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?

@bill54321

Thank you John. I am dumb. what i knee ablation?My knees are so good the term has never come up.

Jump to this post

Hi @bill54321 – You are not dumb! Sometimes it is easy for a discussion to be misinterpreted. I was just commenting on the movie poster in the post that you mentioned you didn't get it. If you are not having any problems or pain with your knees then it is not likely that you need a knee ablation. Here is some information that explains a knee ablation.

Could Radiofrequency Ablation Provide Relief for Painful Osteoarthritis in Your Knees?
–https://health.clevelandclinic.org/could-radiofrequency-ablation-provide-relief-for-painful-osteoarthritis-in-your-knees/

Sorry if I added some confusion with my post.

REPLY

Thank you for the article on Radio frequency for the knee . I thought the original complaint mentioned it Nothing to do with your response. I have been retired too long. Thanks. i do need to look into this again instead of injection type for my back.

REPLY
@lamerex4

I had my first knee replacement at the age of 47 years in 2001. I was plagued by spasms on the outer aspect of my calf caused by scar tissue. After a closed manipulation and traditional PT I got relief with acupuncture and osteopathic manipulation. I know many physical therapists practice under the theory that you have to push through the pain, but when you are a prolific scar tissue creator, I feel a more gradual, alternative approach is better.

Jump to this post

I so agree with you. I am 3.5 months out tkr and one month from manipulation. I had multiple surgeries in this knee prior to tkr and developed adhesions very quickly. I still struggle with hot swollen joint and limited mobility . In fact i got a hamstring sprain from PT and lost more ROM. I finally decided i would do my own PT and osteopathic manipulation ( good friend is DO and doing it for me). Very frustrating and i am now back on Walker instead of cane to work better on my gate. I think it would have been much better with less agressive therapy as it set up severe inflammatory reactions and more adhesions ( on blood thinners so no anti inflammatories ). Heres hoping.

REPLY
@damewocane

Steroids, 6day blister pack-Felt major relief. All is temporary. Advised it will be 6 weeks before I know if knee ablation worked. 3 weeks and counting.

Jump to this post

@damewocane We are rooting for you. I hope that the needed relief does come. Keep up your optimism.
JK

REPLY
@snowdoc2001

I so agree with you. I am 3.5 months out tkr and one month from manipulation. I had multiple surgeries in this knee prior to tkr and developed adhesions very quickly. I still struggle with hot swollen joint and limited mobility . In fact i got a hamstring sprain from PT and lost more ROM. I finally decided i would do my own PT and osteopathic manipulation ( good friend is DO and doing it for me). Very frustrating and i am now back on Walker instead of cane to work better on my gate. I think it would have been much better with less agressive therapy as it set up severe inflammatory reactions and more adhesions ( on blood thinners so no anti inflammatories ). Heres hoping.

Jump to this post

Dear snowdoc. Your problem is the pits. Should not wish it on a dog. Listen to me. I am 90 yrs old and retired with 40 years experience as a physical therapist. I have 2 total knees after 60 yrs old. They are the most tender surgery ever the first 2-3 days. Movement and walking are essensial. But you must never push to extremes. Manual techniques followed by light progressive weights of 2,3,5 lbs is the standard.. Some old fashion therapies vs sports medicine can often times get you back on the right path. First, gentle quadriceps supine with little movement is best. This is usually done in conjunction with manual passive movement to tolerance. A little vibration and tender loving kneading of the joint helps. Some physical therapist go through the motions. If you are lucky to get one, others have educated hand that can not be taught. I mention this, because trust is so important. If you are slow to adapt, certain simple exercise techniques help. Imagine having your therapist rest your knee as you try to extend. Then, relaxing the leg in his hands as you relax into flexion. At this new position you try to extend the knee without the therapist letting it move. You relax again and let the knee move into flexion with just a little kind help from the therapist. This is repeated until you can not tolerate the flexion help after the active attempt to move against resistsnce. After the session, have the knee wrapped in heat and have Electrical stimuation with 4 electrodes crossed your knee(like an X) usinf Interferential modulated surged current for 20 minutes. Follow the stim with deep friction-kneading massage. Again, supine, use a light ankle wt to do set of 10 (1-3). Walk afterwards for correctness of heel strike and toe of with a walker. At home, use ice(cold) for pain and Use a continuous flexion machine for an hour or tolerance.. You should alway ave a home health service when you go home from the hospital.n After that, medicare covers 12 viisits a pause and another 17 visits. From there you should be in the spa with a recumbant bike, treadmill other core and upper trunk strengthening. This should bring you you about 12 months and 100 degrees flexion and -5-10 degrees extension. and a cane as needed. Avoid squats except into a chair repetative exercise with a hand support. Walking down hill lets the femur gluid forward on the tibia. So. have support when you do so. Going up a hill is not as much trouble. I understand they are doing ablations for some bad TK. I think this should come after 6 months. I hope this helps. You m7ust be active but to tolerance

