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?

@sraley1

Had a TKR in Nov 2017. Went through a very vigorous PT, able to straighten my knee and bend it. My challenge is that after about 4 months, my knee was not feeling any better. I gave up walking because it walking makes my knee swell and tight. I went back to see my surgeon at both 6 months and after a year. He said everything is looking good and some people just take longer to heal. He said if I wanted to walk, take walks but don't overdo it.
I do believe my issues are with scar tissue that has developed above my knee cap. Again my surgeon did not clearly state that was my issue or not. He said it could be one of a few issues. Also, I know they cut through nerves with TKP surgery. Anyone else feel extensive numbness still in the knee after a year?
I'm now taking a more aggressive approach and manually with my fingers and knuckles applying pressure to areas I feel scar issue build up.
I'm now reading that several people have had arthroscopic removal of scar tissue which has helped some of you. I'm also hesitant about this surgery. Open to suggestion for relief without using medications.

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I would get a second opinion and perhaps see if a CAT Scan might show scar tissue. If you do have a scar tissue issue, do your research on arthroscopic surgery and speak to at least one dr regarding it. From my understanding, that is often the last resort and not ideal. What is your current ROM? If you have a good bend and extension, scar tissue shouldn't really inhibit your ability to walk and your pain should be subsiding. It's easy to want to blame scar tissue on a problem TKR but often, it is something else. Keep your mind open and if you are not satisfied with your surgeon's response to your concerns, PLEASE get a second opinion. Your TKR was in 2017 and the "healing time" has come and gone. What were the few issues your surgeon was referring to and what solution was offered for a proper diagnosis? Be assertive in your care and get some answers! Please keep me posted because I am curious as to what your problem might be this far out.

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@bisutton May I ask how you you know it's scar tissue growing back? Can you feel it or is just a stiffness? I keep reading the posts on scar tissue and I'm struggling to get to a 110 ROM at almost 7 weeks PO. My therapist hasn't mentioned scar tissue but as a plow through PT, I keep wondering why I'm not making faster progress.

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@lamerex4

I had my first knee replacement at the age of 47 years in 2001. I was plagued by spasms on the outer aspect of my calf caused by scar tissue. After a closed manipulation and traditional PT I got relief with acupuncture and osteopathic manipulation. I know many physical therapists practice under the theory that you have to push through the pain, but when you are a prolific scar tissue creator, I feel a more gradual, alternative approach is better.

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@lamerex4 How does someone know that scar tissue is the problem? Can you feel it or is it the only reason for pain and stiffness after a TKR? I'm just curious because I'll be 7 weeks PO on Thursday and can only get to 105-106 unassisted bend and around 113 with pulling while doing heel slides. Not MUA material but not where I wanted to be 7 weeks out either.

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@damewocane

Heat and a cbd oil+ massaged around knee front and back gives some relief. I swim and paddle around on a floaty in the pool every other day weather permitting. Waiting to see what comes next.

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My 2nd opinion Ortho Dr is going to do a revision-will have to go through All of the TKR pain and pt again-and yes a part too large was put in, hence the excessive scar tissue.

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@damewocane I'm so very sorry to hear about this! Is your original surgeon in the loop? What does sh/e have to say?!

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The original surgeon "fired" me in the first week of December saying "There is nothing more I can do for you"- Never acknowledged this problem. Its taken 3 months to find a new surgeon who will touch me.

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@damewocane I hope you write an email or letter to surgeon #1.

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@damewocane

The original surgeon "fired" me in the first week of December saying "There is nothing more I can do for you"- Never acknowledged this problem. Its taken 3 months to find a new surgeon who will touch me.

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Your experience is exactly like mine. I too was told this is the last thing i can do for you. I finally got a second opinion. That surgeon did my revision. I was being treated for scar tissue when in fact it was the original orthopedic inserted the wrong size.
I am post op 3 months and have continued with PT RELIGIOUSLY. Revions take longer to recover from which can be frustrating at times, but you will be happy with the results. Just remember that you need to be patient. I wish you a full and total recovery.

