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?

@dixiedog

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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Wow, Thank You-what a crazy quest for all of us who continue to suffer- I use a MMJ cream that is massaged into and around the knee- It provides temporary relief.

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@damewocane

Wow, Thank You-what a crazy quest for all of us who continue to suffer- I use a MMJ cream that is massaged into and around the knee- It provides temporary relief.

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What is MMJ cream? I have used a few creams including one prescription one.

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@amberpep

Hi there …. yes, I’ve had scar tissue develop also. It developed slowly over time, but by the time I hit the 1 year mark, my surgeon went in – arthroscopically – and cleaned it up. But, it never was right, and in another year I had to have a revision – a totally new replacement. Since then, my knee could not be any better. I don’t know why this happens to some and not to others … but after several other options had been tried, including the arthroscopic surgery, I opted to just do the revision …. I’m glad I did.
abby

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Hello amberpep, I hope you don't mind but I have a couple questions because I'm having serious scar tissue problems and may need another replacement. So are you saying that you had scar tissue build-up after your first replacement but then no scar tissue build-up after your second replacement? Also, did you notice improvement after the arthroscopy? And why was it that they/you decided to have a second replacement? Thanks for helping, Dave

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@dixiedog

What is MMJ cream? I have used a few creams including one prescription one.

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Medical marijuana ( by Rx only in Florida)

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@gailfaith

gaIlfaith here responding: Yes I had both knees replaced in 2004 and 2006 but I did not have ANY problems with the recovery. After my first, before I left the hospital I was on the passive bending machine but off hand I don’t remember how much bend I got but by the time I left there, but it was above 90 degrees. At the nursing home, the doctor there didn’t know what she was doing !!! and she got very upset with me if I turned the machine there to anything over 90 degrees. When I got home, I lowered the seat on my stationary bike and stretched it more that way. I eventually end up with 124 degrees and my current therapist (for my monotonic dystrophy) measured it recently and now I have even more, something near 129. After my second one, I left the hospital with 123 and when I got to a DIFFERENT nursing home, they said I didn’t need the machine with that much bend already , and by the time I left there I had 132 with just PT. Now I have even more like maybe 135. I don’t think even before the surgery that it was much if anything above that naturally! Sorry to make you all jealous but should I have to get revisions on either knee in the future, I will be apprehensive that I might have problems in the future. The surgeon I had for both just had surgery on one of HIS knees (not TKR) and on the internet they showed his surgery. Not many people get to the see the inside of their surgeon’s knee! My visit last summer to the surgeon, the X-rays showed no wear at that time! I will be 81 next month and hopefully the original TKR’s will last me for the rest of my life, but as I have mentioned previously, right now I am doing a lot of walking for the Dystrophy . I am now up to 45 miles since Aug 13, ’06 (that only includes measured walks, not day to day walking where-ever). And yes, I am thanking the Lord for that!

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This is Lori. I had written before about neuropathy. My foot pain seems to be getting better very slowly. Neurologist, podiatrist, foot and ankle orthopedist all said there was nothing they could identify to cause the pain down the inside of my foot and weak painful feeling when I walk more than a block. I am doing a lot of strengthening on my tkr right knee from surgery 8 months ago, and am up to 75 pounds on squat sets. I got up to 50 miles round trip on my road bike before the weather got too miserable to ride anymore. The problem is that every single morning I have to go through the herl slides pulling up with a strap to get my knee to bend to where I want it to. Without assistance, it is about 128 or 130 lieing on my back, but if I sm doing some activity outside and my foot gets slightly caught up against grass or snow or something, it is incredible pain because the knee is forced to bend the amount that it really needs to clear my leg from stuff on uneven ground when
I am walking. This tells me it is not bending far enough. When I do heel slides, I have to go through a lot of pain and finally pull my heel up to within a thumb to index finger width distance from my butt. I think that distance is about 135 degrees. It is frustrating and I wonder if I have to continue to do these painful heel slides forever every day, or will it finally bend enough on its own? I hope other people read this and respond. Not sure how this works to get other people to see this.

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Do you mean scar tissue inside the knee preventing rom, or visible scar tissue on the outside?

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@damewocane

Medical marijuana ( by Rx only in Florida)

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@damewocane Is MMJ cream the same as CBD cream? What amount of the active ingredient does it have to be effective? I have some I bought at Whole Foods and it does not really seem to help much. It's a pretty small amount of the CBD.
JK

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One to One- 50% tihc to 50% cannaboid (inactive)

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It sounds like scar tissue is more of a problem than i was told. I had knee replacement in june. Had manipulation. Was td was able to bend 120, but then scar tisdue built back up. Now tbinking of going back in to try to remove. Seeing a different doctor.

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Mine was in August. Was told by PT and Doc that scar tissue is your body's way of protecting a 'hurt.' It may take 1 to 2 years to convince your body that you don't need 'protecting' as much. Break it up EVERY DAY. Move it constantly; little even helps (like 1 inch swinging it back and forth). My scar tissue has slowed down and now I deal with the muscle that runs from your hip over your quad, ACROSS THE KNEE CAP, tightening up and pushing down on the knee cap. That really hurts; we stretch it out at PT more than bending. I stretch it out across the bed, the couch, as I walk, etc. See anatomy pics to get a clearer pic of what is happening. Swelling in the quad hurts the knee cap. This pain is due to me actually beginning to live my life; sometimes I overdo it. Even walking too much without a cane an trigger huge pain in kneecap area. So now NAPROXEN helps (tylenol not quite strong enough) but don't need opioids as it isn't nerve pains, it's pressure on kneecap. So keep going to PT and stretch those quads every few hours just like you did ice in the beginning. It may take 1 to 2 YEARS. Hang in. Learning as I go.

