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?

@JustinMcClanahan

@mylynn, I am happy to report that eventually I did get a ROM of 0-115ish. I ended up popping the scar tissue loose on my own once I knew I was recovered and just forced myself to be active. Stick with it. I was not aggressive enough in my PT and I backed off on it which did not help my cause. I allowed my self to get discouraged. In all, it probably took me 18 months from the initial surgery, to the two manipulations, through the crank brace, and then eventually finding my 'new normal' after popping the scar tissue loose playing catch football with my friends. I definitely learned not everyone heals or makes progress at the same speed, and at 7 months post-op, I think you still have some room for improvement! @mylynn, how are you doing with pain & swelling?

Jump to this post

Thanx for your reply . I don’t have much swelling anymore but do have pain. I do my own pt at this point as blew thru insurance. I do stationary bike and tons of bending strengthening exercises but don’t see any improvement, used to play tennis and really miss it.
So am discouraged !!

REPLY
@JustinMcClanahan

@mylynn, I am happy to report that eventually I did get a ROM of 0-115ish. I ended up popping the scar tissue loose on my own once I knew I was recovered and just forced myself to be active. Stick with it. I was not aggressive enough in my PT and I backed off on it which did not help my cause. I allowed my self to get discouraged. In all, it probably took me 18 months from the initial surgery, to the two manipulations, through the crank brace, and then eventually finding my 'new normal' after popping the scar tissue loose playing catch football with my friends. I definitely learned not everyone heals or makes progress at the same speed, and at 7 months post-op, I think you still have some room for improvement! @mylynn, how are you doing with pain & swelling?

Jump to this post

Just thought of another ? What does popping your knee mean and do u think it can be replicated by a doc under anesthesia
Thanx again!!!

REPLY
@gator1965

I am in the same position as you. Only my surgeon completed the one manipulation and 3 months later went and completed arthroscopic arthrolysis and debridment of left knee. This was just over 2 weeks ago, I was unable to bend the knee until Wednesday last week. I can now bend to 90 degrees

Jump to this post

Is that basically arthroscopic surgery and I hope it gives you relief
I’m curious to know if you stay scar free and can continue to bend

REPLY
@mylynn

Is that basically arthroscopic surgery and I hope it gives you relief
I’m curious to know if you stay scar free and can continue to bend

Jump to this post

The most recent surgery was arthroscopic, which is not routinely offered on the NHS.
I am working hard to keep the movement in my knee, yesterday in hydrotherapy I managed +5 -90 degrees. The flexion is the best it has been since the knee replacement in April. I haven't seen any improvement in the flexion over the last week, however it hasn't got any worse, so a positive I think! The stinging and burning sensation is still there, I guess I will have to put up with this for now. Not sure how long it will take until full movement is back, surgeon says 8 weeks, physio says 6-12 months. I still walk with a limp and have done for nearly 2 years, not sure how to resolve this as physio advises one way and the surgeon another way. I am so confused!

REPLY
@mylynn

Just thought of another ? What does popping your knee mean and do u think it can be replicated by a doc under anesthesia
Thanx again!!!

Jump to this post

@mylynn, by popping, I meant that I landed on my leg funny and felt a 'pop' in the knee. Over the next few days I gained more ROM. My guess is that I popped some of the scar tissue loose enough to give me some ROM. I am not sure of what exactly happened, but thankful that it did. This was many months after the initial surgery and after the two manipulations.

REPLY

After reading so many posts about problems with scar tissue, I became very concerned. Had tkr 5 weeks ago, and generally doing remarkably well. Still lingering pain and swelling, but flexion 117 and extension 4 after 4 weeks, so great! However, PT remarked that there will/may be scar tissue forming at the very end (top 1” of incision) above the knee cap. Wondering how much and where the scar tissue is that is causing people so many problems….. I’m massaging daily, and so far it seems to be ok. On the other hand, some posts indicated that the problems can start much farther into the future. Any input?

REPLY
@ellerbracke

After reading so many posts about problems with scar tissue, I became very concerned. Had tkr 5 weeks ago, and generally doing remarkably well. Still lingering pain and swelling, but flexion 117 and extension 4 after 4 weeks, so great! However, PT remarked that there will/may be scar tissue forming at the very end (top 1” of incision) above the knee cap. Wondering how much and where the scar tissue is that is causing people so many problems….. I’m massaging daily, and so far it seems to be ok. On the other hand, some posts indicated that the problems can start much farther into the future. Any input?

Jump to this post

My scar tissue started occurring at just under 3 weeks post TKR, certainly this was when a very observant physio noticed that things were not progressing as they should do. At this point my knee flexion was under 70 degrees, and then despite intensive physio this continued to worsen in between physio appointments. It felt like my knee was surrounded by concrete. I had a manipulation under anaesthetic at 11 weeks post TKR, I was then advised that I had arthrofibrosis. The scar tissue reformed at 2 weeks post manipulation despite more intensive physio, and I was unable to maintain by range of movement between physio sessions. 13 weeks after the manipulation I underwent arthroscopic arthrolysis and debridment of left knee for extensive fibrosis . It is a daily battle to keep my knee flexion at 90 degrees, it feels as though my knee is surrounded by Velcro.

REPLY
@gator1965

My scar tissue started occurring at just under 3 weeks post TKR, certainly this was when a very observant physio noticed that things were not progressing as they should do. At this point my knee flexion was under 70 degrees, and then despite intensive physio this continued to worsen in between physio appointments. It felt like my knee was surrounded by concrete. I had a manipulation under anaesthetic at 11 weeks post TKR, I was then advised that I had arthrofibrosis. The scar tissue reformed at 2 weeks post manipulation despite more intensive physio, and I was unable to maintain by range of movement between physio sessions. 13 weeks after the manipulation I underwent arthroscopic arthrolysis and debridment of left knee for extensive fibrosis . It is a daily battle to keep my knee flexion at 90 degrees, it feels as though my knee is surrounded by Velcro.

