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?

@damewocane

Thank You for posting your experiences- I have been diagnosed after TKR in July, MUA in September and months of painful PT. Don't know what to do…

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@damewocane @rayreich3 @gator1965

Here’s an update on the arthroscopic lysis I had done 3 weeks ago.

I was at my wits end last week – crying in each PT session as they forced my leg back to 130 – where it was after the surgery. I broke down and emailed the surgeon to see if he could do anything. He doubled my dose and said to try that for a week (eg 3 more PT sessions and the homework).

The first of those PT sessions was yesterday- and guess what? I “graduated”!!! I was able to force my leg on my own to 125 – so the PT guy said I can now walk 10 mins twice a day and reduce the homework to 3 times a day! Other than that- butt on the couch with leg elevated – but no longer 5 hours of stretching a day!!!!! Only bad news is I can’t lift my leg for a short arc anymore- but can move the kneecap – so PT just upped the quad sets to “unlimited “ or as many a day as I can stand.

I’m convinced that I’m one of those unlucky people that has a genetic disposition to generate scar tissue. This is the third surgery that I have had this issue and by far the most painful.

But – there is hope. Slot of painful work in front of me still – but hope. And if I can get back to standing and walking without pain eventually- I’ll take that pain (and the pain meds) now.

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I had laser for scar tissue about 6 months after surgery. Was very quickly done and worked well.

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@debbraw

Hi @damewocane – Welcome to Connect! I'm sorry to hear about your painful recovery. It does sound frustrating to have worked so hard and feel like you are not getting anywhere. Can I ask what led to them doing the manipulation under anesthesia in September? It sounds as if that was just 8 weeks or so after the TKR. I don't have any experience with MUA's so I'm curious what triggers their decision to use this technique?

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Yes, thats right in just 8 weeks after, My Dr felt that the scar tissue was building faster than my intensive Pt was breaking it down-I had hoped that this would be enough with strenuous pt work- It has been a long painful journey which is still unresolved.

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i am 6 mths post TKR i had manipulation at 16 weeks, loud breaking of scar tissue ROM improved but the extensive nerve damage (whole of knee numb) which developed 4 weeks after surgery has not resolved.
right knee being replaced in new year hoping for an easier ride next time!

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@melcpa86

I had the arthroscopic lysis done 1.5 weeks ago. Despite a ton of research, I feel like I was unprepared for the recovery. So I’ll let you know how my last week and a half has been.

Prior to the surgery, I was at 105 degrees flexion. The surgery was on Wednesday afternoon and the surgeon got me to 130 flexion. First PT was Thursday at noon. On my own, i could only get my flexion to 105. The PT therapist forced my leg to 130. I was given the following “homework”.

10 mins stationary Bike
10 mins supine leg pull
10 mins prone leg pull
10 mins extensionator
20 mins ICE
1 hour elevated rest
REPEAT 5 times
Walk no more than .25 miles in house only

That’s one hour of stretching, one hour rest for a minimum of 10 hours a day.

Next session was Friday afternoon and I got to 115 on my own pulling – and the therapist forced it to 130. Weekend I was in my own with the homework.

The next Monday, I had PT early in the AM and got to 118 on my own pulling and the therapist forced to 130. I was told then that- since there was progress over the weekend (ie I could move it more on my own – even forced) and the therapist could still get to 130 – I had a decent shot at remolding the scar tissue.

I have PT three times a week and the homework is now

10 mins stationary Bike or eliptical (alternate)
10 mins supine leg pull
10 mins prone leg pull
10 quad sets
20 short arcs
10 mins extensionator
20 mins ICE
30 mins rest
20 mins heat
REPEAT 5 times
Walk no more than .25 miles in house only

The home PT is very painful. It’s hard to pull on your leg for 30 mins every other hour all day long and I am in tears doing it. It hurts to bend and walk any right now and I’m wondering if this was the right answer.

However – I can bend it more for sure and if I’m being honest with myself, the pain is probably surgical mostly since I’m only 1.5 weeks out and will probably ultimately pass. Still, forcing movement like this and this much PT is very very hard.

Good Luck

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1st I hope u r doing well and getting that bend!!!
2 Nd thankyou for sharing your experience
3 rd I too am thinking of doing this surgery and tired of throwing $ at possible but not workable fixes
So please would like to hear from u and hope u r doing well!!!

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@mylynn

1st I hope u r doing well and getting that bend!!!
2 Nd thankyou for sharing your experience
3 rd I too am thinking of doing this surgery and tired of throwing $ at possible but not workable fixes
So please would like to hear from u and hope u r doing well!!!

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@mylynn

Here’s an update on the arthroscopic lysis I had done 3 weeks ago.

Last Friday, the surgeon upped my pain med dose so I could better tolerate the forced PT. It’s very painful.

However, on Monday, I was able to force my leg on my own to 125 – so the PT guy said I can now walk 10 mins twice a day and reduce the homework to 3 times a day! Other than that- butt on the couch with leg elevated.

