@bengalady I doubt that PT would help much now but if your orthopedic doctor thinks it might he will prescribe it. My orthopedic doctor is huge on riding a recumbent bike, getting the seat as far up as possible. I have used that a lot. I also do pool walking/jogging. When I do that I lift my leg up high to get a good knee bend.
I did actually have slight improvement — a few degrees — beyond that first year.
JK

You who have a decent bend ,please be thankful . I still have less than 60 degrees and the pain- unmanaged is off the charts-2 years out from original tkr.

Hi Justin. I hope youre still around on these boards- I read your story about the end stage arthritis you had at such an early age. My daughter was born with JRA, now they call it JIA (juvenille rhumatoid arthritis). She had knee destruction by the time she was 12. At 37 she had bi later TKR. Now two years later one leg is totally frozen. she cant bend the knee at all. tomorrow she starts physical therapy again. I dont know what they can do since I believe she had scar tissue growth like yourself. How do they tell if theres scar tissue? her xray looks good. Do you get an MRI? I was thinking of taking her back to the surgeon who did the surgery. Im concerned if she cant bend it soon it will be permanently frozen.
any suggestions? Thanks. this board is very helpful though Im reading posts from 2017 I hope you can see this in Dec. 2019.

Hi…I am 2 1/2 years post-op, bilateral TKR and have had problems since day 1. They finally found both knees to be full of scar tissue, so I’m scheduled for the left, scope lysis of adhesions next week. Does anyone have experience with this procedure? I don’t want to mess up the recovery with too much or too little pt, exercise, etc. And I live by myself, what should I expect for recovery? Thank you!

@kimbies1204 – problems with your TKR since Day 1 sounds like a tough road. You'll note I moved your post on adhesions after total knee replacement (TKR) here to an existing discussion on scar tissue after TKR so you can connect with members like @leithlane @bengalady @cheril252 @damewocane @contentandwell and others who may have input your situation with scar tissue and the scope lysis of adhesions.

Will you be doing any patient education at the hospital before this procedure? What day will you be having it?

I had that done and my Dr. was surprised there was so much scar tissue. I used my stationary bike every three hours after procedure (tiring, but I did not want the scar tissue to come back.) It worked quite well and I have been diligent about lunges, bike, walking, etc but it has come back after a year ( two years post TKR). Without the Lysis I probably would have very little movement. Good luck.

Thank you! I am scheduled for the left arthroscopic lysis of adhesions, Thursday. I’m torn on recovery. CPM or not, aggressive PT or passive, etc. The last 2 1/2 years have been miserable and I’m holding onto this as possible help. I don’t want to mess it up.

I’m so sorry it has come back for you. I’m struggling with my post care. Aggressive PT or no, CPM or not, etc. The last 2 1/2 years have been miserable.

I would go very aggressive. CPM. Everything. Ice after all care. Let us know how it goes.

I had an arthroscopic lysis of adhesions a year ago. My knee now easily bends to 125. However, the PT was brutal. A 10 hour a day routine for a month starting the day after surgery. I would be at the PT office 3x a week for 2 hour sessions where he would force my leg to move to the number the surgeon gave him. I learned how to cry silently as he pushed. PT then went to 8 hours, then 6. I was discharged at 3 hours of PT a day and told keep it up – don’t loose it. I now go to a rowing gym and row an hour 4 days a week and do an hour of stretching at home 4-5 times a week now.

Thank you for your reply. I struggle because there are so many differing opinions on recovery. Some believe aggressive PT others say absolutely not. That’s why I’m so frustrated, I don’t know which direction to go. Both philosophies make sense to me.

To everyone confused about PT:

I was very lucky to come across this British site during the run-up to my revision. It's been my experience that aggressive PT just continues to traumatize an already very acute injury, the one cause by the surgery itself. Their views on post-op exercise and PT saved me this time around. I'm against aggressive PT and so is my surgeon:
https://bonesmart.org/forum/threads/post-operative-exercise-–-the-bonesmart-view.25463/
https://bonesmart.org/forum/threads/bonesmart-philosophy-for-sensible-post-op-therapy.37103/

Hello @babette
As PT, I appreciate your comments and insight and you are right about PTs sometimes being too aggressive. I have seen PTs push way to hard and they wonder why things are worse (rebound effect). Sometimes other things need to occur (massage, soft tissue work, etc) before stretching. But there is the flip side in which some people are too passive and barely do anything and then blame the doctor or PT for their lack of progress. I do think there needs to be more education and explanation upfront about all the pros and cons before surgery. With my knee replacement surgery (and I am a PT) not one single person mentioned any risks other than infection or rejection including the lingering pain and scar tissue build up or sizing issue with the prosthesis (my issue). I never realized that a prosthesis could be too small or large! I'm not even sure how scar tissue is determined other than going back into the joint, which in itself is another traumatic event for the joint.

I do know from my experience- persistence and continuing your exercises daily, pushing a bit past your tolerance, is necessary.

I am now totally against being extremely aggressive- and even in clinic practice, I never saw the value to being over aggressive. It's the patient that leaves the clinic in agony, not the therapist. There is no literature or evidence to say this aggressive approach results in more desired outcomes. I do feel that you have to shove gently- push to your limit but then a bit further. For those that have a low or poor pain tolerance, you have to push through.

There is current evidence that indicates that CPM (continuous passive motion) machines are not effective in more desired outcomes in uncomplicated knee replacements. I haven't see any literature about the use of machines in more problematic knees. The biggest issue is that the machine is passive and active motion is always preferred over passive for lots of reasons.