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@gmajudy

Mine was in August. Was told by PT and Doc that scar tissue is your body's way of protecting a 'hurt.' It may take 1 to 2 years to convince your body that you don't need 'protecting' as much. Break it up EVERY DAY. Move it constantly; little even helps (like 1 inch swinging it back and forth). My scar tissue has slowed down and now I deal with the muscle that runs from your hip over your quad, ACROSS THE KNEE CAP, tightening up and pushing down on the knee cap. That really hurts; we stretch it out at PT more than bending. I stretch it out across the bed, the couch, as I walk, etc. See anatomy pics to get a clearer pic of what is happening. Swelling in the quad hurts the knee cap. This pain is due to me actually beginning to live my life; sometimes I overdo it. Even walking too much without a cane an trigger huge pain in kneecap area. So now NAPROXEN helps (tylenol not quite strong enough) but don't need opioids as it isn't nerve pains, it's pressure on kneecap. So keep going to PT and stretch those quads every few hours just like you did ice in the beginning. It may take 1 to 2 YEARS. Hang in. Learning as I go.

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Hello,
I don't know all the issue with your circumstances but you may want to ask your PT about some manual therapy- my professional experience and from personal experience is that you can stretch and stretch (with no results) but until you release the underlying tissue (fascia)- your issue will continue. Some examples of manual therapy include: cupping, instrument assisted soft tissue mobilization (IASTM), or Rock Blade- there are a few other types of this, use of foam roller, or even deep tissue work.
I don't know how they exactly measure the amount of scar tissue nor how they determine it's no longer forming. My clinical experience is that this is very subjective but a therapist can manually feeling tissue tightness. But everyone has their own degree of scar tissue formation due to the degree of collagen in their body and how those bonds form after trauma. I feel fortunate to have not have this issue specifically but I do have less then desired outcomes after my knee replacement, now coming up on two years. If you are not icing after you stretch, you should check with your PT about that as for me, even two years later, ice is still the most helpful for pain management. Better than any medication- prescription or over the counter.

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@irol

This is Lori. I had written before about neuropathy. My foot pain seems to be getting better very slowly. Neurologist, podiatrist, foot and ankle orthopedist all said there was nothing they could identify to cause the pain down the inside of my foot and weak painful feeling when I walk more than a block. I am doing a lot of strengthening on my tkr right knee from surgery 8 months ago, and am up to 75 pounds on squat sets. I got up to 50 miles round trip on my road bike before the weather got too miserable to ride anymore. The problem is that every single morning I have to go through the herl slides pulling up with a strap to get my knee to bend to where I want it to. Without assistance, it is about 128 or 130 lieing on my back, but if I sm doing some activity outside and my foot gets slightly caught up against grass or snow or something, it is incredible pain because the knee is forced to bend the amount that it really needs to clear my leg from stuff on uneven ground when
I am walking. This tells me it is not bending far enough. When I do heel slides, I have to go through a lot of pain and finally pull my heel up to within a thumb to index finger width distance from my butt. I think that distance is about 135 degrees. It is frustrating and I wonder if I have to continue to do these painful heel slides forever every day, or will it finally bend enough on its own? I hope other people read this and respond. Not sure how this works to get other people to see this.

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Hello. I had a TKR in October. You are talking about your foot. Since my surgery my foot had either had numbness, tingling or so HOT I can barely stand it. It also has a feeling of a ball under it when I walk. Different feelings every day. Painful.
My knee is really painful as well. So hard to get a good nights rest.
Is that what you are doing?
You are getting really good flexion the best I have ever done “cold” is 120 and 124 with PT.
I am worried because I cannot go for walks anymore but maybe it will all come with time?

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have you seen a neurologist? That would be my first stop. And your flexion is very good ! Why are you worried about it? Lots of people never get past 120. And I hear that improvement continues for the first year, so that is something to look forward to. Just keep moving. I had my second knee done late September, and I just got to 120. and 125 with some help.

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@zakcat

have you seen a neurologist? That would be my first stop. And your flexion is very good ! Why are you worried about it? Lots of people never get past 120. And I hear that improvement continues for the first year, so that is something to look forward to. Just keep moving. I had my second knee done late September, and I just got to 120. and 125 with some help.

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I saw a neutologist but think the results were not accurate. He said he was sure it had nothing to do with knee surgery before he even did any tests! He was very negative and treated me like I was crazy and overdramatic and did not like rhe zillion questions I kept asking him (because I was curious about all parts of rhe nerve conduction test and muscle stimulus tests he did). It showrd that one nerve was slow or not at all responding, but that nerve Is not connected to the area where I have symptoms. Anyway, my worry about flexion is that I wonder if it is expected at this point post surgery, to have to force-flex my knee every single morning for 15 to 30 minutes (with painful heel slides) to get it to bend enough to be comfortable enough to go down stairs and move around for the day, and I am almost 8 months out from surgery!

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@irol

I saw a neutologist but think the results were not accurate. He said he was sure it had nothing to do with knee surgery before he even did any tests! He was very negative and treated me like I was crazy and overdramatic and did not like rhe zillion questions I kept asking him (because I was curious about all parts of rhe nerve conduction test and muscle stimulus tests he did). It showrd that one nerve was slow or not at all responding, but that nerve Is not connected to the area where I have symptoms. Anyway, my worry about flexion is that I wonder if it is expected at this point post surgery, to have to force-flex my knee every single morning for 15 to 30 minutes (with painful heel slides) to get it to bend enough to be comfortable enough to go down stairs and move around for the day, and I am almost 8 months out from surgery!

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I hate Doctors like that. I just switch when they act like that. I’m three years TKR, still with tightness, swelling. I do get 102, as far as it’s going to go. I don’t do stairs very well, walk sideways. Gabapentin has helped with the swelling. Maybe another round of PT may help ? Good Luck

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