Liked by dixiedog

REPLY
@zakcat

A friend has bilateral knee replacements in April, and she is suffering too. And can't take pain meds except for Tylenol! She is depressed too. I am 2 months post TKR, and my knee hurt all night again. They tell me it gets better! Maybe Its a waiting game?

Jump to this post

I have had success with nortriptyline for sleeping at night. It relieves nerve pain. Amitriptyline is another one that is similar. I used just 10 mg.

REPLY
@hospdoc

This is the first time I have ever joined a discussion group for medical issue or anything else for that matter. I had a left TKR on 9/6/17. In 2015 I tore my left meniscus and had surgery done. Since that arthroscopic repair I had a chronic flexion contraction; my left leg was permanently bent at 15 degrees unable to straighten of fully bend the leg. I walked with a chronic limp. I still managed to stay very active; running, hiking, biking. The arthritis continued to get worse and the limping was affecting my hip and back. A total knee replacement was my only option. I bit the bullet and found a surgeon. I was able to straighten my knee but not bend it; the best I have gotten is 85 degrees. I had a manipulation done on Halloween but despite doing aggressive physical therapy the stiffness returned and my knee is just the same as it was before. I had a follow up yesterday with my surgeon and they say there is not much more that can be done. They are going to put me in a dynasplint and see how that works.
I cried all the way home and at work today wondering how am I going to function like this. I have to walk with a walker and can basically do nothing; not even walk my dog. I am so overwhelmed by this. I am only 46 and cannot think that this is how it is going to be the rest of my life. This sucks to say the least.
I got a call from a friend who is an orthopedic surgeon and does sports medicine. He told me about a therapy called Astym therapy. He said that it has been used for people who developed arthrofibrosis following knee replacement and they had a fairly good result with it. I will be looking into this for myself but you can find a lot more info on the internet about this. I found a research paper that looked at 16 patients who had good outcomes with this. It is noninvasive so it wouldn’t hurt to at least try this. I hope this information helps.

Jump to this post

I am 6 weeks from surgery for TKR and PT has been horrible. I simply cannot get flexion even assisted beyond 96°.
There is NO way I could endure manipulation and intense PT.
Searching for alternate ways to increase flexion I found 10Xtherapy.com. it is a rental unit I am considering in the event my surgeon.presents me the manipulation route.
You may investigate this alternate route.doesnt cost to investigate.

REPLY
@ruthannejoan

I am 6 weeks from surgery for TKR and PT has been horrible. I simply cannot get flexion even assisted beyond 96°.
There is NO way I could endure manipulation and intense PT.
Searching for alternate ways to increase flexion I found 10Xtherapy.com. it is a rental unit I am considering in the event my surgeon.presents me the manipulation route.
You may investigate this alternate route.doesnt cost to investigate.

Jump to this post

6 weeks is still early. Keep up P.T. Minimize pain pills. Ask for interferential electrical current from P.T

REPLY
@sharonbrenna

I have had success with nortriptyline for sleeping at night. It relieves nerve pain. Amitriptyline is another one that is similar. I used just 10 mg.

Jump to this post

After a few days I should add that the nortriptyline took away the sharp pains, but I still have aching at night. Ice helps a lot. I use a Donjoy clear three cold therapy machine.

REPLY
@kimbies1204

Sigh…getting nervous as the procedure is tomorrow. I’ve dealt with this for 2 1/2 years and am nervous it won’t help. I’m trying to stay positive and hopeful, maybe just sullen because it’s Christmas and I was supposed to go home but can’t now that they’ve rescheduled the surgery for tomorrow. So, alone and anxious.

