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?

@marthajean

I had total knee replacement a little over one year ago, and a manipulation a couple of months after the surgery. I still have a stiff knee with limited mobility although there has been slight improvement in that it is a little easier to put on socks and boots and I can lift my knee replacement leg a little more during showers. I have stopped therapy temporarily but have been forcing myself to bend my knee, which has resulted in some periodic burning sensations which have become frequent. I believe the pain is from the breaking up of scar tissue. I will be seeing the surgeon for another follow-up later this month. My surgeon said my case was not typical. I am unable to do a round on an exercise bike because of the limited mobility. I was in a nursing/rehabilitation facility for about 15 days and I don’t think I received the kind of physical therapy that I should have received initially. By the time I was released the physical therapist that saw me initially at home questioned what had been done in the rehab facility. I had nearly zero mobility. This therapist worked with the surgeons to get me set up for a manual manipulation. A physical therapist in the hospital measured my mobility at 65 after the manipulation. Does this seem normal?

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no. but not unheard of. Someone did not do their job. This is why i will not get another tkr

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@marthajean

I had total knee replacement a little over one year ago, and a manipulation a couple of months after the surgery. I still have a stiff knee with limited mobility although there has been slight improvement in that it is a little easier to put on socks and boots and I can lift my knee replacement leg a little more during showers. I have stopped therapy temporarily but have been forcing myself to bend my knee, which has resulted in some periodic burning sensations which have become frequent. I believe the pain is from the breaking up of scar tissue. I will be seeing the surgeon for another follow-up later this month. My surgeon said my case was not typical. I am unable to do a round on an exercise bike because of the limited mobility. I was in a nursing/rehabilitation facility for about 15 days and I don’t think I received the kind of physical therapy that I should have received initially. By the time I was released the physical therapist that saw me initially at home questioned what had been done in the rehab facility. I had nearly zero mobility. This therapist worked with the surgeons to get me set up for a manual manipulation. A physical therapist in the hospital measured my mobility at 65 after the manipulation. Does this seem normal?

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The surgeon said it was the nursing/rehab facility and the various physical therapists I have had seemed to think along the same lines.

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@marthajean

I had total knee replacement a little over one year ago, and a manipulation a couple of months after the surgery. I still have a stiff knee with limited mobility although there has been slight improvement in that it is a little easier to put on socks and boots and I can lift my knee replacement leg a little more during showers. I have stopped therapy temporarily but have been forcing myself to bend my knee, which has resulted in some periodic burning sensations which have become frequent. I believe the pain is from the breaking up of scar tissue. I will be seeing the surgeon for another follow-up later this month. My surgeon said my case was not typical. I am unable to do a round on an exercise bike because of the limited mobility. I was in a nursing/rehabilitation facility for about 15 days and I don’t think I received the kind of physical therapy that I should have received initially. By the time I was released the physical therapist that saw me initially at home questioned what had been done in the rehab facility. I had nearly zero mobility. This therapist worked with the surgeons to get me set up for a manual manipulation. A physical therapist in the hospital measured my mobility at 65 after the manipulation. Does this seem normal?

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I will have to seriously consider doing my left knee; it wasn’t as bad as the right. But I am inclined not to get another TKR either. Others have had TKR without any problems. I went to one of the best hospitals in the country with an experienced surgeon – so go figure. I have been taking Instaflex which has helped with discomfort in my left knee. I have been awakened with the kind of pain others have described here. I have not taken pain killers since shortly after the manipulation. I took an Aleve for the pain I mentioned recently. It probably helped but the pain was not constant.

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@marthajean

I had total knee replacement a little over one year ago, and a manipulation a couple of months after the surgery. I still have a stiff knee with limited mobility although there has been slight improvement in that it is a little easier to put on socks and boots and I can lift my knee replacement leg a little more during showers. I have stopped therapy temporarily but have been forcing myself to bend my knee, which has resulted in some periodic burning sensations which have become frequent. I believe the pain is from the breaking up of scar tissue. I will be seeing the surgeon for another follow-up later this month. My surgeon said my case was not typical. I am unable to do a round on an exercise bike because of the limited mobility. I was in a nursing/rehabilitation facility for about 15 days and I don’t think I received the kind of physical therapy that I should have received initially. By the time I was released the physical therapist that saw me initially at home questioned what had been done in the rehab facility. I had nearly zero mobility. This therapist worked with the surgeons to get me set up for a manual manipulation. A physical therapist in the hospital measured my mobility at 65 after the manipulation. Does this seem normal?

