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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I want to know if anyone has gone through knee revision surgery and still developed scar tissue??? What did you do about it?

I had total knee replacement April of 2022. I developed scar tissue immediately. After doing much reading, this may had been the result of prior surgery for an ACL replacement about 14 years ago. I started out ok, but after struggling to reach 115 it started going backwards and I ended up with a 90 degree flexion. In February of 2023, I had a knee revision. They replaced my ligaments with a metal hinge. I am 5 weeks post surgery and bending at 117 flexion. The recovery is not easy but way easier than the TKR. I have had little swelling, my flexion is better, and I am recovering quicker. I do get tired and my knee will hurt if I am walking a lot. I don't need any pain pills, just celebrex to keep the swelling down. I do my stretching and biking exercises twice a day, everyday. Was it worth it? Well, I am a very active person. I bike ride, play pickleball, hike, kayak, etc. I couldn't walk downstairs, ride a bike or hike before surgery. So for me, it was necessary. For someone else it would depend on lifestyle.
Thank you.

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Not my first keloids, but I was left with bad and very painful keloids from my double mastectomy. Besides looking unsightly, I had terrible pain every hour that lasted for seconds to a minute, but level 10. It would stop me in my tracks out in public and even make me jump backwards like someone had just hit me in the chest. It through those around me for a loop. The sensations varied from stabbing to slicing to waking up in the middle of the night feeling like my chest just tore wide open. After 2.5 years of this, my dermatologist convinced me to let her give me kenalog injections in the scars. I was hesitant because I had them in my shoulder at 11 years old and they were excruciating with little benefit. She told me the needles are much smaller now and she had the skills. So I had about 120 injections (10-15 at a time) over 2.5 years and the pain is 99% gone. The injections were painful, but less than as a kid and well worth it. Each time the pain would be gone for 3 months, then year two for 4 months then 6 and eventually permanent. I haven't needed more injections for about 5 years now. Be sure your dermatologist has experience with this. You need someone who cares and knows what they are doing. The scars are also flat and pink now instead of red and raised. I hope this is helpful to anyone that gets keloids. My heart goes out to you.

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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 totally hear you on the butt and hip pain. I'm constantly massaging those areas. The scar tissue is really annoying though and impeding my progress on ROM.

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My first knee surgery, to repair a torn ligament injured during football, was in 1970. Over the decades I developed arthritis and lost range of motion. Finally decided to do a TKR, 11/14/22. Even though I do a lot of research, it wasn't till my 6 week checkup, and poor progress on ROM, that I learned about arthrofibrosis. I wished my surgeon had been up front on the possibility and likelihood of that developing because of my prior surgery, maybe I would have backed off from the surgery. They wanted to do a MUA, manipulation under anesthesia, but I refused. I just felt too fragile and, based on my research, the manipulation doesn't always work and since I live out in the country, getting into town for PT every day was problematic.
Now I'm stuck with the scar tissue and the only therapy I've heard of that can help is ASTYM. https://astym.com/knee-replacement/ Unfortunately the nearest practitioner is 200 miles away. Don't know if it would be covered by Medicare or not but the next time I am up that way, I am going to check it out.

A therapy I chanced upon that has been really helpful for post TKR pain is PEMF, Pulsed Electromagnetic Field therapy. I only found out it about 4 months after surgery and am lucky there is a guy not to far away who has a machine. He is not a medical practitioner so doesn't charge, only accepts donations. I go once a week but would do it more often if I could. I'm thinking about getting my own machine for home use but they are expensive and there are so many options to choose from. One needs to really understand the science before making such a big purchase.

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I'm in the same boat with my scar tissue, although it's on both my knees. I will research this machine to see what I can learn about it.

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@carolharris2121

I had bad sciatica after my first TKR. 1trip to my Chiropractor solved my problem. Anything is worth a try.
I am 6 months out from my 1st TKR and 3 from my second. My biggest issue is continuing stiffness and pain when standing from sitting. Hopefully all will continue to get better. ROM in both knees is great.

