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?

@damewocane

Hi all , checking in again-still in nasty pain managed by a pain dr who monitors me bi weekly with urinalysis which is very invasive but have no choice if I want the controlled Rrx. i have been waiting fo an ablation of the nerves under the scar tissue of my knee. Now the insurance co. has refused to pay citing that this procedure is "too experimental" I will have to self pay approx, $4,000. if I want to try it-no guarantees and will be needed very 6 -to 12 months as nerves regrow. Has any one here had this?. This whole thing- 2 years now, is bankrupting me as the bills Never end and I am unable to hold a job anymore because of the pain…

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I had to appeal my insurance companies denial TWICE before they agreed to pay for the nerve block to see if it helps prior to the ablation. The second appeal was to an external review agency, and the doctor they hired agreed that this was the only thing left for them to try for my pain. It took almost 5 months from the time my doctor submitted the prior-authorization to the time I was able to have the block – but oh, the relief I had with the block!! I enjoyed the few hours I had pain-free!!! In August I had the ablation – I would say it took away about 80% of my pain, so I'm calling it a success. I'm now able to walk again and work out, which I hadn't been able to do for around 3 years or so prior to the ablation. Keep at it and good luck!

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@kibe75

I had to appeal my insurance companies denial TWICE before they agreed to pay for the nerve block to see if it helps prior to the ablation. The second appeal was to an external review agency, and the doctor they hired agreed that this was the only thing left for them to try for my pain. It took almost 5 months from the time my doctor submitted the prior-authorization to the time I was able to have the block – but oh, the relief I had with the block!! I enjoyed the few hours I had pain-free!!! In August I had the ablation – I would say it took away about 80% of my pain, so I'm calling it a success. I'm now able to walk again and work out, which I hadn't been able to do for around 3 years or so prior to the ablation. Keep at it and good luck!

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Bless you for your info here! That's an amazing story! You give me hope. I will follow your lead.

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@damewocane

Yes, I would appreciate hearing from any one else who knows of this. First will be the nerve test and then a week or so later, I am to go back and report if there was any relief, the cost for that out of pocket is $320.00-If that works, then they will go in to do the ablation.

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@damewocane I hope this procedure is successful for you. Please let us know, either way. I feel very fortunate to not have had the problems that many people have experienced.
JK

Liked by damewocane

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I had the genicular nerve test on my knee last week under fluoroscopy. It was painful but only lasted about 20 mins and then sent home w/a pain journal. I was told that the first 24 hrs are the most important to monitor to help the M.D. decide whether or not you are a candidate for the ablation I was pleasantly surprised to feel relief within approx.30 minutes. After 2 yrs of chronic pain, I thought-wow this it!…. I felt so good that I decided to do some holiday shopping and braved a mall, the 2nd hour passed almost pain free and I was elated. The third hour, I felt myself regressing a bit and came home thinking:"Did I over do it?" There were no post op instructions. At the end of the 4th hour my pain was back full on at a 9-10. I was devastated. My understanding was that it"works" for approx 70 % of the candidates and confusedly diagnosed myself as not one of those fortunates. Anxious for some answers, I met with the P.A. today who reviewed my notes …was told that I Am a candidate for ablation. I am surprised as the relief was so short lived. My insurance co. refuses to pay as mentioned before hand and Yes, it is performed at a surgery center with "twilight" anesthesia and will cost me out of pocket approx $4,000.00, and there are no guarantees.

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@damewocane

I had the genicular nerve test on my knee last week under fluoroscopy. It was painful but only lasted about 20 mins and then sent home w/a pain journal. I was told that the first 24 hrs are the most important to monitor to help the M.D. decide whether or not you are a candidate for the ablation I was pleasantly surprised to feel relief within approx.30 minutes. After 2 yrs of chronic pain, I thought-wow this it!…. I felt so good that I decided to do some holiday shopping and braved a mall, the 2nd hour passed almost pain free and I was elated. The third hour, I felt myself regressing a bit and came home thinking:"Did I over do it?" There were no post op instructions. At the end of the 4th hour my pain was back full on at a 9-10. I was devastated. My understanding was that it"works" for approx 70 % of the candidates and confusedly diagnosed myself as not one of those fortunates. Anxious for some answers, I met with the P.A. today who reviewed my notes …was told that I Am a candidate for ablation. I am surprised as the relief was so short lived. My insurance co. refuses to pay as mentioned before hand and Yes, it is performed at a surgery center with "twilight" anesthesia and will cost me out of pocket approx $4,000.00, and there are no guarantees.

