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?

Interested in more discussions like this? Go to the Joint Replacements Support Group.

P.S. Well, this is interesting. I did a quick Google search of "TKR and MRI" and this was one of the first articles that popped up: https://pubs.rsna.org/doi/full/10.1148/rg.2015140216

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I had a titanium hip replacement in 2007. Years later I had an MRI and the results stated that it was inconclusive ( not the word used but in a nutshell) due to the implant. It was the most ridiculous radiology report I've ever read. It may have shown the surrounding areas but the device definitely had a negative impact on the MRI. So much so, that I wondered why they even did it knowing I had a replacement.

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@rjas44

Hello. I am new to the forum and i still 2 yrs later experience sharp behind the knee and the outer part of my knee as well. Hasn't gotten better nor has it gotten worse since surgery. I've done 3 stints of rehab and now starting number 4. I have no idea what's wrong nor does the 3 surgeons I've had look at it for different opinions. I am not ready for a revision but they said its an option. Quite frustrated at this point.

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Has anyone mentioned you may have the wrong fit? I had a revision 3 months ago after a year and one half of misery, pain, limp etc. I also did extensive PT, hoping it would be better and also I was told my problem was scar tissue and given exercises for that.
My revision doctor thought probably my fit was wrong and that was the problem plus tibia was slightly crooked and had to be filed down. Minimal scar tissue but he removed it as well.
I don’t know if any of this is helpful but I feel the revision was worth it, best of luck

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@bevinauburn

Has anyone mentioned you may have the wrong fit? I had a revision 3 months ago after a year and one half of misery, pain, limp etc. I also did extensive PT, hoping it would be better and also I was told my problem was scar tissue and given exercises for that.
My revision doctor thought probably my fit was wrong and that was the problem plus tibia was slightly crooked and had to be filed down. Minimal scar tissue but he removed it as well.
I don’t know if any of this is helpful but I feel the revision was worth it, best of luck

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@bevinauburn poor fit can definitely be a problem. The typical TKR uses an “off the shelf” knee, whereas newer technologies create images of the natural knee and the new knee is built to match the original. This was why I chose Conformis, but I think there are other custom knees. I am very happy with my knee, it’s been great.
JK

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@contentandwell

@bevinauburn poor fit can definitely be a problem. The typical TKR uses an “off the shelf” knee, whereas newer technologies create images of the natural knee and the new knee is built to match the original. This was why I chose Conformis, but I think there are other custom knees. I am very happy with my knee, it’s been great.
JK

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I spoke with my doctor before getting my knee replacement 1-23-2019) about proper fit and he assured me that surgeons have a protocol they used to ensure a proper fit. I’m hoping that’s true since I never heard of a custom fit knee replacement. I’m definitely going to look into that when I get my other knee done and thank you for that info! I’ve heard they are called Conformus. I wonder if a surgeon can be sued if they put the wrong size in because it is their job to ensure that doesn’t happen. Just a thought.

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@debbraw

Hi @damewocane - I agree with @contentandwell - I physically winced when I read your post about twisting your knee. I am feeling for you. Does anything help - icing it? getting on the bike? massage? I don't know if you've seen this thread but you may want to check out some alternative therapies:
https://connect.mayoclinic.org/discussion/cold-laser-therapy-for-scar-tissue-after-knee-replacement/?orderby=DESC#chv4-comment-stream-header
Wishing you the best. Please keep us posted.

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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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@dkapustin

I spoke with my doctor before getting my knee replacement 1-23-2019) about proper fit and he assured me that surgeons have a protocol they used to ensure a proper fit. I’m hoping that’s true since I never heard of a custom fit knee replacement. I’m definitely going to look into that when I get my other knee done and thank you for that info! I’ve heard they are called Conformus. I wonder if a surgeon can be sued if they put the wrong size in because it is their job to ensure that doesn’t happen. Just a thought.

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@dkapustin The spelling is Conformis. If you google it you can find the surgeons who use that knee. I was fortunate, I live in southern NH so Boston is about 55 miles away -- actually a bit further for the orthopedic surgeon. The doctor I went to though is one of the developers of the knee. He was absolutely great. The first time I was scheduled for surgery I got to the hospital, was all ready to be brought in the operating room, IV in and all, and he came to me and told me he couldn't do it because my platelet count was too low. I was heartbroken but I would much rather have a cautious surgeon than one who might have gone ahead with it anyway.
I knew a woman who had a problem for a couple of years before a different orthopedic surgeon figured it out and fixed it. The knee itself was not a problem I don't think, but the stem that goes up to the knee was too long or something to that effect.
I have no idea if they can be sued for something like that. I think negligence has to be proven.
JK

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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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@sraley1 Don't you just love how surgeons know everything before and during surgery then, suddenly, they have *no clue* as to why we are in pain, numb, etc. Anyway, your story sounds a bit like mine, but I'm only out 8 months. My first 4 months were like yours but the tight, numb "band" above my kneecap hasn't improved. Since it seems I need my other knee replaced soon anyway, I'm going to get a second opinion.

In the meantime, what I have found to be most helpful is riding a stationary bike at home. I really warms up the knees and I feel a lot better on days I've done that exercise. I bought the bike on Amazon for less than 200 and it's a gem.

Best wishes for healing.

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@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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