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?

@mylynn

So u have had arthroscopic surgery?
Are u ok and what does a good pt person do differently?
I had the mri , called MARS metal, artifact reduction system
Saw doc today and he said yes scar tissue there, he recommends arthroscopic surgery and manipulation while I’m under
Then 2 weeks of pt
He said there is no guarantee scar tissue won’t come back, some do ,others not
And there is a higher risk of infection when u have a replaced knee, ie foreign object. Which would be really bad.
I’m leaning towards having this done as my quality of life is worth the gamble

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It has worked for me.i can now resume my career as a nurse in full clinical capacity. I read my operation notes and it was not a pretty read. In 4 weeks following arthroscopic arthrolysis and debridment of left knee I feel fabulous. Yes I still have pain (Neuropathic pain)but better than I have done

I wish I could get this done but I dont know why but all my doctor says about removing all the scar tissue is that he will reopen the knee and remove it that way which I do not want to go though all of that again I am 6 1/2 months out of partial knee replacement and still cant walk on it

Liked by gator1965

@kneeproblem

I wish I could get this done but I dont know why but all my doctor says about removing all the scar tissue is that he will reopen the knee and remove it that way which I do not want to go though all of that again I am 6 1/2 months out of partial knee replacement and still cant walk on it

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I suppose it depends on the location of the scar tissue. I was fortunate and like you I was around 6 months post TKR and could not walk.i can walk better now but still have a bit of a limp.

Hi. I am stuck at 90 degrees 6 months after knee replacement. Had an x-ray 2 days ago and the radiologist said there is evidence of heterotopic ossification, or bone growth where it's not supposed to happen. Surgeon said it was significant scarring and that I might need a revision with surgical removal of scars. Has anyone else had this happen to them post-knee replacement? I am wondering about options. While I can at least sit with much less pain, all the things I used to enjoy doing are now impossible (cycling, hiking).

Here's the backstory. I had a TKR in April at Mayo. Surgery went well and minimal post-surgical complications other than pain, stiffness and a large hematoma in the knee capsule. ROM was never more than 60 degrees flexion and 12 degrees extension. Had 2 manipulations under anesthesia and while they each increased flexion, the knee has remained stiff with a max flexion of 90 degrees when not under anesthesia. Have been going to PT since release from hospital after surgery. The PT started with brute force, bending the knee until I yelled. Not much success there. Now we are doing a lot of massage on quads and hamstrings to loosen the muscles, which has been much more successful.

Thanks in advance!

Hi…I’m 14 months post-op, bilateral tkr. I have good ROM, but I still have stiff knees, cement block like heaviness, nerve pain, etc. I can’t stand or walk for more than about 15-30 minutes. It feels like someone put in volleyball knee pads, made of setting concrete and soaked in acid. Did MUA, acupuncture, massage, genicular nerve ablation, laser therapy, cryotherapy, you name it. I swear, I’m losing my mind. My surgeon says nothing is wrong. Please, if anyone has any advice, thoughts, direction…I’ll do anything. Thank you.

kimbies1204 Oh my gosh, I'm so sorry you're going through all of this! First of all if your surgeon says nothing's wrong, start shopping! Do you live near a teaching/research hospital? I guess that's my only advice. I feel powerless to help given all that you've tried. : (

@kimbies1204

Hi…I’m 14 months post-op, bilateral tkr. I have good ROM, but I still have stiff knees, cement block like heaviness, nerve pain, etc. I can’t stand or walk for more than about 15-30 minutes. It feels like someone put in volleyball knee pads, made of setting concrete and soaked in acid. Did MUA, acupuncture, massage, genicular nerve ablation, laser therapy, cryotherapy, you name it. I swear, I’m losing my mind. My surgeon says nothing is wrong. Please, if anyone has any advice, thoughts, direction…I’ll do anything. Thank you.

