunt for a pain-free life. I now accept that I will never be pain-free. I just want to have something to do with controlling the pain. Is that eating well, drinking lots of water, and getting up and out into nature for some exercise?

What I am not willing to do is deal with the side effects of medications as well as the neuropathic pain and itching. Today it is the itching. Tomorrow may be the pain. In between, I will enjoy the day and everything life has to offer me.

May you be free of suffering and the causes of suffering.
Chris

REPLY

It has been 1 1/2 years since my TKR. Prior to surgery i could do everything just arthritis pain. After surgery and PT. My knees are horrible. Top doctors did my knees. Xrays look great, scar tissue seems to be the culprit. MUA on one knee to 120 degrees, but neither one can go past 80-85 degreed and my life is really crappy, rely on lift chair, knees get tight and hurtful. One of my Dr said i need to live with it, scar tissue grows back if you have surgery, other Dr said he dosent want to make my situation worse, surgery is trauma to the knee, use cbd and do my best. I dont want to stay like this. Ive heard of the Iovera treatment yo temp deaden nerves but would prefer a real fix, but dosent seem to be one.

REPLY
@buickturboman

It has been 1 1/2 years since my TKR. Prior to surgery i could do everything just arthritis pain. After surgery and PT. My knees are horrible. Top doctors did my knees. Xrays look great, scar tissue seems to be the culprit. MUA on one knee to 120 degrees, but neither one can go past 80-85 degreed and my life is really crappy, rely on lift chair, knees get tight and hurtful. One of my Dr said i need to live with it, scar tissue grows back if you have surgery, other Dr said he dosent want to make my situation worse, surgery is trauma to the knee, use cbd and do my best. I dont want to stay like this. Ive heard of the Iovera treatment yo temp deaden nerves but would prefer a real fix, but dosent seem to be one.

Jump to this post

Unfortunately I'm right there with you.

REPLY
@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???

Jump to this post

Your gait may have changed, or favoring one leg post surgery can do it. Have the therapist treat it.

REPLY

I had a partial knee replacement 2-3 yrs ago, I do fine during the day, no pain, good range of motion. But when I go to bed it gets very painful on the inner side of my knee, very painful to turn over or get out of bed. After I am up I have no more trouble till I go to bed again. I was waking up due to the pain when I moved and started taking Tylenol PM, with that I am not waking during the night, but it is still painful moving it to get out of bed. Because I have moved out of State I am unable to return to my orthopedic surgeon.
I have never heard of this problem, my PCP did not have much advice to offer. I have tried wearing an elastic knee support to bed but find it uncomfortable when I bend my knee for any length of time, I have also tried rubbing Diclofenac Sodium Topical Gel on my knee before bedtime, does not seem to help.
I suppose if I have to live with it, it's better than having it hurt during the day. I would be interested to hear if anyone else has had this problem. I hope those who are having pain during the day time will be able to get some relief, it seems that there are as many different problems with a TKR as there are people having it done. My best to you all.

REPLY

I take ambien to sleep but dosent last the entire night. When my knees were first replaced bed was uncomfortable. Now with my knees together I’m not really feeling discomfort but after a few hours, my knees let me know they want to be stretched. Scar tissue is my nemesis and can’t seem to find a good resolution. As for you, I hope time makes it better but in the mean time Id ask your dr about a sleep agent.

REPLY
Please sign in or register to post a reply.