I walked yesterday and there is still pain when I stand, walk behind my knee after only 5 mins and can’t lift my leg for a short arc anymore. I can move the kneecap though.

So right now I think the scope solved some of my problem- but not all. I think my issue is genetic because I do all the work and am still pushing against a rope.

But –right now there is hope. Slot of painful work in front of me still – but hope. And if I can get back to standing and walking without pain eventually- I’ll take that pain (and all the pain meds) now.

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@rayreich3

Thank you so much this is the answer I was looking for the only answer is arthroscopic surgery to remove the scar tissue

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I agree
The answer unfortunately is surgery
I too am going to think this way.
Cause I’ve tried it all
So just live with it or deal w surgery.

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I have been hesitant to write as I am 10 days post op of revision of left TKR. Initial surgery was June 2017. I wrote on here about three month# post op. I was being treated for scar tissue. After extensive physical therapy there was no change. In March this year I had a manipulation. Two weeks post op, back to the same. Doctor wanted me to work harder on scar tissue by doing lunges with left foot on first step of step stool or just a step, pushing forward with all my might, taking 2 10 mg Percocet and 800m ibuprofens at least 3 times a day. After 2 months I got nowhere so the plan was another manipulation arthroscopically and removal of scar tissue. Post op appointment was not to my liking as he told my daughter who was with me, most people go back to where they were.
I canceled my surgery as this was not convincing me I had a chance.

I started my search for a second opinion. By the grace of god, I am sure, I got an appointment with orthopedic who does revisions. He told me at first appointment that he didn’t think my problem was scar tissue. He felt there was a problem with the fit or other possibilities.
He found multiple problems and fixed them all. Fit being one of them and the straightness of cut on tibia that needed shaving.
After surgery I had full extension and have maintained it. PT has been to my home twice and I can see some flexion happening.

My point of writing this is the value of a second opinion and finding a doctor who accepts the challenge of wanting to help you. I was turned away by two other Orthopaedic who did not want to take on what someone else started. My doctor is known for doing revisions
Like many of you I lived with pain and fear of addiction.

Feel free to respond and I will do my best to help if I can.

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@bevinauburn

I have been hesitant to write as I am 10 days post op of revision of left TKR. Initial surgery was June 2017. I wrote on here about three month# post op. I was being treated for scar tissue. After extensive physical therapy there was no change. In March this year I had a manipulation. Two weeks post op, back to the same. Doctor wanted me to work harder on scar tissue by doing lunges with left foot on first step of step stool or just a step, pushing forward with all my might, taking 2 10 mg Percocet and 800m ibuprofens at least 3 times a day. After 2 months I got nowhere so the plan was another manipulation arthroscopically and removal of scar tissue. Post op appointment was not to my liking as he told my daughter who was with me, most people go back to where they were.
I canceled my surgery as this was not convincing me I had a chance.

I started my search for a second opinion. By the grace of god, I am sure, I got an appointment with orthopedic who does revisions. He told me at first appointment that he didn’t think my problem was scar tissue. He felt there was a problem with the fit or other possibilities.
He found multiple problems and fixed them all. Fit being one of them and the straightness of cut on tibia that needed shaving.
After surgery I had full extension and have maintained it. PT has been to my home twice and I can see some flexion happening.

My point of writing this is the value of a second opinion and finding a doctor who accepts the challenge of wanting to help you. I was turned away by two other Orthopaedic who did not want to take on what someone else started. My doctor is known for doing revisions
Like many of you I lived with pain and fear of addiction.

Feel free to respond and I will do my best to help if I can.

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@bevinauburn

I completely agree you need to get a second opinion if there is still pain after the TKR. I did too. And my second was done by a professor that teaches revisions at the Orthopedic school in the Houston Medical Center. With his help, infection and improper alignment (like you mentioned) were ruled out.

I had no idea there are sub-specialists in Orthopaedics but apparently there are – and treating problem implants is one of them!

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After you saw the revision specialist did they do surgery again ? How did you go about finding a specialist I live in Pennsylvania and can not seem to find any

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@kneeproblem

After you saw the revision specialist did they do surgery again ? How did you go about finding a specialist I live in Pennsylvania and can not seem to find any

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@kneeproblem I use to live in Pa.,now in Ca but have you gone to the University hospital like Pittsburgh or Philadelphia? Any big hospital orthopedic dept should be able to advice you. maybe give them a call and ask about revision surgery ?

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@kneeproblem

After you saw the revision specialist did they do surgery again ? How did you go about finding a specialist I live in Pennsylvania and can not seem to find any

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I would google using words like revision and orthopedic in your area. Once I started through the list I could see in their bio and comments that they do revisions. It is a speciality of sorts. I was told many orthopedic in the area send their problem patients to my surgeon. I also called the PT I worked with my first round and asked her if she or co workers had any names of surgeons who had sent clients to them after revisions. That was where I first got the name of my surgeon

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