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?

@killerbees

Hi Doodles…My PT, who is excellent, and has been working with me for the last 5 months. Also, other Pt's who I know and trust their opinion, have agreed as well as my extemely knowledgeable IMed doc. For movement, I walk, stretch, use the weight machines doing the strenth training my PT gives me, accupunture (really helped with the painful bands), I do the recumbant bike (warm up on Airodyne first), water exercises and continue to push my knee for full ROM. For pain, Tylenol 500 (two) every 6 hrs as needed, Skelaxin (muscle relaxant) for spasms and for extreme pain Vicodin 5/325, one to two tablets. Also, I ice, ice ice and go to accupunture for management of pain. Honestly, knowing my body very well, having a very high pain threshold and having excellent mobility, I try to remain hopeful, yet I am going for second opinion and think I will need a replacement again. Also, because I am petite, the implant is huge compared to my right knee, and since my surgeon said he lets the rep chose the size implant for his pts, I'm wondering if the rep just stocked med, lge and extra large! Hope this helps. Good luck to you.

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how frightening that the doctor lets the REP chose the knee hardware ! Yikes. Sounds incompetent !

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@hospdoc

This is the first time I have ever joined a discussion group for medical issue or anything else for that matter. I had a left TKR on 9/6/17. In 2015 I tore my left meniscus and had surgery done. Since that arthroscopic repair I had a chronic flexion contraction; my left leg was permanently bent at 15 degrees unable to straighten of fully bend the leg. I walked with a chronic limp. I still managed to stay very active; running, hiking, biking. The arthritis continued to get worse and the limping was affecting my hip and back. A total knee replacement was my only option. I bit the bullet and found a surgeon. I was able to straighten my knee but not bend it; the best I have gotten is 85 degrees. I had a manipulation done on Halloween but despite doing aggressive physical therapy the stiffness returned and my knee is just the same as it was before. I had a follow up yesterday with my surgeon and they say there is not much more that can be done. They are going to put me in a dynasplint and see how that works.
I cried all the way home and at work today wondering how am I going to function like this. I have to walk with a walker and can basically do nothing; not even walk my dog. I am so overwhelmed by this. I am only 46 and cannot think that this is how it is going to be the rest of my life. This sucks to say the least.
I got a call from a friend who is an orthopedic surgeon and does sports medicine. He told me about a therapy called Astym therapy. He said that it has been used for people who developed arthrofibrosis following knee replacement and they had a fairly good result with it. I will be looking into this for myself but you can find a lot more info on the internet about this. I found a research paper that looked at 16 patients who had good outcomes with this. It is noninvasive so it wouldn’t hurt to at least try this. I hope this information helps.

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Did you try the Astym therapy? Did it work?

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@zakcat

Has your doctor offered to do a scar manipulation under anesthesia? (MUA)

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Yes -Here I go again, while the hip is being replaced a MUA will be performed. I don't know when I will ever get out of ortho hell.

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Sounds like a good plan. And, Hip replacement is Much easier to recover from than knees. You'll be happy.

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@damewocane

Thanks- We'll see- by pure chance I was in a store last week and a young lady asked me what was wrong with my knee as she was in orthopedics- i told her the sad story- she asked,"Would you mind telling me who the surgeon was?" I did and she stated earnestly,"Oh wow this is the third botch I've heard about him lately."Random encounter, my stomach churns and my knee screams.

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@damewocane From what I have learned here, and in a Facebook group about knee replacements, one of the most important things when getting one is doing a lot of research on the doctor. I did not do enough on the doctor who did my first TKR. My knee is OK, but not nearly as good as my second one.
The second doctor is phenomenal. When I first went to him and he asked he which brand of knee I wanted — he uses two — he also said that he believes the outcome depends less on the brand of the knee than it does on the competence of the doctor. I believe him. I did choose the knee that he was a developer of, Conformis, simply because I had heard so much good about it. I have not regretted it at all.
I live in southern NH but go to Boston for most of my medical issues. There is a doctor up here who does zillions of TKRs but I think he does so many that they are all just done the same way without regard to the needs of different patients. People either love him or hate him.
JK

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thanks for the insight; I did ask a doctor friend who was good, and she recommended my doctor highly. Who you chose really is important !

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@debbie64131

Thanks so much for reaching out to me. I have done water therapy & it works great while I’m in the pool but it doesn’t take long after I go home for the bands to come back. I’ve had months of therapy but I haven’t tried acupuncture.

