Scar tissue after knee replacement

Scar tissue is an elusive problem. I had my right knee replaced in Feb. 2021. Within three weeks I was dealing with excruciating pain, mostly on the lateral side. I tried acupuncture, traditional PT, MFR, genicular nerve ablation-all to no avail. Very reluctantly, my surgeon agreed to open it up again-full incision-to try to identify the source of my pain. Two weeks ago today, he Operated and found significant scar tissue throughout, most especially involving the IT band-the cause of the most significant pain. Two days post surgery I was walking with no aids and climbing stairs. I spend most of my time icing, icing, icing and have started PT with a concentration on ROM. It seems as if scar tissue is a very real complication, that it can appear even years after the initial surgery, and there’s little that can be done to prevent it. I replaced my left knee three months before this left one and had no problem whatsoever. Good luck!

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goodpeople,

I think the chances of developing scar tissue can be drastically reduced by doing all the recommended PT immediately after a TKR. It worked for me. You know that once the scar tissue forms, it's hell to get it out.

So to all contemplating a TKR, get in shape first, and follow the therapist guidelines every day for at least 6 weeks, or as your condition demands. TKR is an amazing, life-changing procedure but the patient has to do about 90% of the work!

All the best,

Joe

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Totally agree with this! I was really ready to “get going” on home PT as soon as my surgery was over. However, I couldn’t tolerate the pain meds and then they told me to just take Tylenol Extra Strength which did nothing for the pain. When the home PT would come in, it was so difficult for me to do the exercises due to pain. The pain was horrible! I was so afraid of developing scar tissue because I couldn’t do the exercises! Once I got to outside PT, I felt like I made some strides, but I can tell that I still have some scar tissue in there. My advice to anyone is that if you can tolerate the pain meds, start doing PT in your home right away and then go to an outside site for PT. If you can do this immediately, you will avoid scar tissue building up.

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Hi Joe, First I want to thank you for your friendly and caring manner as you share with others on Connect. You are also a dedicated...."You can do this!' person, especially in support of PT before and after surgery.

Now....I do have a response to your statement above, "once scar tissue forms, it creates a problem that can't be fixed with therapy alone". Fortunately for me, I discovered MFR (myofascial release therapy) when my first TKR was about 3 years old and scar tissue was beginning to make itself recognized with pain and discomfort. My MFR therapist recognized it, diagnosed it, and relieved me of it. That took about 6 weeks with 15-20 minutes devoted to releasing the actual tissue and another 10 minutes to work on the swelling.

With my 2nd TKR last year, my Orthopedic PT worked in tandem with my MFR therapist, and I have not experienced any scar tissue. I agree with you that every patient and every surgery is amazingly different. However, I want to hang my hat out for MFR. Have you ever tried it?

I now appear on time twice a week for my MFR sessions. My SFN (small fiber neuropathy) has become more of an issue in the last 9 years and I now need to be there twice a week and am treated by two MFR therapists to even keep up with this progressive condition. As an example, I have stretch Yoga class on Tuesdays.....so my preparatory MFR is on Monday.

May you have happiness and the causes of happiness.
Chris

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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 am very fortunate to have an excellent doctor of physical therapy for both my RTS and my most recent TKR. He has many certifications in addition to his DPT degree. I started with him when he was 2 years fresh out of school. First my surgeon told me these are major surgeries and would require a great deal of work on my part to recover. My therapist has used a variety of things to include deep massage, very uncomfortable to point tears at times but I knew it had to be done, Muscle stimulator, and dry needling in addition to all the other exercises and weight training. I was in his office the day after my TKR and had pt strengthening with him for 2 months preop. One day post op I was at zero degrees and 65 degrees. Awesome He told me these exercises are important to keep up for eternity. My knee is awesome. If one can find a therapist that does it all it’s great. I see a lot of people have a pt and a different person for MFR. I’m fortunate to have a therapist that has all the credentials to do it all. For anyone anticipating any joint replacement, find a great therapist (before surgery) just as important as a great surgeon.
Every time I go for my joint replacement check ups my surgeon does X-rays to make sure all is okay! Also cryocuff machine is the best pain relief for a RTS and TKR! It is also my opinion after seeing a relative with in home PT it’s not as good as going to the office if at all possible. Best to all

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How is it that everyone seems to be having physio except me. I have been given exercises to do after the op but that is it. Im still doing those leg raises and stretches and bending of the knee. I had a total knee replacement 6 weeks ago. Im Walking with one crutch now and sometimes without crutches around the house. I have be er been told to do anything about scar tissue. What am I missing here.can someone explain it to me please.

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I had a knee replacement 14 months ago and still have knee pain and my IT band is still tight and gives me pain and my knee doesn’t bend far because of that. Really frustrated! Went for second opinion and doctor suggested manipulation but could cause other issues or arthroscopic surgery to clean out scar tissue.During pt I was doing great in the beginning but then started having back issues and sciatica so had to deal with both.Still can’t walk down stairs without stiffness and pain. Any suggestions?

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