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There is something wrong. Arthrofibrosis. You have massive scar tissue surrounding your knee. You need arthroscopic lysis. I had the procedure as did several on this site. It made all the difference.
Arthrofibrosis
From Wikipedia, the free encyclopedia
Arthrofibrosis (from Greek: arthro- joint, fibr- fibrous and -osis abnormality) is a complication of injury or trauma where an excessive scar tissue response leads to painful restriction of joint motion, with scar tissue forming within the joint and surrounding soft tissue spaces and persisting despite rehabilitation exercises and stretches. Scarring adhesions has been described in most major joints, including knees, shoulders, hips, ankles, and wrists as well as spinal vertebrae.[1][2]
Arthrofibrosis of the knee[edit]
Arthrofibrosis of the knee has been one of the more studied joints as a result of its frequency of occurrence.[3][4] Beyond origins such as knee injury and trauma, arthrofibrosis of the knee has been associated with degenerative arthritis.[5] Scar tissues can cause structures of the knee to become contracted, restricting normal motion. Depending on the site of scarring, knee cap mobility and/or joint range of motion (i.e. flexion, extension, or both) may be affected.[6] Symptoms experienced as a result of arthrofibrosis of the knee include stiffness, pain, limping, heat, swelling, crepitus, and/or weakness.[4] Clinical diagnosis may also include the use of magnetic resonance imaging (or MRI) to visualize the knee compartments affected.[7]
The consequent pain may lead to the cascade of quadriceps weakness, patellar tendon adaptive shortening and scarring in the tissues around the knee cap—with an end stage of permanent patella infera—where the knee cap is pulled down into an abnormal position where it becomes vulnerable to joint surface damage.[8]
Patients who are recognized as developing arthrofibrosis may improve motion with appropriately directed physical therapy, corticosteroid injections, non-steroidal anti-inflammatory drugs, and cryotherapy. In many instances, however, as fibrosis has set in, surgical intervention is necessary.
Specialized arthroscopic lysis of adhesions knee procedures such as anterior interval releases may be indicated and utilized to great success, in the hands of an appropriately trained specialist.[5]

@kimbies1204

Hi…I’m 14 months post-op, bilateral tkr. I have good ROM, but I still have stiff knees, cement block like heaviness, nerve pain, etc. I can’t stand or walk for more than about 15-30 minutes. It feels like someone put in volleyball knee pads, made of setting concrete and soaked in acid. Did MUA, acupuncture, massage, genicular nerve ablation, laser therapy, cryotherapy, you name it. I swear, I’m losing my mind. My surgeon says nothing is wrong. Please, if anyone has any advice, thoughts, direction…I’ll do anything. Thank you.

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@kimbies1204 – Welcome to the group and I totally agree with @babette – you need to get a 2nd opinion. You should not EVER hear that "nothing is wrong" when you are experiencing the kind of pain you are. Something IS wrong. Try to find the best orthopedic surgeon you can. Wishing you relief and hope.

@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

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I’m interested in your overall outcome. I’m 2 weeks post op and in top of all the issues that follow that, have developed sciatica and find it uncomfortable to sit, stand, lay, everything! I’m miserable and doing 2 weeks of in home pt have brought me to the point of complete discouragement. I thought I hurt before the surgery- it’s nothing compared to after!. The pain meds help minimumally but they have never had the pain managed from the very beginning. I cry a lot and it seems no end in sight. I can’t use chiropractor until incision is healed enough to stand the laying in my stomach for adjustment, etc. I’m depressed and often wish I’d never done this but at 54 I’m active and want to be able to do things with my husband who has been a troooer helping me but I’m sick of Percocet being a daily pill and not working well!!!! Getting ready to begin outpatient pt at a facility. I get to choose that facility. Am interested in what kind of facility I should look for… one with hydrotherapy, one with the various types of therapy mentioned here. Scar tissue is building up and the pain is unbearable. I’m glad and saddened that I’m not alone in my journey.

@sdhkkjmz

I’m interested in your overall outcome. I’m 2 weeks post op and in top of all the issues that follow that, have developed sciatica and find it uncomfortable to sit, stand, lay, everything! I’m miserable and doing 2 weeks of in home pt have brought me to the point of complete discouragement. I thought I hurt before the surgery- it’s nothing compared to after!. The pain meds help minimumally but they have never had the pain managed from the very beginning. I cry a lot and it seems no end in sight. I can’t use chiropractor until incision is healed enough to stand the laying in my stomach for adjustment, etc. I’m depressed and often wish I’d never done this but at 54 I’m active and want to be able to do things with my husband who has been a troooer helping me but I’m sick of Percocet being a daily pill and not working well!!!! Getting ready to begin outpatient pt at a facility. I get to choose that facility. Am interested in what kind of facility I should look for… one with hydrotherapy, one with the various types of therapy mentioned here. Scar tissue is building up and the pain is unbearable. I’m glad and saddened that I’m not alone in my journey.