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Acupuncture worked well for me as he was able to ease the spasms in my IT band, lower back and hip. Also strength training on the machines at fitness center, using exercises given to me by my PT have helped. I walk for at least 40 minutes 5 days a week to exercise my dog (and myself), but I have to take extra care to not fall as this whole experience has caused me to have balance issues, which is really frustrating. The tightness is still there and I can feel the popping in both the lateral portion of my knees and also in my sacrum and mid hip. No MD's here can agree on what is causing this…..I've seen 4 now with so many MRI's I probably paid for the machine by now!
I called Mayo Ortho and am seeing an MD that, hopefully, can tell identify the problem and "fix" it and (praying!) I can then solve my balance issue and resume my bucket list. I am petite and my implant is huge in comparison to my other knee. When I asked my surgeon "who choses the implant size?" He replied, "Oh the rep for the company is in the OR and chooses the right size"!!!! One of my doc's said the issue has to be that a nerve is impinged, most likely in the lateral area of the knee….I bet he is right. I will let you all know what the doc's at Mayo say and/or do. (Back in 2002, I needed a 2 level fusion of my lumbar spine and the surgeon in my city turned out to be on drugs and shattered my pelvis, literally in pieces and left me to die when he nicked my glutial artery and I began loosing alot of blood. My anesthesiologist and the hemotologist on call saved my life. Surgeon was gone in a flash never to return again. I went to 15 of our area's best spine surgeons said there wasn't any way to rebuild me and "you will live your life in a wheelchair". My reply was "Oh no I won't!" and I asked the good Lord to lead me or heal me. He led me to an incredible surgeon and his team at Mayo who gave me a chance to walk again, even tho they told me it was only an 8% one, and it was so invasive to the human body that I had a 50% risk of not surviving the surgery. I knew the Lord had chosen these doctors to heal me and He would work through their hands. I never doubted for a minute that I would walk again. It was a huge operation, and ended up being 4 operations as I wouldn't let them give up on me when a few " monkey wrenches" were thrown on our path. My Mayo surgeons and their team, who literally figured out a way to give me my life back were unbelievably talented, creative, determined and caring in successfully rebuilding my broken body. After 5 weeks, I was allowed to begin using my scooter, then onto a walker, then crutches and/or walker and finally after 3 more months, Dr H and his team met me in a room at St Mary's and he said, give me your crutches and walk across the room. No pain, no limping…..I was rebuilt just as God had made me. It had been a long journey, not so much for me, but for all my phenomenal, dedicated doc's and nurses as well. Dr H looked down at me, (he's very tall and I am short), and said "You know none of us thought you would ever walk again but you kept telling us "God won't leave me behind because he led me to you" and we should not give up either as he was working through our hands. Well, you have something to that God thing of yours as we all agreed if you did ever walk it would be a miracle"
So, don't ever give up. Keep searching for the answers, pray to your God asking to be put on the right path to find complete healing for yourself. Believe your knee will be restored and you will no longer have pain. For if we are not our own tenacious, advocate how can we find the healing we desperately need. We may have to have patience as it may or may not come right away, but with a strong postive spirit (which is hard when you hurt and can't do what you want to right now), I believe we can all be healed.

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@zakcat

Has your doctor offered to do a scar manipulation under anesthesia? (MUA)

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Hi @zakcat – If its any consolation, I think most of us still have pain – sometimes night and day – at 6 weeks. I've had 2 TKRs. On both, I found 8 weeks to be a real milestone. Lots of things like walking, being able to comfortably turn over in bed, and staying on top of my PT became much easier in the 3rd month. I know there are pros and cons to the CBD oil and there is no regulation of the stuff and there are snake oil salespeople out there. All that said, I've heard some pretty good things about it when people have found reliable sources. Good luck with your recovery. Is pain at night your worst problem or do you still have pain with PT?

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Thanks for the encouragement ! My doctor wants to do a manipulation on Friday, but I reached a milestone today at PT (with much sweating and groaning!) and my PT said I really won't need it. I look forward to being done with this recovery period ! Nights are finally getting better. 3 am used to be my worst time of the day(and night ) Found a reliable source for CBD so I'll try it soon.

