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

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 ?

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@damewocane I'm sorry that the ablation did not work, that must have been discouraging, particularly since you were in greater pain afterward.
When you say a "synovial ganglion implant" that sounds like more than a shot, is it? I had synovial shots prior to my TKRs and they did help. There are a couple of brands but I found that Synvisc seemed to work best for me, although that could just have been a coincidence, perhaps the doctor or PA administering the shot of the other brand didn't do as good a job.

Certainly, I would not do another TKR without having the allergy testing, it could be fruitless if that's the problem. Is your flex still very low too?
JK

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Keep up with the massage, I used baby oil and vibrating massager everynight watching TV the first 10 weeks, I barely have any bumps ( scar tissue) also I used Vitamin E cream, you can barely see my scar.

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I’ve posted on this forum off and on over the past two years or so. I wanted to give an update on what looks like a definitive answer as to the multitude of issues with the replacement that I have been facing.

Short synopsis is that at 53 I had a torn meniscus at the root from a running injury. That was almost immediately turned into I had arthritis bad enough that I needed a partial knee replacement.

The physicians office forgot to order the replacement parts the day of the surgery and on the day of the rescheduled surgery, I fell in the parking lot. I woke up from what should have been a partial knee replacement with a total knee replacement, a very swollen knee and swollen ankle.

Two months after the surgery, I still could not stand or walk without pain and my ROM was less than 110. I was diagnosed with arthofibrosis and had another surgery to remove scar tissue. Significant pain and PT later I was able to get my knee bending more, but still could not stand or walk.

Multiple other doctors and 18 months later, I was diagnosed with a broken foot and shredded tendon from the parking lot fall from the original surgery. A bone fragment in my foot from the fall shredded the tendon. However, I still can not stand or walk without significant pain. At 56 now, I went from running and cross-fit to being able to walk less than 5,000 steps a day.

More doctors, tests and appointments later, the doctors are thinking I have a stress reaction or stress fracture in my tibia. I then found a doctor who deals with periprothetic fractures. He took a bunch of X-rays with my knee in positions I never had before. He then told me what you never want to hear after this surgery…

My implant is crooked. It’s not loose. It’s cemented in good – but at the wrong angle. It was installed crooked to the tune of slightly more than 5 degrees. The forces on my tibia and ankle are too much. My pain will never go away until it comes out and by the way, your good side hip is now a mess because your standing on one leg.

I told the doctor I’m only 56 and what happens at 66 when the revision wears out. He told me to go home and think if I wanted the revision. I sent him a follow up question in the portal asking the same thing a week ago and haven’t heard back. But I think I know the answer – it can’t be done.

So for those of you who have been following this story along and are still struggling with the pain – you now know one way this story ends.

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Some ortohpedist do these total knees all day long. The yhave plenty of back up parts. I would seek another physicain,I am a retired PT with two wonderful. knees 20 years ago.. I am 90.yrs old. Go to the facility and surgeon who does only knees all day long. Sounds like you have a once in a while Surgeon.

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I live in Texas – in between Dallas and Houston and have now been to 11 doctors. I have Orthopaedic centers in both cities doing diagnosis and confirmation. Both major centers only joint replacement. But the initial surgery was done by a major university surgeon, just not one in the major city

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Contact Dr, Junik, orthopedist in Alburqueque, NM. He is the best. No scar tissue after surgery because they spin the fluid and pour it back into the wound closure. He does nothing all day long but Total Knees. I have two of his in 2002 and 2004. I hear these poor stories and wonder why?

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@melcpa86

I’ve posted on this forum off and on over the past two years or so. I wanted to give an update on what looks like a definitive answer as to the multitude of issues with the replacement that I have been facing.

Short synopsis is that at 53 I had a torn meniscus at the root from a running injury. That was almost immediately turned into I had arthritis bad enough that I needed a partial knee replacement.

The physicians office forgot to order the replacement parts the day of the surgery and on the day of the rescheduled surgery, I fell in the parking lot. I woke up from what should have been a partial knee replacement with a total knee replacement, a very swollen knee and swollen ankle.

Two months after the surgery, I still could not stand or walk without pain and my ROM was less than 110. I was diagnosed with arthofibrosis and had another surgery to remove scar tissue. Significant pain and PT later I was able to get my knee bending more, but still could not stand or walk.

Multiple other doctors and 18 months later, I was diagnosed with a broken foot and shredded tendon from the parking lot fall from the original surgery. A bone fragment in my foot from the fall shredded the tendon. However, I still can not stand or walk without significant pain. At 56 now, I went from running and cross-fit to being able to walk less than 5,000 steps a day.