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Sorry. The pain will subside shortly ( most of it).. i started using CBD cream and it really helped. I still needed an arthroscopic surgery later. My wife has had Sciatica for years and we tried the CBD on her. She loves it. But it only lasts a few hours.

@dduke Would you mind sharing which brand of CBD cream you use and whether or not one can get it via Amazon? There are so many out there! B.

@babette

@dduke Would you mind sharing which brand of CBD cream you use and whether or not one can get it via Amazon? There are so many out there! B.

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I am on the road right now a d do not have it. I bought it at Lassen's. It is a pump dispenser.

@debbraw

@kimbies1204 – Welcome to the group and I totally agree with @babette – you need to get a 2nd opinion. You should not EVER hear that "nothing is wrong" when you are experiencing the kind of pain you are. Something IS wrong. Try to find the best orthopedic surgeon you can. Wishing you relief and hope.

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@debbraw @babette @dduke Thank you for your replies…the isolation with this is just as bad as everything else, so I greatly appreciate this venue. The problem is, in my area, all of the Ortho Surgeons are in the same group and they don’t want to see me. The others I’ve reached out to, Steadman Clinic, won’t even see me because as they tell me, “They weren’t involved from the beginning”. I have researched Arthrofibrosis at nauseum, and My surgeon has said I definitely have it, but yet, I have really good ROM, so they aren’t certain. My surgeon also said he won’t do lysis of adhesions due to risk of infection. I have Kaiser insurance, and am self-employed (however unable to work since the surgeries), so I’m somewhat limited with options. They did a Nuclear Bone Scan last week where nothing was found. I see a Neurologist Wednesday. I’m just exhausted, frustrated, angry and don’t know what to do when every Specialist I see, says they can’t help me. We’ve discussed Arthrofibrosis before, and he told me “Kim, I out in the implants, what your body does with them, is out of my hands”. Sigh…anyone?

@babette

@dduke Would you mind sharing which brand of CBD cream you use and whether or not one can get it via Amazon? There are so many out there! B.

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I live in Colorado and have been using products for a couple years now. The best cream I have found is Apothecanna Extra Strength Relieving Body Cream. It truly is amazing! I just wish it helped me now. It was a miracle worker priorr to my TKR’s, not so much now. Hiwvwer, my brother-in-law had a tiring in July and he loves it with his recovery. You can buy it online.

@sdhkkjmz

I’m interested in your overall outcome. I’m 2 weeks post op and in top of all the issues that follow that, have developed sciatica and find it uncomfortable to sit, stand, lay, everything! I’m miserable and doing 2 weeks of in home pt have brought me to the point of complete discouragement. I thought I hurt before the surgery- it’s nothing compared to after!. The pain meds help minimumally but they have never had the pain managed from the very beginning. I cry a lot and it seems no end in sight. I can’t use chiropractor until incision is healed enough to stand the laying in my stomach for adjustment, etc. I’m depressed and often wish I’d never done this but at 54 I’m active and want to be able to do things with my husband who has been a troooer helping me but I’m sick of Percocet being a daily pill and not working well!!!! Getting ready to begin outpatient pt at a facility. I get to choose that facility. Am interested in what kind of facility I should look for… one with hydrotherapy, one with the various types of therapy mentioned here. Scar tissue is building up and the pain is unbearable. I’m glad and saddened that I’m not alone in my journey.

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@sdhkkjmz – Hi and welcome to the Joint Replacement Group. I'm sorry to hear about what brought you here. I had a TKR one and a half years ago. It's unfortunate that they haven't gotten your pain meds adjusted because at 2 weeks postop, I was definitely still experiencing enough discomfort to need regular and reasonably strong pain killers. As to what type of facility you should look for, here is my experience. After 3 weeks of inhome PT, I went to a place that had both regular PT and hydrotherapy. They said that if I just did the hydrotherapy, recovery would be slower- but it would be easier to achieve the movement. So… I tried to do as much regular PT as possible. That place has a health club attached to it and they give a discount to people who did PT there. Now, I do one day a week of acquatic yoga to help with my balance and then regular strength training (which I hate but I do it) 3 days a week. Wishing you relief and comfort – soon!

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