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?

@debbraw

Hi Mary Ann @registerednurse – Welcome to Connect! Great people here with great experience to share. I'm 68 years old and had my first TKR in April 2017. My next one is coming up next Tuesday 1/29/19… I feel for you on the difficulties you experienced with your TKR. I would have been totally frustrated with those results. I'm curious about what kind of physical therapy you had? Wish me luck on my next TKR on Tuesday. I'm hoping I get good recovery on this one.

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Good morning, registerednurse (and all) –

Infection in the joint capsule after a TKR is a big deal (typically). I hope the antibiotics "work"
and i am crossing my fingers for you. My own situation is so inflammation sensitive that my
previous surgery arthroscopy essentially ended up being like bailing water from a seriously
leaky boat (we regained the scar tissue to the same degree – almost immediately). I'm glad
to hear your exerience has been better (or sounds as if it has – and I hope that continues).

Yes (JK), those gym hot tubs (and swimming pools) do have bacteria in them of all types
(regardless of the amount of clorine put in them). If I had immune suppression issues, I would
share that same concern. Counter-intuitively (at least based on what I think I understand now),
my inflammation problems are driven by too much of an immune system response (some
inflammation being "the normal response"). That's part of "why" a steroid injection "works" to
reduce inflammation – it does this by partially suppressing that same immune system response.
It would make a lot of sense to me – that they would consider "bathing" the joint capsule with
steroids during the TKR surgery (particularly where this is a revision – with a well-understood
history of inflammation causing previous problems), but it's my understanding they generally
will not do this.

More "grist for the mill"

Best to all (and good luck JK),

John

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@gutthookd

Good morning, registerednurse (and all) –

Infection in the joint capsule after a TKR is a big deal (typically). I hope the antibiotics "work"
and i am crossing my fingers for you. My own situation is so inflammation sensitive that my
previous surgery arthroscopy essentially ended up being like bailing water from a seriously
leaky boat (we regained the scar tissue to the same degree – almost immediately). I'm glad
to hear your exerience has been better (or sounds as if it has – and I hope that continues).

Yes (JK), those gym hot tubs (and swimming pools) do have bacteria in them of all types
(regardless of the amount of clorine put in them). If I had immune suppression issues, I would
share that same concern. Counter-intuitively (at least based on what I think I understand now),
my inflammation problems are driven by too much of an immune system response (some
inflammation being "the normal response"). That's part of "why" a steroid injection "works" to
reduce inflammation – it does this by partially suppressing that same immune system response.
It would make a lot of sense to me – that they would consider "bathing" the joint capsule with
steroids during the TKR surgery (particularly where this is a revision – with a well-understood
history of inflammation causing previous problems), but it's my understanding they generally
will not do this.

More "grist for the mill"

Best to all (and good luck JK),

John

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All pools have bacteria in them. I went in a hydropool 36 hours post arthroscopic arthrolysis and debridment of left knee, no problems it was highly chlorinated.
I paid 12K for a knee replacement in the UK, only to get me back to work ASAP….it didn't work due to scar tissue. I still don't have knee flexion to what some people get 96 degrees….

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@gator1965

All pools have bacteria in them. I went in a hydropool 36 hours post arthroscopic arthrolysis and debridment of left knee, no problems it was highly chlorinated.
I paid 12K for a knee replacement in the UK, only to get me back to work ASAP….it didn't work due to scar tissue. I still don't have knee flexion to what some people get 96 degrees….

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I too am a registered nurse

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@contentandwell, @debbraw, and all the other mentors: I wish there was a way (perhaps there is??) to get word of this website out to the general public. I happened on it by lucky accident, of course AFTER the TKR, which has had generally successful results so far. However, it would be so much better when more people could gain some insight into the problems, the questions to ask before the surgery, and also hear about the positive outcomes experienced by actual patients. Obviously the latter are not posted here as frequently, though. Thanks for the good work!

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@ellerbracke

@contentandwell, @debbraw, and all the other mentors: I wish there was a way (perhaps there is??) to get word of this website out to the general public. I happened on it by lucky accident, of course AFTER the TKR, which has had generally successful results so far. However, it would be so much better when more people could gain some insight into the problems, the questions to ask before the surgery, and also hear about the positive outcomes experienced by actual patients. Obviously the latter are not posted here as frequently, though. Thanks for the good work!

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@ellerbracke – Thanks for the kind words! I agree that the Connect platform can really be a lifesaver when we are going through some of these medical "adventures" and need friendly encouragement and support. We try to get the word out with flyers and brochures but it can be an uphill battle. Meantime, please share on any social media platforms you use yourself. Also, is there a way you think might be even more effective to spread the word?

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@ellerbracke

@contentandwell, @debbraw, and all the other mentors: I wish there was a way (perhaps there is??) to get word of this website out to the general public. I happened on it by lucky accident, of course AFTER the TKR, which has had generally successful results so far. However, it would be so much better when more people could gain some insight into the problems, the questions to ask before the surgery, and also hear about the positive outcomes experienced by actual patients. Obviously the latter are not posted here as frequently, though. Thanks for the good work!

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@ellerbracke
I had my TKR 5 years ago. Although I did wind up back in the hospital a couple of days after being released, it was due to kidney issues, not my knee surgery. The knee surgery was probably typical, with pain and swelling after. I’ve hesitated to comment because I’m so happy with the results. I have maximum ROM and negligible pain. I did the exercises before and after surgery and had PT. I remember while doing PT, my knee was cracking a lot. The therapist said it was probably scar tissue breaking. When I’ve gone in for follow up appointments, the dr always gets a little grin when he sees how far my knee bends. I’ve told him that it was the best thing I’ve done for myself. That was before my kidney transplant, though. I was pretty naive about what could go wrong. Maybe that was a good thing. I hope this is encouraging for anyone considering a TKR.

