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?

@lioness

@contentandwell my post disappeared Dr said it'd inflammation ,put her on anti inflammatory diet Legs drain like lympadema

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@lioness Is she doing better now, since being put on anti-inflammatory drugs? I hope so, pain can be so wearing when it's persistent.
JK

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@contentandwell

@lioness no, I’ve never heard of it so I just googled it – it’s actually lipedema. Did she need the flex machine for that?
JK

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@Contantandwell no she didn't but her legs are wrapped for the leakage and Dr is ordering her some kind of wrap for her legs she is doing better on the anti inflammatory diet and the ginger-Tumeric tea I suggested to her.

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@lioness

@Contantandwell no she didn't but her legs are wrapped for the leakage and Dr is ordering her some kind of wrap for her legs she is doing better on the anti inflammatory diet and the ginger-Tumeric tea I suggested to her.

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@Contantandwell Im going to tell her about the golden milk I just had some I like it maybe better then the G-T tea

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@lioness

@Contantandwell Im going to tell her about the golden milk I just had some I like it maybe better then the G-T tea

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@lioness if you don’t mind a few extra calories, Whole Foods has a delicious turmeric, ginger “chai” in non-refrigerated cartons, made by Rishi. You’re supposed to froth milk to add to it but I just add plain almond milk.
JK

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@contentandwell

@lioness if you don’t mind a few extra calories, Whole Foods has a delicious turmeric, ginger “chai” in non-refrigerated cartons, made by Rishi. You’re supposed to froth milk to add to it but I just add plain almond milk.
JK

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@contentandwell sounds good

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@peach414144 one that is for nny on T.V is America,s funniest videos just saw a 🦃 fighting with a postman

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@contentandwell

@melcpa86 The flex they want you to achieve is generally 120, anything more than that is gravy. Mine is not at that in either leg but I do very well walking in most things, just cannot bend it enough for ease in getting up and down from the floor. I would give anything to have 125! When we were on vacation in October I walked about 37 miles in four days!

@klouis I am going to be having that surgery soon, I think it is probably the same thing. It's good to know that someone else found it did help.
JK

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I think the surgery you and @klouis mentioned is the one I had 5 weeks ago. If so, it has helped. But be prepared for the workload after surgery if you want the results.

At 5 weeks post op My passive motion is now at 132 with less of a push from PT and fewer tears and I am walking normally and no longer limping constantly.

I am by no means at the end of this journey. PT won’t tell me my active ROM (probably for fear of discouraging me). It still hurts to stand and after walking about 15 mins.

The journey after the surgery has been intense. Starting at 10 hours of PT a day – I’m now down to 6 hours a day. That might be because My surgeon and PT are the orthos for a major university football & soccer team and their job is to get folks back on the field fast. I don’t know.

I was supposed to head back to work tomorrow- but PT asked me to wait one more week – I think to try and get me to where he is comfortable reducing the PT to 4 hours so I can try and manage.

Just letting you know my journey for reference.

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@melcpa86

I think the surgery you and @klouis mentioned is the one I had 5 weeks ago. If so, it has helped. But be prepared for the workload after surgery if you want the results.

At 5 weeks post op My passive motion is now at 132 with less of a push from PT and fewer tears and I am walking normally and no longer limping constantly.

I am by no means at the end of this journey. PT won’t tell me my active ROM (probably for fear of discouraging me). It still hurts to stand and after walking about 15 mins.

The journey after the surgery has been intense. Starting at 10 hours of PT a day – I’m now down to 6 hours a day. That might be because My surgeon and PT are the orthos for a major university football & soccer team and their job is to get folks back on the field fast. I don’t know.

I was supposed to head back to work tomorrow- but PT asked me to wait one more week – I think to try and get me to where he is comfortable reducing the PT to 4 hours so I can try and manage.

Just letting you know my journey for reference.