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If you would have had both knees replaced at the same time you would have qualified for ACUTE Rehab Facility. Ins usually does not pay for Acute Facility with one knee replacement. That is probably why you went to a SKILLED Facility ( Nursing Home ). It sounds like you did not have proper rehab in the first 15 days which would hugely contribute to your less than par rehab. My surgeon told me to rehab as much and as hard as possible the first 2 weeks because you get close to 80% of you new motion at that time. It takes around 12 months to gain all the movement you will gain. Glad you got the manipulation and hope you can perhaps get a second chance at rehab. I had bi TKR and that’s how I found out the difference in facilities. The hospital mistakingly put 1 knee replacement on Ins application for Acute Facility and they refused to allow me to go there. Surgeon appealed it and still said no. He said the per to per person he had to speak with didn’t understand orthopedics. So I had to go to a Skilled Facility which is actually a nursing home. Luckily they sub out their Physical Therapy Department so I did receive decent therapy . I was to be there 2 weeks and checked myself out on day 3. It was a most horrible experience. I had both knees replaced and it took 20 minutes to 2 hours for them to help me out of bed for the restroom. With 2 knee replacements I couldn’t get my legs off the bed and needed assistance. They gave me someone elses pill cup etc. I sure feel sorry for nursing home residents. An elder man down the hall from me kept yelling help help. My husband came in and said go help that man he needs help. That’s when an assistant ran into his room. The dear older gentleman needed to go to the restroom. Wishing you the best recovery from here on out. I am 7 weeks out and feel like I am on schedule but need to start walking outside alot.

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@marthajean

I had total knee replacement a little over one year ago, and a manipulation a couple of months after the surgery. I still have a stiff knee with limited mobility although there has been slight improvement in that it is a little easier to put on socks and boots and I can lift my knee replacement leg a little more during showers. I have stopped therapy temporarily but have been forcing myself to bend my knee, which has resulted in some periodic burning sensations which have become frequent. I believe the pain is from the breaking up of scar tissue. I will be seeing the surgeon for another follow-up later this month. My surgeon said my case was not typical. I am unable to do a round on an exercise bike because of the limited mobility. I was in a nursing/rehabilitation facility for about 15 days and I don’t think I received the kind of physical therapy that I should have received initially. By the time I was released the physical therapist that saw me initially at home questioned what had been done in the rehab facility. I had nearly zero mobility. This therapist worked with the surgeons to get me set up for a manual manipulation. A physical therapist in the hospital measured my mobility at 65 after the manipulation. Does this seem normal?

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Hello @marthajean,

I had my right knee replaced in 2006. Like you, my recovery was long and difficult. I had aggressive scar tissue formation that led to two manipulation procedures. My post-op ROM was 15-45 (I couldn’t straighten my leg either after years of atrophy). I finally broke the scar tissue loose on my own after playing catch football with my friends and landing on my knee funny. All said and done, it was probably 18-24 months after my initial surgery that I found my new “normal.” I now have 0-105 degree ROM and am mostly pain free, except when I overdo it and irritate the remaining scar tissue surrounding the knee.

All of us are so different and how we recover is much different. I was told by my surgeon that it was one of the most aggressive scar tissue formations he had ever seen and one of the worst post-op recovery. That being said, I did end up with good ROM and the elimination of pain, but it was a hard road to get there.

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I am 7 weeks out from double total knee replacements. I seem to be doing ok with my recovery but I do have a question. As far as reading about all the scar tissue problems I’m not really sure how to know if I have scar tissue. I am pushing through the pain to maintain 0 extensions in both. Right knee has been easier all around and at 122. The left knee has been harder to rehab. I have had to go out of town for 3 weeks for a family emergency and am doing the rehab on my own. I hate not going to rehab as I really know it helps me. My left knee ranges
115-117.

How do I know what is scar tissue? I still have some swelling. If I don’t do knee bends etc every day my left knee gets very stiff. It is always a little stiff and working to the pain and through the pain is how I get relief. I still ice a couple of times a day.