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@cmael

@ellerbracke
I had my TKR 5 years ago. Although I did wind up back in the hospital a couple of days after being released, it was due to kidney issues, not my knee surgery. The knee surgery was probably typical, with pain and swelling after. I’ve hesitated to comment because I’m so happy with the results. I have maximum ROM and negligible pain. I did the exercises before and after surgery and had PT. I remember while doing PT, my knee was cracking a lot. The therapist said it was probably scar tissue breaking. When I’ve gone in for follow up appointments, the dr always gets a little grin when he sees how far my knee bends. I’ve told him that it was the best thing I’ve done for myself. That was before my kidney transplant, though. I was pretty naive about what could go wrong. Maybe that was a good thing. I hope this is encouraging for anyone considering a TKR.

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@ellerbracke It sounds as if both the knee and the kidney have worked out great for, that's wonderful.
What is considered to be "maximum ROM"? I know that if you reach 120 that is considered to be good but a woman in my water aerobic class claims to be at 145. Is that even possible? I'm wondering if she may have misunderstood something.
JK

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@ellerbracke

@contentandwell, @debbraw, and all the other mentors: I wish there was a way (perhaps there is??) to get word of this website out to the general public. I happened on it by lucky accident, of course AFTER the TKR, which has had generally successful results so far. However, it would be so much better when more people could gain some insight into the problems, the questions to ask before the surgery, and also hear about the positive outcomes experienced by actual patients. Obviously the latter are not posted here as frequently, though. Thanks for the good work!

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@ellerbracke I think some people realize the importance of being as knowledgeable as possible about their medical care, and those people will google things and may well discover Connect.
There are people who just assume that everything will be great and do no research. They, of course, will not come upon a forum like Connect.
I think Facebook can be a great way to get people informed but other than that I don't know how you would do it.
JK

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@contentandwell

@ellerbracke It sounds as if both the knee and the kidney have worked out great for, that's wonderful.
What is considered to be "maximum ROM"? I know that if you reach 120 that is considered to be good but a woman in my water aerobic class claims to be at 145. Is that even possible? I'm wondering if she may have misunderstood something.
JK

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I don’t know the maximum Rom. The orthopedist holds up his measurer and I’m well beyond so he just smiles and sets it down and tells his assistant taking notes that it’s at maximum. Because it was never an issue, I didn’t ask.

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Hi. I had knee replacement, in Aug. 2018, got to 90° Bend, then fell, severed quad muscle, fractured femur, had surgery was in cast then stabilizing brace. Now my knee won’t bend past 60° I started at under 30, progressed to 60 ° nowbuts stuck. Was told can not be manipulated even tho 4 months after quad reattachment. Could re damage, p.t.is torturous and wouldn’t mind if I was making progress, I’m not, been 5 weeks going on 6 stuck Dr. Wants me to wait at least another 3 to 4 months before even thinking about arthroscopic. After every p.t. session, which is very painful, I have swelling, black and blue, sever pain. At my wits end. Anyone else experience this?? Any suggestions???

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@aabhealey

Hi. I had knee replacement, in Aug. 2018, got to 90° Bend, then fell, severed quad muscle, fractured femur, had surgery was in cast then stabilizing brace. Now my knee won’t bend past 60° I started at under 30, progressed to 60 ° nowbuts stuck. Was told can not be manipulated even tho 4 months after quad reattachment. Could re damage, p.t.is torturous and wouldn’t mind if I was making progress, I’m not, been 5 weeks going on 6 stuck Dr. Wants me to wait at least another 3 to 4 months before even thinking about arthroscopic. After every p.t. session, which is very painful, I have swelling, black and blue, sever pain. At my wits end. Anyone else experience this?? Any suggestions???

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Hello @aabhealey, welcome to Connect. You may notice that I moved your discussion and combined with an existing discussion on scar tissue after knee replacement. The conversation is a bit long, but by moving your post, all the members who are discussing scar tissue issues after knee replacement or surgery will see your message. You can also read through some of the previous posts made by members as well. If you are replying by email, in your email notification to this message, you can click on VIEW & REPLY to be brought to the new location of your post and to see other posts.

I also experienced severe scar tissue after my knee replacement in 2006. It took two manipulations and a freak jumping incident to finally loosen my scar tissue a good 18 months after my initial surgery. However, I did not have the added complication of breaking a femur, which, from what I understand, is a major recovery on its own. Has your surgeon or PT provider mentioned muscle atrophy as a potential reason for slow gains? I am not a medical professional, but it would be reasonable to assume that the surgery, which causes scar tissue, combined with having to be sedentary and not move your leg would be a combination for the scar tissue to grow while the muscles weaken.

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@bisutton

Since your problems are so similar to mine, I’m wondering if you have more pain when you exercise more? I really had pain when I tried warm water pool therapy. I still have the tightness around the joint, which seems to get worse. I’m just picturing scar tissue around my knee joint. I’m also wondering about laser treatments.

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I am new to this discussion group and just saw your post. Like most participants on this site I suffer from chronic pain in both knees three years after double knee replacement surgery. My diagnosis is arthrofibrosis or excessive scar tissue. I have had both knees surgically manipulated which helped initially, but then over time the scar tissue continued forming. I finally tried 25 laser treatments (deemed experimental so not covered by insurance) but my condition did not improve. Now my hip is becoming compromised because of compensating for my knee that won't bend more than 80 degrees, making it difficult to get in and out of the driver's seat in my cars. My X-rays all look perfect and my surgeon is afraid that if I try revision surgery I will simply develop the same problem post-op. I notice your post is over a year old, did you ever find relief?

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