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@bevinauburn

Your experience is exactly like mine. I too was told this is the last thing i can do for you. I finally got a second opinion. That surgeon did my revision. I was being treated for scar tissue when in fact it was the original orthopedic inserted the wrong size.
I am post op 3 months and have continued with PT RELIGIOUSLY. Revions take longer to recover from which can be frustrating at times, but you will be happy with the results. Just remember that you need to be patient. I wish you a full and total recovery.

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I am so sorry to hear that your surgeon didn’t ensure a proper fit. Can you sue hecor she since it was clearly the surgeons error? From what I understand, that is rare and most surgeons know how to avoid an improper fit. I hope your recovery is complete and you finally have relief!

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@damewocane

My 2nd opinion Ortho Dr is going to do a revision-will have to go through All of the TKR pain and pt again-and yes a part too large was put in, hence the excessive scar tissue.

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I am a 56 year old male with my first TKR and am almost 4 month post op with only 90 degrees ROM. I have had a MUA 2 1/2 months ago and again, still no relief. I had a scar tissue issue 21 years ago after a ACL on the same knee, and my surgeon is saying that I am dealing with scar tissue this go around as well. My question is how your 2nd opinion surgeon determined that the wrong size hardware was installed and the procedure for that determination. Trying to find a surgeon for 2nd opinion around here is almost impossible. They will but not till after a 1 year anniversary from my TKR.

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@hoover

I am a 56 year old male with my first TKR and am almost 4 month post op with only 90 degrees ROM. I have had a MUA 2 1/2 months ago and again, still no relief. I had a scar tissue issue 21 years ago after a ACL on the same knee, and my surgeon is saying that I am dealing with scar tissue this go around as well. My question is how your 2nd opinion surgeon determined that the wrong size hardware was installed and the procedure for that determination. Trying to find a surgeon for 2nd opinion around here is almost impossible. They will but not till after a 1 year anniversary from my TKR.

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First I want to reply to the question, could I sue? Probably so if I wanted to go through that but I haven’t felt the energy to go through that process. My first surgery was June 15th 2017, second surgery December 10th 2018. .i I had one MUA which I was told he got me to 130 ROM. After months of Pt I could only get to about 110 at Pt but it would never hold. I was lucky to be ay 90 thereafter until my second surgery. I was never without pain that year and one half. The final suggestion was maybe I could have arthroscopic surgery to remove scar tissue with another manipulation . At my pre op appointment I canceled the surgery as I was frustrated with the surgeon and his opinion of the success of this procedure.
I understand your frustration with getting an appointment with another surgeon. I have been told you can continue to increase ROM up to a year and I am guessing since you are only at 4 months, they may consider it is too soon.

I tried getting in with other doctors but they didn’t want to do revisions. Finally the doctor who did my surgery agreed to see me and I didn’t know at the time he was known for doing revisions so that might be what you need to research. I believe that after reviewing my file forwarded to him and extensive questioning of my experience and examination he then told me he didn’t think it was scar tissue only but the fit. After surgery he said I had little scar tissue but he removed it and it was the fit. I know this is quite lengthy but I want to explain to you my total experience. I hope it helps.
I know we want to see more progress but it is a slow process and we get tired of hearing we need to be patient!

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@bevinauburn

First I want to reply to the question, could I sue? Probably so if I wanted to go through that but I haven’t felt the energy to go through that process. My first surgery was June 15th 2017, second surgery December 10th 2018. .i I had one MUA which I was told he got me to 130 ROM. After months of Pt I could only get to about 110 at Pt but it would never hold. I was lucky to be ay 90 thereafter until my second surgery. I was never without pain that year and one half. The final suggestion was maybe I could have arthroscopic surgery to remove scar tissue with another manipulation . At my pre op appointment I canceled the surgery as I was frustrated with the surgeon and his opinion of the success of this procedure.
I understand your frustration with getting an appointment with another surgeon. I have been told you can continue to increase ROM up to a year and I am guessing since you are only at 4 months, they may consider it is too soon.