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@kibe75

Hi. Just joined today after finding this thread while googling about scar tissue after knee replacement. I am 42 years old and 6 weeks out from a partial knee replacement, at my post op visit this week was basically scolded by the PA I saw about my flexion and extension (9-100) and was told with “only” a partial I should be back to my pre-op of 0-130 and break up the scar tissue. I left that visit so discouraged. I have been doing my physical therapy religiously daily, but the pain has been so bad that I’m in tears most days. The PA upped my physical therapy appointments back to 3x/week. My physical therapist said yesterday that he feels somewhat responsible in the development of the scar tissue because he should have been more aggressive from the beginning but because of the severe pain I was in backed off some hoping that as the pain subsided I would be able to tolerate more. Well, the pain hasn’t subsided but I’m still having to push more through the pain to try to get “normal”. I was in tears at physical therapy from the pushing he was doing on the knee to get it to bend further and to break up that tissue. I’m back on the Diclofenac I was pre surgery to try to help with the inflammation and was given Tramadol to take before PT and at night to help with the pain, unfortunately that doesn’t really help much. I feel like every time I call my surgeon’s office to ask for something more for the pain I’m treated like a drug seeker. I was told that if I don’t make significant progress in the next couple of weeks, I would probably be needing a manipulation. I’ve been through 3 surgeries in the past year (knee scope-where the severe osteoarthritis was discovered, the partial knee replacement, and gallbladder removal), that thinking about anesthesia again makes me ill – and I’m almost out of medical leave benefit. My emotions are all over the place these days. Thanks for letting me vent, for reading, and for helping me to realize I’m not so alone in this journey.

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I just joined this group. 9 weeks ago I underwent a total knee replacement with my right knee. My extension was pretty much lost before surgery and it has been a very painful 2 month journey of PT appointments. These are hell on earth. I scream and writhe in pain. It is awful. Now I have plenty of scar tissue to deal with as well as the end of an infection due to dissolvable stitches not dissolving. I am on a 3rd course of antibiotics. Some days the pain level is okay. After PT I am a mess. Cancelling events appointments etc. this has had a huge impact on my life and just getting back to normal. I guess my question is. Should I seek out an acupuncturist or homeopathic manipulator. My other knee was replaced 9 years ago and I experienced none of these problems. Am open to any ideas. Thanks.

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Hi my knee Is still covered with scar tissue I’m going to try acupuncture twice a week for the next six weeks I’ll let you know the results after that it’s or arthro scopic surgery

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Many thanks. I am anxious to hear how it goes.

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@kibe75

Hi. Just joined today after finding this thread while googling about scar tissue after knee replacement. I am 42 years old and 6 weeks out from a partial knee replacement, at my post op visit this week was basically scolded by the PA I saw about my flexion and extension (9-100) and was told with “only” a partial I should be back to my pre-op of 0-130 and break up the scar tissue. I left that visit so discouraged. I have been doing my physical therapy religiously daily, but the pain has been so bad that I’m in tears most days. The PA upped my physical therapy appointments back to 3x/week. My physical therapist said yesterday that he feels somewhat responsible in the development of the scar tissue because he should have been more aggressive from the beginning but because of the severe pain I was in backed off some hoping that as the pain subsided I would be able to tolerate more. Well, the pain hasn’t subsided but I’m still having to push more through the pain to try to get “normal”. I was in tears at physical therapy from the pushing he was doing on the knee to get it to bend further and to break up that tissue. I’m back on the Diclofenac I was pre surgery to try to help with the inflammation and was given Tramadol to take before PT and at night to help with the pain, unfortunately that doesn’t really help much. I feel like every time I call my surgeon’s office to ask for something more for the pain I’m treated like a drug seeker. I was told that if I don’t make significant progress in the next couple of weeks, I would probably be needing a manipulation. I’ve been through 3 surgeries in the past year (knee scope-where the severe osteoarthritis was discovered, the partial knee replacement, and gallbladder removal), that thinking about anesthesia again makes me ill – and I’m almost out of medical leave benefit. My emotions are all over the place these days. Thanks for letting me vent, for reading, and for helping me to realize I’m not so alone in this journey.