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@melcpa86 Hi, I'm not sure I understand your figures. What are you referring to when you say "My passive motion is now at 132" if not ROM?
It sounds as if for you the PT after this minor surgery was more intense than after the initial TKR. Am I reading that correctly? I cannot imagine doing 10 hours a day, or even 6. I think the surgery I will be having is more minor than what you had, but I will know soon.
Thanks for the info and heads up.
JK

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@contentandwell

@melcpa86 Hi, I'm not sure I understand your figures. What are you referring to when you say "My passive motion is now at 132" if not ROM?
It sounds as if for you the PT after this minor surgery was more intense than after the initial TKR. Am I reading that correctly? I cannot imagine doing 10 hours a day, or even 6. I think the surgery I will be having is more minor than what you had, but I will know soon.
Thanks for the info and heads up.
JK

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My understanding is there are two types of range of motion. Passive – which is assisted (an MUA, or PT moving or you forcing with a strap) and Active – which is totally on your own with no help. What my PT has told me is that your passive range of motion is your personal max. If you can maintain your passive range of motion farther out from the surgery – it should convert to an active range of motion if you stick with the program.

After my initial knee replacement, I developed arthofibrosis, which is an official diagnosis painful restriction of joint motion, with scar tissue forming within the joint and surrounding soft tissue spaces and persisting DESPITE aggressive rehabilitation. My initial PT was considered medically aggressive since for 4 months and 3 hours per day. They started me at this level because I had a documented history of excessive scar tissue from two other surgeries. However, despite PT both my passive and range of motion would decrease weekly. My PT identified that I had arthofibrosis at about 2 months post op – but after a knee replacement, they won't do a lysis until you are at least 6 months post replacement.

What my surgeon explained to me is that anytime you damage your body with trauma or surgery – your body heals with scar tissue. When a joint is involved, you are in a race between the scar tissue and your motion. The lysis surgery allows the race to restart when the surgeon removes the excessive scar tissue – but you have to race to prevent the NEW scar tissue from preventing any gains in your motion. Hence the aggressive PT again – but at a higher level.

My PT tells me the passive number at each session. As long as I'm hitting what the surgeon had me at coming out of the lysis surgery – I'm winning the race.

Hope that explains it

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@melcpa86

My understanding is there are two types of range of motion. Passive – which is assisted (an MUA, or PT moving or you forcing with a strap) and Active – which is totally on your own with no help. What my PT has told me is that your passive range of motion is your personal max. If you can maintain your passive range of motion farther out from the surgery – it should convert to an active range of motion if you stick with the program.

After my initial knee replacement, I developed arthofibrosis, which is an official diagnosis painful restriction of joint motion, with scar tissue forming within the joint and surrounding soft tissue spaces and persisting DESPITE aggressive rehabilitation. My initial PT was considered medically aggressive since for 4 months and 3 hours per day. They started me at this level because I had a documented history of excessive scar tissue from two other surgeries. However, despite PT both my passive and range of motion would decrease weekly. My PT identified that I had arthofibrosis at about 2 months post op – but after a knee replacement, they won't do a lysis until you are at least 6 months post replacement.

What my surgeon explained to me is that anytime you damage your body with trauma or surgery – your body heals with scar tissue. When a joint is involved, you are in a race between the scar tissue and your motion. The lysis surgery allows the race to restart when the surgeon removes the excessive scar tissue – but you have to race to prevent the NEW scar tissue from preventing any gains in your motion. Hence the aggressive PT again – but at a higher level.

My PT tells me the passive number at each session. As long as I'm hitting what the surgeon had me at coming out of the lysis surgery – I'm winning the race.

Hope that explains it

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@melcpa86 Thank you for the explanation. It makes sense for sure, and I wonder why this was never explained to me by either of the two doctors or by my physical therapist. I have a real aversion to medical jargon so it is possible that it was explained and did not register, but I honestly do not think so.
I hope that you continue to win the race.
JK

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@contentandwell

@melcpa86 Thank you for the explanation. It makes sense for sure, and I wonder why this was never explained to me by either of the two doctors or by my physical therapist. I have a real aversion to medical jargon so it is possible that it was explained and did not register, but I honestly do not think so.
I hope that you continue to win the race.
JK

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Yes thanks for your message it’s been very helpful

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@dduke

I also had it done. It is called: arthroscopic lysis and debridement of the knee. https://www.arthroscopytechniques.org/article/S2212-6287(17)30061-0/fulltext

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Going in for a 2nd opinion this week- knee seems to be getting worse as in more pain and -is it possible?- more scar tissue building around tkr-quite sad- original surgeon said only a 50% chance of relief after doing All the pt etc after the lysis/debridement. i am frightened and looking at shelling at least 12 k for the experiment…

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