I tried getting in with other doctors but they didn’t want to do revisions. Finally the doctor who did my surgery agreed to see me and I didn’t know at the time he was known for doing revisions so that might be what you need to research. I believe that after reviewing my file forwarded to him and extensive questioning of my experience and examination he then told me he didn’t think it was scar tissue only but the fit. After surgery he said I had little scar tissue but he removed it and it was the fit. I know this is quite lengthy but I want to explain to you my total experience. I hope it helps.
I know we want to see more progress but it is a slow process and we get tired of hearing we need to be patient!

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@bevinauburn I'm so glad you are finally doing better, Bev.
I knew a woman who walked around limping and in pain for two years before she found a doctor who diagnosed the problem, fit, and he fixed it for her. At the time she did look into suing but as I recall she really could not since it was fixable. Nothing for two years of pain curtailing her activities, she runs a business.
JK

Liked by damewocane

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It can take a full year for a TKA to fully heal and just as long for the swelling to go down. As long as you can fully straighten your knee and get at least 90 degrees Physicians (everywhere) consider that a great outcome. You really have to do the work. Stretching, heel slides with a sheet, having somebody push that knee back for you when you hit your own plateau. Hold that stretch for up to 10 minutes and do sets of 5 up to 3 times per day. Roll on an exercise ball. Sit on a porch swing and slowly keep bending your knee and increase your time. Google exercises. There are 2 PT guys that do YouTube videos showing advanced stretching. Are people going to the gym and riding a bike? Forward/back increasing and holding the stretch until a full revolution forward or backward can be done. Lower the seat, move the seat forward to increase the stretch. Stretch the hamstrings, soleus and gastronomic muscles (these all prevent a full ROM if they are tight). I think doing a MUA within that first 3-mths is extreme unless there is a medical condition that warrants it. Nobody knows scar tissue is solely the problem. We all get it after surgery and injury. You can loosen it on one part and have it sticking on another. It comes loose in pieces and sometimes not all of it ever loosens. Just keep doing aggressive therapy on your own and you'll get there.

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Hi, I had my TKR Jan. 8,2019 and MUA on Feb. 27, 2019. I go to PT 3 X week and the other days I exercise @ home. Like you said the scar tissue builds as soon as I finish PT or exercising at home. it seems as though the scar tissue is luring and waiting to jump back on me. I also massage it daily many times throughout the day by hand. I have not tried anything to break it up. I have an appt. with my surgeon tomorrow we are going to discuss the pros and cons of arthroscopic surgery or him going back into it to maybe putting a different size knee. Has anyone ever heard of putting a different size knee in. Also has anyone experienced the feeling of metal squeezing both sides of the knee.

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@bevinauburn

First I want to reply to the question, could I sue? Probably so if I wanted to go through that but I haven’t felt the energy to go through that process. My first surgery was June 15th 2017, second surgery December 10th 2018. .i I had one MUA which I was told he got me to 130 ROM. After months of Pt I could only get to about 110 at Pt but it would never hold. I was lucky to be ay 90 thereafter until my second surgery. I was never without pain that year and one half. The final suggestion was maybe I could have arthroscopic surgery to remove scar tissue with another manipulation . At my pre op appointment I canceled the surgery as I was frustrated with the surgeon and his opinion of the success of this procedure.
I understand your frustration with getting an appointment with another surgeon. I have been told you can continue to increase ROM up to a year and I am guessing since you are only at 4 months, they may consider it is too soon.

I tried getting in with other doctors but they didn’t want to do revisions. Finally the doctor who did my surgery agreed to see me and I didn’t know at the time he was known for doing revisions so that might be what you need to research. I believe that after reviewing my file forwarded to him and extensive questioning of my experience and examination he then told me he didn’t think it was scar tissue only but the fit. After surgery he said I had little scar tissue but he removed it and it was the fit. I know this is quite lengthy but I want to explain to you my total experience. I hope it helps.
I know we want to see more progress but it is a slow process and we get tired of hearing we need to be patient!

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Hi bevinauburn, you mention that it was the fit. Can you give me more clarity and what kind of problems did you experience? I asked this question down below, did your doctor go back in and give you a different knee, if so how did that work. Are you feeling better and do you have much scar tissue with the new knee.

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