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Saw my surgeon today for a follow up, I’m now 11 weeks out from my partial knee replacement, I was doing really good until Friday. I left PT that day feeling so good about things, I measured 2-120, almost to where I needed to be. Went to work (I work at a hospital), and was telling my co-workers how well everything was goint, then was walking down the hall and felt like my knee gave out with intense pain. I limped to my desk and called my physical therapist. He said he thought the pain might be some scar tissue breaking up since we were finally getting into new territory with my range of motion. Over the weekend, the pain would come and go getting progressively worse each time. Monday at physical therapy he still thought it was from scar tissue, but could definitely fell that i was in more pain. He didn’t measure me on Monday because he knew I wouldn’t be happy with the numbers since I went backwards some. He worked more on some tissue massage than he has since the surgery, in addition to the other things we have been doing.

After a couple of nights with hardly any sleep, I called my surgeon’s office and talked with a triage nurse who recommended I move my 1w wk appt up to today to make sure nothing else was going on. X-ray and everything look good. My surgeon said it is common to slide backwards periodically. While he wasn’t as hard on me as his PA was 5 wks ago, he did say I needed to continue to be very aggressive in physical therapy. In his office today i measured 5-120.

My surgeon restarted me on neurotin hoping that it will help the pain at night so I can sleep. I see him again in a month. He said in no uncertain terms that i have to get my extension back to 0 since that is what it was when I left the operating room.

I’m getting tired if dealing with all the pain, but am very thankful for supportive co-workers who understand that some days I just can’t do it and need to leave early.

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@cobweb

I had my tkr done 5 years ago, still swells especially in water therapy. That is why i went to stem cells for the other knee. All i can say is live with it and try to strengthen the leg as best you can. My surgeon just shrugged his shoulders and said move on. I noticed in my years of dealing with it is some really do well and others do not and they have the same surgeons. Pain pills and i do not get along so working out and doing my exercises is all i can recommend. If i had do overs i would never had the tkr done. Next life will be different.

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If I need another TKR, I will cut it off! Any Dr. That tells you to tough it out, find another doctor! Why Dr.’s Think pain is good, haven’t had a TKR. Pain can be controlled with combination of pain meds, but Dr. won’t prescribed them.

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@kibe75

Hi. Just joined today after finding this thread while googling about scar tissue after knee replacement. I am 42 years old and 6 weeks out from a partial knee replacement, at my post op visit this week was basically scolded by the PA I saw about my flexion and extension (9-100) and was told with “only” a partial I should be back to my pre-op of 0-130 and break up the scar tissue. I left that visit so discouraged. I have been doing my physical therapy religiously daily, but the pain has been so bad that I’m in tears most days. The PA upped my physical therapy appointments back to 3x/week. My physical therapist said yesterday that he feels somewhat responsible in the development of the scar tissue because he should have been more aggressive from the beginning but because of the severe pain I was in backed off some hoping that as the pain subsided I would be able to tolerate more. Well, the pain hasn’t subsided but I’m still having to push more through the pain to try to get “normal”. I was in tears at physical therapy from the pushing he was doing on the knee to get it to bend further and to break up that tissue. I’m back on the Diclofenac I was pre surgery to try to help with the inflammation and was given Tramadol to take before PT and at night to help with the pain, unfortunately that doesn’t really help much. I feel like every time I call my surgeon’s office to ask for something more for the pain I’m treated like a drug seeker. I was told that if I don’t make significant progress in the next couple of weeks, I would probably be needing a manipulation. I’ve been through 3 surgeries in the past year (knee scope-where the severe osteoarthritis was discovered, the partial knee replacement, and gallbladder removal), that thinking about anesthesia again makes me ill – and I’m almost out of medical leave benefit. My emotions are all over the place these days. Thanks for letting me vent, for reading, and for helping me to realize I’m not so alone in this journey.

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Hey You are doing great compared to many others sounds like you just need to hang in there and you’re in going in the right direction I’m envious

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I am 9 weeks out from a TKR an my scar tissue has been a real problem. I have read that heat really helps. Hopefully you are doing that as well as icing. But I have to add I bought a tiny bottle of Serica, moisturizing scar formula. Got it at the local CVS drugstore. A bi pricey but worth it. I massage in the direction of the scar and then opposite, across the scar, massaging the scar tissue underneath. That seems to help as well. I got ahold of some KT tape (at drug store) and my husband watched U-Tube videos on how to apply the tape to your knee. It feels so good and gives you support but only for a day or two. Its so easy to get demoralized but chin up. As has been said here before, just when you think you are turning a corner, its easy to slip 10 steps back. Day by Day is my motto.