Jump to this post

You have described my situation almost except I haven’t had the arthroscopic surgery. I was scheduled for that surgery last week. At pre op appointment my surgeon didn’t give me much hope that I would be better so I canceled my surgery. I am now trying to get another opinion. I had one manipulation and the outcome was like yours . I am 16 months post op., still only 90 degrees. I am now wondering i getting a second opinion is worth it, I have started my own PT routine of my bike, lunges (doctor had me doing them daily after taking pain meds to try to betray scar tissue) medicine ball and long walks..
Do you feel the arthroscopic surgery was worth it? I am assuming you had intense PT after?

REPLY

I also had similar problems. I had the arthroscopic surgery and it made a big difference. After the surgery, I biked for eight minutes and did lunges every three hours ( even through the night). I did not want to allow scar tissue to form again after the Dr. cut it out. I have much better ROM now, can go down the stairs, etc. Still a little stiff, but working much better.

REPLY

WOW! I was just going to ask if others could respond about this surgery. My doctor didn’t give me much hope. I have worked very hard and am willing to do PT again at facility and at home.
How long ago was your surgery and what is your ROM now?

REPLY
@bevinauburn

You have described my situation almost except I haven’t had the arthroscopic surgery. I was scheduled for that surgery last week. At pre op appointment my surgeon didn’t give me much hope that I would be better so I canceled my surgery. I am now trying to get another opinion. I had one manipulation and the outcome was like yours . I am 16 months post op., still only 90 degrees. I am now wondering i getting a second opinion is worth it, I have started my own PT routine of my bike, lunges (doctor had me doing them daily after taking pain meds to try to betray scar tissue) medicine ball and long walks..
Do you feel the arthroscopic surgery was worth it? I am assuming you had intense PT after?

Jump to this post

It is still early days, but I feel that the arthroscopic surgery was worth while. I have been off sick from work for nearly a year. My surgeon gave me 3 options back in late August:- 1. To leave things as they were and that things might get better in a year or so.2. Repeat manipulation under anaesthetic 3. Arthroscopic arthrolysis and debridment of left knee. Having offered me 3 choices he felt that the arthroscopic surgery was the best option in order to get me back to work. I saw occupational health earlier this week, and they are happy for me to return to work next month, I just need to convince my manager and HR.
Today for the first time I have managed to complete a full revolution on my excercise bike, and managed to cycle for 2 minutes.
In terms of physio I am having weekly hydrotherapy, and then doing my own physio regularly during the day. My physio at the operating hospital, has backed off, although still keeping an eye on things, as she believes that aggressive physio is or has triggered off the arthrofibrosis. What has also helped this time is baclofen and amitriptyline for neuropathic pain.

REPLY

@gator1965

I'm interested in your comment about aggressive PT triggering scar tissue. Especially early on, my gut told me that PT was causing more inflammation and pain/problems than it was helping. I persevered, and still go (though to a new therapist) but I would have to be much better educated to understand how over-traumatizing a replaced body part repeatedly is really going to help things.

REPLY
@babette

@gator1965

I'm interested in your comment about aggressive PT triggering scar tissue. Especially early on, my gut told me that PT was causing more inflammation and pain/problems than it was helping. I persevered, and still go (though to a new therapist) but I would have to be much better educated to understand how over-traumatizing a replaced body part repeatedly is really going to help things.

Jump to this post

My understanding is that physiotherapy needs to be aggressive enough to restore movement in the joint, but not so aggressive that it triggers an inflammatory reaction. My physio explained that it is a fine balance. I am learning to listen to my knee after this surgery, and avoid the temptation to push it to the limit.
I believe that given time the arthrofibrosis tissue remodels itself, but this can take a year or longer.

REPLY
@babette

@gator1965

I'm interested in your comment about aggressive PT triggering scar tissue. Especially early on, my gut told me that PT was causing more inflammation and pain/problems than it was helping. I persevered, and still go (though to a new therapist) but I would have to be much better educated to understand how over-traumatizing a replaced body part repeatedly is really going to help things.

Jump to this post

I agree with gator . There is a balance . At first pt pushed so hard that my swelling increased and made everything worse.

REPLY
@gator1965

It is still early days, but I feel that the arthroscopic surgery was worth while. I have been off sick from work for nearly a year. My surgeon gave me 3 options back in late August:- 1. To leave things as they were and that things might get better in a year or so.2. Repeat manipulation under anaesthetic 3. Arthroscopic arthrolysis and debridment of left knee. Having offered me 3 choices he felt that the arthroscopic surgery was the best option in order to get me back to work. I saw occupational health earlier this week, and they are happy for me to return to work next month, I just need to convince my manager and HR.
Today for the first time I have managed to complete a full revolution on my excercise bike, and managed to cycle for 2 minutes.
In terms of physio I am having weekly hydrotherapy, and then doing my own physio regularly during the day. My physio at the operating hospital, has backed off, although still keeping an eye on things, as she believes that aggressive physio is or has triggered off the arthrofibrosis. What has also helped this time is baclofen and amitriptyline for neuropathic pain.

Jump to this post

I am considering arthroscopic surgery but today a new doc told me that I should get a special mri first. It is a metal suppression mri for tkr. And then he could see the amount of scar tissue and where it is, and perhaps see if the surgery would help.

REPLY
Please login or register to post a reply.