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I had this done and prior to the ablation, I had two nerve blocks to determine if I was a candidate. I had great results with the first block with no pain for 6 days (first tme of no pain in 4 years) and about 3 days with second one. Unfortunately, I didn't have much success with the ablation as the pre-ablation issue persists. I was disappointed as I was assured success if the blocks works. That price seems so high and I'd explore other options. Unfortunately, there are no guarantees. I do wish you well to finding some success.

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I appreciate your input dixiedog -This is my fear- So much of a gamble… what other options have you pursued?

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I had TKR on my right knee in early 2017. Had all kinds of physical therapy, home, in and out patient; also had a personal trainer which seemed to help more at the time and did some lap swimming once a week or so but not enough to brag about. Still have a stiff knee but a little less. I use a cane but more for balance because of the lack of flexion in the knee. I do walk every day for about 40 minutes (however, not conscious walking; have to walk to and from my office to transportation). I had some pain off and on – also different types of pain – until several weeks ago. The pain was not enough to take pain killers beyond the occasional aspirin though, although it did wake me up at night at times pulsating. During the last 12 months I've lost a large amount of weight; I am still in a medically supervised weight loss program at NYU Medical Center in NYC. I do think losing weight helps. About one year ago I invested in a hot tub which is outdoors and runs 24-7 continuously ($30,000 plus with all that I had to do to support it — concrete patio, exterior lights, 22 Kw generator, etc.); did squats in the hot tub (which sometimes resulted in pain afterwards because I probably squatted too far). I try to get in the tub daily either early in the A.M. (like 3:30 A.M. or after 10:00 P.M. – I commute). i have not returned to surgeon in over 2 years. It is still difficult to put on shoes/boots because of my lack of bend but it is slightly better. On the commuter bus (90+ minutes each way) I try to sit in the rear seat in the aisle whenever I can get it or in an aisle seat so that I can stretch my leg out. I now stand on the subway (easier than having people inadvertently knocking against or stepping on the foot that is swung out for my 15 minute subway ride). I cannot say definitively why the pain has disappeared but will tell you what I've been doing now. Started mixing organic Moringa oleifera leaf powder (1 tiny scoop, about a teaspoon) in my meal replacement protein shakes twice a day. It does not taste great but the vanilla shake masks the taste to a great degree. Since I started taking this (have not discussed this with my medical team yet though) I started noticing less discomfort and actually no pain, and feel I am walking more freely. I just started forcing myself to walk around at home and in my office without the cane. I believe that the Moringa leaf powder is reducing the inflammation. Yes I do have scar tissue but I am sure there was more inflammation before (sometimes my knee appeared swollen to others). You can read up on this on line but the important thing is to purchase it from a good source. I also started drinking matcha green tea (purchased the powder and make it myself). You can also include the powder in cereal, shakes, etc. I eat one or two healthy meals a day (small amount of poultry, fish or meat, broccoli, cautiflower, kale, spinach greens, etc.). However you can read up on this too. I do believe, however, that the Moringa leaf powder has most to do with my feeling better.