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@zakcat

Thanks for the encouragement ! My doctor wants to do a manipulation on Friday, but I reached a milestone today at PT (with much sweating and groaning!) and my PT said I really won't need it. I look forward to being done with this recovery period ! Nights are finally getting better. 3 am used to be my worst time of the day(and night ) Found a reliable source for CBD so I'll try it soon.

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@zakcat – I am so happy to hear your good news. All of that sweating and groaning brings back memories. Good for you. Will you keep us posted?

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sure, thanks. The support is welcome. I must have my other knee replaced, and soon. So not looking forward to it ! but at least I'll know the pitfalls, and what to do.

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I had a total knee replacement on May 21, My knee is doing really well however I am having a huge issue with a pinched nerve in my back. They think it’s the sciatica as it goes down my leg and my foot is asleep like pins and needles. I would like to know if anyone is ever here at the house if she’ my knee is doing really well however I am having a huge issue with a pinched nerve in my back. They think it’s the sciatica as it goes down my leg and my foot is asleep like pins and needles. I would like to know if anyone has had this issue? I never had a problem before this and now they’re trying to tell me that when my knee wasn’t surgery it was the way they positioned it. Please help if anyone has had this issue and let me know how you took care of that, the pain from the back and sciatica is worse than the knee pain.

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@sandie2749

I had a total knee replacement on May 21, My knee is doing really well however I am having a huge issue with a pinched nerve in my back. They think it’s the sciatica as it goes down my leg and my foot is asleep like pins and needles. I would like to know if anyone is ever here at the house if she’ my knee is doing really well however I am having a huge issue with a pinched nerve in my back. They think it’s the sciatica as it goes down my leg and my foot is asleep like pins and needles. I would like to know if anyone has had this issue? I never had a problem before this and now they’re trying to tell me that when my knee wasn’t surgery it was the way they positioned it. Please help if anyone has had this issue and let me know how you took care of that, the pain from the back and sciatica is worse than the knee pain.

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I had a lot of sciatic nerve pain after both my knee replacements
Physical therapy helps but took several months to get resolved

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@zakcat

Thanks for the encouragement ! My doctor wants to do a manipulation on Friday, but I reached a milestone today at PT (with much sweating and groaning!) and my PT said I really won't need it. I look forward to being done with this recovery period ! Nights are finally getting better. 3 am used to be my worst time of the day(and night ) Found a reliable source for CBD so I'll try it soon.

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@zakcat That's great to have reached a milestone, congratulations. My second TKR is fabulous. When I do a lot of exercises or walking the first one still annoys me a bit with discomfort. I wouldn't say pain, it's not that severe, or maybe I just have a high pain tolerance. The second one is a Conformis and the doctor who did it is a developer of the Conformis knee. He was great. I rushed into my first TKR because I was in pain 24/7, limping badly. That doctor is supposed to be good but he definitely was not as good as the second doctor, yet when I hear the problems other people have I have to realize, I am not bad off.

@sandie2749 I did not have sciatica after either of my TKRs but I have suddenly had it recently. I doubt your sciatica is directly related to the TKR but perhaps related to a way you might be compensating for the new knee. As your knee improves I bet your sciatica will also. I am not sure what has caused mine but it has been getting better overall. It has good days and then it will take a step backward. As long as it goes forward more than backward though I will be happy. It's the leg below my hip that has bursitis and I wonder if the bursitis is indirectly responsible for it.
JK

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@contentandwell

@zakcat That's great to have reached a milestone, congratulations. My second TKR is fabulous. When I do a lot of exercises or walking the first one still annoys me a bit with discomfort. I wouldn't say pain, it's not that severe, or maybe I just have a high pain tolerance. The second one is a Conformis and the doctor who did it is a developer of the Conformis knee. He was great. I rushed into my first TKR because I was in pain 24/7, limping badly. That doctor is supposed to be good but he definitely was not as good as the second doctor, yet when I hear the problems other people have I have to realize, I am not bad off.

@sandie2749 I did not have sciatica after either of my TKRs but I have suddenly had it recently. I doubt your sciatica is directly related to the TKR but perhaps related to a way you might be compensating for the new knee. As your knee improves I bet your sciatica will also. I am not sure what has caused mine but it has been getting better overall. It has good days and then it will take a step backward. As long as it goes forward more than backward though I will be happy. It's the leg below my hip that has bursitis and I wonder if the bursitis is indirectly responsible for it.
JK

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Thank you

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