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@kibe75

Hi. Just joined today after finding this thread while googling about scar tissue after knee replacement. I am 42 years old and 6 weeks out from a partial knee replacement, at my post op visit this week was basically scolded by the PA I saw about my flexion and extension (9-100) and was told with “only” a partial I should be back to my pre-op of 0-130 and break up the scar tissue. I left that visit so discouraged. I have been doing my physical therapy religiously daily, but the pain has been so bad that I’m in tears most days. The PA upped my physical therapy appointments back to 3x/week. My physical therapist said yesterday that he feels somewhat responsible in the development of the scar tissue because he should have been more aggressive from the beginning but because of the severe pain I was in backed off some hoping that as the pain subsided I would be able to tolerate more. Well, the pain hasn’t subsided but I’m still having to push more through the pain to try to get “normal”. I was in tears at physical therapy from the pushing he was doing on the knee to get it to bend further and to break up that tissue. I’m back on the Diclofenac I was pre surgery to try to help with the inflammation and was given Tramadol to take before PT and at night to help with the pain, unfortunately that doesn’t really help much. I feel like every time I call my surgeon’s office to ask for something more for the pain I’m treated like a drug seeker. I was told that if I don’t make significant progress in the next couple of weeks, I would probably be needing a manipulation. I’ve been through 3 surgeries in the past year (knee scope-where the severe osteoarthritis was discovered, the partial knee replacement, and gallbladder removal), that thinking about anesthesia again makes me ill – and I’m almost out of medical leave benefit. My emotions are all over the place these days. Thanks for letting me vent, for reading, and for helping me to realize I’m not so alone in this journey.

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Oh thanks for that. I really try. It seems like my life is centered around rehabbing this crazy knee. And it’s 9 weeks out. Who knew? The gym helps. Leg press and leg extension machines. Also hanging a 5 pound ankle weight and lying face down on a bed with knee hanging off. Really works. Do this 8 minutes. Not easy but do this bit by bit.

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@kibe75

Hi. Just joined today after finding this thread while googling about scar tissue after knee replacement. I am 42 years old and 6 weeks out from a partial knee replacement, at my post op visit this week was basically scolded by the PA I saw about my flexion and extension (9-100) and was told with “only” a partial I should be back to my pre-op of 0-130 and break up the scar tissue. I left that visit so discouraged. I have been doing my physical therapy religiously daily, but the pain has been so bad that I’m in tears most days. The PA upped my physical therapy appointments back to 3x/week. My physical therapist said yesterday that he feels somewhat responsible in the development of the scar tissue because he should have been more aggressive from the beginning but because of the severe pain I was in backed off some hoping that as the pain subsided I would be able to tolerate more. Well, the pain hasn’t subsided but I’m still having to push more through the pain to try to get “normal”. I was in tears at physical therapy from the pushing he was doing on the knee to get it to bend further and to break up that tissue. I’m back on the Diclofenac I was pre surgery to try to help with the inflammation and was given Tramadol to take before PT and at night to help with the pain, unfortunately that doesn’t really help much. I feel like every time I call my surgeon’s office to ask for something more for the pain I’m treated like a drug seeker. I was told that if I don’t make significant progress in the next couple of weeks, I would probably be needing a manipulation. I’ve been through 3 surgeries in the past year (knee scope-where the severe osteoarthritis was discovered, the partial knee replacement, and gallbladder removal), that thinking about anesthesia again makes me ill – and I’m almost out of medical leave benefit. My emotions are all over the place these days. Thanks for letting me vent, for reading, and for helping me to realize I’m not so alone in this journey.

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You sound just like me. You keep thinking that it will all get better as the days pass by. But no. It really puts you back to square one and it is disheartening. My knee pain at night is off the charts. Still have ICY HOT patches on from applying them at 4:00 am. I would really welcome a good night’s sleep. Got sleep to heal, right? Well, how does that work I ask? Go easy on yourself. Its great you can leave early some days. Also try and put your leg up during the day…..Scar tissue is the worst!

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