Liked by dixiedog

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@marthajean

I had TKR on my right knee in early 2017. Had all kinds of physical therapy, home, in and out patient; also had a personal trainer which seemed to help more at the time and did some lap swimming once a week or so but not enough to brag about. Still have a stiff knee but a little less. I use a cane but more for balance because of the lack of flexion in the knee. I do walk every day for about 40 minutes (however, not conscious walking; have to walk to and from my office to transportation). I had some pain off and on – also different types of pain – until several weeks ago. The pain was not enough to take pain killers beyond the occasional aspirin though, although it did wake me up at night at times pulsating. During the last 12 months I've lost a large amount of weight; I am still in a medically supervised weight loss program at NYU Medical Center in NYC. I do think losing weight helps. About one year ago I invested in a hot tub which is outdoors and runs 24-7 continuously ($30,000 plus with all that I had to do to support it — concrete patio, exterior lights, 22 Kw generator, etc.); did squats in the hot tub (which sometimes resulted in pain afterwards because I probably squatted too far). I try to get in the tub daily either early in the A.M. (like 3:30 A.M. or after 10:00 P.M. – I commute). i have not returned to surgeon in over 2 years. It is still difficult to put on shoes/boots because of my lack of bend but it is slightly better. On the commuter bus (90+ minutes each way) I try to sit in the rear seat in the aisle whenever I can get it or in an aisle seat so that I can stretch my leg out. I now stand on the subway (easier than having people inadvertently knocking against or stepping on the foot that is swung out for my 15 minute subway ride). I cannot say definitively why the pain has disappeared but will tell you what I've been doing now. Started mixing organic Moringa oleifera leaf powder (1 tiny scoop, about a teaspoon) in my meal replacement protein shakes twice a day. It does not taste great but the vanilla shake masks the taste to a great degree. Since I started taking this (have not discussed this with my medical team yet though) I started noticing less discomfort and actually no pain, and feel I am walking more freely. I just started forcing myself to walk around at home and in my office without the cane. I believe that the Moringa leaf powder is reducing the inflammation. Yes I do have scar tissue but I am sure there was more inflammation before (sometimes my knee appeared swollen to others). You can read up on this on line but the important thing is to purchase it from a good source. I also started drinking matcha green tea (purchased the powder and make it myself). You can also include the powder in cereal, shakes, etc. I eat one or two healthy meals a day (small amount of poultry, fish or meat, broccoli, cautiflower, kale, spinach greens, etc.). However you can read up on this too. I do believe, however, that the Moringa leaf powder has most to do with my feeling better.

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I had a TKR in both knees almost four years ago and have been suffering from persistent pain and stiffness for at least three years and was diagnosed with arthritis fibrosis. A good friend of mine is a physical therapist and she has been researching this condition. She recently discovered a trial that dealt with persistent pain following TKR:
Arthroplasty
Persistent pain after total knee arthroplasty (TKA) has been speculated to be a result of central sensitization5. The authors of 1 randomized controlled trial (RCT) found that, of 464 patients with primary osteoarthritis scheduled for elective TKA, 80 demonstrated signs of central sensitization6. These 80 patients were randomized to treatment with duloxetine (30 mg daily for 6 weeks) or no duloxetine (control group). The duloxetine group demonstrated significantly greater improvement from 2 to 12 weeks in all pain outcome measures assessed (p < 0.05). The 2 groups did not differ significantly with respect to adverse events6.

I presented this information to my family doctor and he has given me a prescription of duloxetine (Cymbalta) to try. Has anyone else tried this approach?

Liked by dixiedog

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@exflyer

I had a TKR in both knees almost four years ago and have been suffering from persistent pain and stiffness for at least three years and was diagnosed with arthritis fibrosis. A good friend of mine is a physical therapist and she has been researching this condition. She recently discovered a trial that dealt with persistent pain following TKR:
Arthroplasty
Persistent pain after total knee arthroplasty (TKA) has been speculated to be a result of central sensitization5. The authors of 1 randomized controlled trial (RCT) found that, of 464 patients with primary osteoarthritis scheduled for elective TKA, 80 demonstrated signs of central sensitization6. These 80 patients were randomized to treatment with duloxetine (30 mg daily for 6 weeks) or no duloxetine (control group). The duloxetine group demonstrated significantly greater improvement from 2 to 12 weeks in all pain outcome measures assessed (p < 0.05). The 2 groups did not differ significantly with respect to adverse events6.