Merry Christmas everyone!

Jump to this post

How are you doing after your arthroscopic lysis of adhesions? My doctor has recommended that for me. I have had a TKR in November and an MUA in January and still have limited range of motion. I would love to hear how it worked for you.

REPLY

I’ve have knee issues for going on 4.5 yrs. Had TKR in right knee 1/16. It became infected and had revision. Had that knee scoped due to excessive scar tissue. New scar tissue developed. In November 2017 had right knee replaced. That knee had to be revised as tibial trey came loose. Throughout this time there were brief periods of time in which the pain was manageable. In July 2019 I learned that both knees were infected with a bacteria that likely entered my system during dental surgery in 2016. The gestation period for this bacteria is 4-6 yrs. I was prescribed Cephalexin 3000 mg per days orally for 5 months by my Infectious Disease Doctor. This did not impact infection and I had a picc line in my right arm and was administered an IV antibiotic that I had to discontinue after 2 weeks due to the effect it was having on my liver. Three weeks ago I started a new IV antibiotic that administers at a low dose 24 hours a day. I am supposed to have picc line removed this Thursday. Knee pain has diminished in the last 2 weeks. My Orthopedic is going to draw a synovial sample on 3/24/20 to see if the infection is cleared. I am still experiencing some discomfort by what I believe is lingering scar tissue. Saw an article today concerning the use of cold laser treatment for scar tissue. Curious if anyone has has any success with this technique in the reduction of pain associated with scar tissue? Will update later.

REPLY
@cheris

I experienced sciatica with both knee replacements. First knee it lasted about 4 months. This knee I am still dealing with it and it has been since Dec. I have been going to PT. Got an injection which helped a little. Doing lots of exercises. I find the thing that helps the pain the most is just walking. ROM was at 119 4 weeks out and is staying at that level. I can fully extent the knee. I would be doing great except for the sciatic pain. They seem to think it is a combination of SI joint inflamation and periformis also.

Jump to this post

If you had a tourniquet during surgery. It could be trauma to the sciatic nerve.

REPLY
@rmeddings

I’m afraid a second opinion will only lead to the same results for me also. As my joints look perfect on X-ray. I suppose I just keep hanging on to the hope that there is someone out there that will have the knowledge to help me. As I sit and write this at 4:00 am , I wonder if my Dr’s even have any idea, or really believe what an ordeal this has been , or what it’s like to go to bed each night, and wake each morning, with the same old pain !!
I really hate that anyone else is going thru this, but at he same time, it strengths me know that there is someone else in the world that does understand my pain.. I have the gabapentin route, I was on Percocet for nine months ( as you say it only dulls the pain) I have tried nerve blocks,also. All to to avail..
I’m still holding on to the hope that someday this nightmare will end for me, and all of you ,who are going thru this.

Jump to this post

I'm experiencing the same problem. Constant pain after tkr. Its been 3 years after arthroscopic surgery to scrape the scar tissue. I was blissfully out of pain for 2 weeks only for it to come back with a vengeance. Now I take gabapentin & percoset with only a little relief. My rom is excellent. Just have pain when I do any activity. Did anyone have results with anything else?

REPLY
@contentandwell

@damewocane We are rooting for you. I hope that the needed relief does come. Keep up your optimism.
JK

Jump to this post

Thanks JK-along with everything we are all going through, I haven't had the heart to comment, but now can reply. The ablation did not work, in fact it introduced more pain . I have been barely managing and then one month ago, the surgeon suggested one more shot, which was hellish and left my knee bruised and angry. The last shot was that he suggested a synovial ganglion implant and I ran. When will this suffering end… i've lost so much. Last resort, new surgeon suggests metal allergy test-which will be $400+ out of pocket as insurance doesn't cover it. The idea being that if it was so then a new total new knee replacement w/o said allerg yinducing components would -perhaps be a remedy. Any one else ?

REPLY

Catalytic Hydrolasis or desolving is more common.Google different metals and metal on metal, metal on plastic, etc.

Liked by damewocane

REPLY
Please login or register to post a reply.