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I am 6 months out. Still have stiffness & pain. I also have had sciatica pain. I had manipulation done also. Actually this is my 2nd TKR - 1st one i had sciatica issues too. This time I went to chiropractor and got relief immediately but if you are still limping some it will bring it back & may require you to go back for an adjustment from time to time. Night pain is the worst for me. I have to get up & walk it off. Then ice pack & try to go back to sleep. I didn’t have night pain with first TKR. I feel my pt first time was so much better than last. (Moved to another state so I couldn’t go back to first pt). Your pt is most important. My ROM is bad. Pushing myself to go up & down staircase. TKR is not easy for many. Age I believe makes a difference or perhaps I choose to blame it on that. 80 yrs old.

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@rostonstar

I am 6 months out. Still have stiffness & pain. I also have had sciatica pain. I had manipulation done also. Actually this is my 2nd TKR - 1st one i had sciatica issues too. This time I went to chiropractor and got relief immediately but if you are still limping some it will bring it back & may require you to go back for an adjustment from time to time. Night pain is the worst for me. I have to get up & walk it off. Then ice pack & try to go back to sleep. I didn’t have night pain with first TKR. I feel my pt first time was so much better than last. (Moved to another state so I couldn’t go back to first pt). Your pt is most important. My ROM is bad. Pushing myself to go up & down staircase. TKR is not easy for many. Age I believe makes a difference or perhaps I choose to blame it on that. 80 yrs old.

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Well at 80 I'd say you're doing great. I'm 68 and had both knees replaced last year. With a good surgeon and a lot of time in the gym I'm doing fine. I know that's not the case for all.

I'm curious though - are you suggesting the TKR has something to do with your sciatica? I thought sciatica starts with pinched nerves in the lumbar region. I've had it twice, many years ago. One time it resolved but the other time a disc exploded into the spinal canal at L-5, S-1. I had a laminotomy at S-1, L-5, and L-4 to remove the disc fragments and "sand down" arthritic spurs and make more room in the spinal canal. I didn't require fusion and I'm doing a ton of core work to keep it that way. So far so good. But damn, sciatica can be hell on the legs.

But I don't know why a TKR would affect or cause sciatica, unless your gait was affected and that in turn affected your lower spine. Can you clarify?

Thanks and keep up the good work. At 80, I'd say you're doing a hell of a good job!

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@jud

Hip/butt pain, oh yes. I found that CBT oil actually got rid of the butt pain which I have had for years. Then I forgot about it and missed taking the CBT oil so the pain came back.

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Oral cbt or topical?

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@cheris

I experienced sciatica with both knee replacements. First knee it lasted about 4 months. This knee I am still dealing with it and it has been since Dec. I have been going to PT. Got an injection which helped a little. Doing lots of exercises. I find the thing that helps the pain the most is just walking. ROM was at 119 4 weeks out and is staying at that level. I can fully extent the knee. I would be doing great except for the sciatic pain. They seem to think it is a combination of SI joint inflamation and periformis also.

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Because the TKR causes the surgery leg to lengthen, this would throw you out of alignment. it’s possible this could cause sciatic pain.
This also could cause the piriformis muscle to tighten, have you tried massage on that?

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@heyjoe415

Well at 80 I'd say you're doing great. I'm 68 and had both knees replaced last year. With a good surgeon and a lot of time in the gym I'm doing fine. I know that's not the case for all.

I'm curious though - are you suggesting the TKR has something to do with your sciatica? I thought sciatica starts with pinched nerves in the lumbar region. I've had it twice, many years ago. One time it resolved but the other time a disc exploded into the spinal canal at L-5, S-1. I had a laminotomy at S-1, L-5, and L-4 to remove the disc fragments and "sand down" arthritic spurs and make more room in the spinal canal. I didn't require fusion and I'm doing a ton of core work to keep it that way. So far so good. But damn, sciatica can be hell on the legs.

But I don't know why a TKR would affect or cause sciatica, unless your gait was affected and that in turn affected your lower spine. Can you clarify?

Thanks and keep up the good work. At 80, I'd say you're doing a hell of a good job!

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Doctor said the surgery leg is longer, so therefore it has put me out of alignment. He didn’t suggest I wear a lift, so my sciatic reacted. I have since put a lift in, and I am better.

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