I presented this information to my family doctor and he has given me a prescription of duloxetine (Cymbalta) to try. Has anyone else tried this approach?

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Thank you for the information. I am not sure why my pain has ceased (or perhaps ceased temporarily).

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@exflyer

I had a TKR in both knees almost four years ago and have been suffering from persistent pain and stiffness for at least three years and was diagnosed with arthritis fibrosis. A good friend of mine is a physical therapist and she has been researching this condition. She recently discovered a trial that dealt with persistent pain following TKR:
Arthroplasty
Persistent pain after total knee arthroplasty (TKA) has been speculated to be a result of central sensitization5. The authors of 1 randomized controlled trial (RCT) found that, of 464 patients with primary osteoarthritis scheduled for elective TKA, 80 demonstrated signs of central sensitization6. These 80 patients were randomized to treatment with duloxetine (30 mg daily for 6 weeks) or no duloxetine (control group). The duloxetine group demonstrated significantly greater improvement from 2 to 12 weeks in all pain outcome measures assessed (p < 0.05). The 2 groups did not differ significantly with respect to adverse events6.

I presented this information to my family doctor and he has given me a prescription of duloxetine (Cymbalta) to try. Has anyone else tried this approach?

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I have been on Cymbalta for years (I have Bipolar Disorder) and I take a lot more than that and none of my 4 knee surgeries have been painless – ever – since 2002! Good luck!

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@damewocane

I appreciate your input dixiedog -This is my fear- So much of a gamble… what other options have you pursued?

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Quite a bit of therapy, dry needling, massage therapy (who has been great) foam roller. I’m trying cupping and this is something one can do on your own so that cost is low. I’m going to ask about something called ASTYM – there are other names for it (ISTYM, rock blade) but it involves using a blunted instrument and working the soft tissue. I feel I need to work my iliotibial band and distal rectus femoris muscle (one of the front knee muscles). No clue if it will help my rubber band tightness issue but I know both are tight still despite all the stretching I do.

Liked by damewocane

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@damewocane

I appreciate your input dixiedog -This is my fear- So much of a gamble… what other options have you pursued?

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I should have also mentioned I did CBD oil (Drops, roll on, balm that you rub on the knee) with THC, high grade, for three months with no change thus did not continue. This was most disappointing as a few of my coworkers got good results with CBD. But there is no clear evidence to support it despite the current market and popularity. Prior to this, I did turmeric supplement, both pill and liquid forms, with no change in pain after 2-3 months (but not at the same time as CBD). Like CBD, others got great results. So for some reason my body doesn’t even respond. And for me to keep taking all these products without any results, is too costly and wasteful.

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@dixiedog

Quite a bit of therapy, dry needling, massage therapy (who has been great) foam roller. I’m trying cupping and this is something one can do on your own so that cost is low. I’m going to ask about something called ASTYM – there are other names for it (ISTYM, rock blade) but it involves using a blunted instrument and working the soft tissue. I feel I need to work my iliotibial band and distal rectus femoris muscle (one of the front knee muscles). No clue if it will help my rubber band tightness issue but I know both are tight still despite all the stretching I do.

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Please keep me up to date on results

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Keep it up give us updates we are all wondering how to get relief

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@dixiedog

Quite a bit of therapy, dry needling, massage therapy (who has been great) foam roller. I’m trying cupping and this is something one can do on your own so that cost is low. I’m going to ask about something called ASTYM – there are other names for it (ISTYM, rock blade) but it involves using a blunted instrument and working the soft tissue. I feel I need to work my iliotibial band and distal rectus femoris muscle (one of the front knee muscles). No clue if it will help my rubber band tightness issue but I know both are tight still despite all the stretching I do.

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I stretch that band several times a day oike i used to do with iceing. Past
scar tissue breaking, but that band swells and oushes against kneecap. The
pain is in the swelling pushing the knee cap. That's what my doc and PT
person says.

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