More doctors, tests and appointments later, the doctors are thinking I have a stress reaction or stress fracture in my tibia. I then found a doctor who deals with periprothetic fractures. He took a bunch of X-rays with my knee in positions I never had before. He then told me what you never want to hear after this surgery…

My implant is crooked. It’s not loose. It’s cemented in good – but at the wrong angle. It was installed crooked to the tune of slightly more than 5 degrees. The forces on my tibia and ankle are too much. My pain will never go away until it comes out and by the way, your good side hip is now a mess because your standing on one leg.

I told the doctor I’m only 56 and what happens at 66 when the revision wears out. He told me to go home and think if I wanted the revision. I sent him a follow up question in the portal asking the same thing a week ago and haven’t heard back. But I think I know the answer – it can’t be done.

So for those of you who have been following this story along and are still struggling with the pain – you now know one way this story ends.

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Hi it's been a while since I've posted, but after reading your post I wonder if I am going through the same thing. I had a TKR back in January of 2019, a MUA in February, a revision in May to put a smaller cushion & in November arthroscopic surgery to remove scar tissue. I've had home & out patient therapy, nothing seems to help. I'm on a cane my knee hurts to touch. I can barely bend it & it hurts to walk. Sometimes my whole left leg hurts. I've had several xrays they always say everything is going well. I even had a second opinion to Gainesville (Shands) they too say things are going according. The doctor say my severe pain could be due to all of the surgeries I've had right behind the other. I go to pain management, but I'm tired of taking pills they only put me to sleep & when I wake up the pain is still there.

Liked by damewocane

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@bill54321

Contact Dr, Junik, orthopedist in Alburqueque, NM. He is the best. No scar tissue after surgery because they spin the fluid and pour it back into the wound closure. He does nothing all day long but Total Knees. I have two of his in 2002 and 2004. I hear these poor stories and wonder why?

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I’m pretty sure it’s not quite as simple as you make it out to be! No matter how good the surgeon, some people still have significant problems after TKR. You’re fortunate you did not!

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@lynnwade54

Hi it's been a while since I've posted, but after reading your post I wonder if I am going through the same thing. I had a TKR back in January of 2019, a MUA in February, a revision in May to put a smaller cushion & in November arthroscopic surgery to remove scar tissue. I've had home & out patient therapy, nothing seems to help. I'm on a cane my knee hurts to touch. I can barely bend it & it hurts to walk. Sometimes my whole left leg hurts. I've had several xrays they always say everything is going well. I even had a second opinion to Gainesville (Shands) they too say things are going according. The doctor say my severe pain could be due to all of the surgeries I've had right behind the other. I go to pain management, but I'm tired of taking pills they only put me to sleep & when I wake up the pain is still there.

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I feel the same way and have been thru the mill of so many procedure, I have very similar lousy results. Keep believing there Must be some way to fix this…

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@damewocane @lynnwade54 – and here is more to the story

The doctor who is saying my leg is crooked is the Section Chief of Adult Reconstruction Surgery at Houston Methodist. His office called and told me to come in after I sent the metal allergy test results and the implant labels. They said in addition to the implant being crooked, I’m allergic to it. I told them that the original doctor said I had a titanium implant and the allergy test results were fine for the implant. The PA then said “we will double check with our device rep, but we are fairly certain your original surgeon was wrong”

I’ll find out more in 3 weeks when I go see him.

Liked by damewocane

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@melcpa86

@damewocane @lynnwade54 – and here is more to the story

The doctor who is saying my leg is crooked is the Section Chief of Adult Reconstruction Surgery at Houston Methodist. His office called and told me to come in after I sent the metal allergy test results and the implant labels. They said in addition to the implant being crooked, I’m allergic to it. I told them that the original doctor said I had a titanium implant and the allergy test results were fine for the implant. The PA then said “we will double check with our device rep, but we are fairly certain your original surgeon was wrong”

I’ll find out more in 3 weeks when I go see him.

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Some reaction is hydrolytic Hydrolosis….The bone melts around the implant extension. This is not rocket science. It is loose.

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I had TKR of my left knee in October 2019. I had a raised scar after about 4 months which I was told is a keloid. I have an appointment coming up soon with a dermatologist and my surgeon told me that I will need to take a cortisone injection. I cannot bend the knee not even to 90 degrees. It is like 86 degrees. I also still have a pain on the right side of the left knee where the artificial knee is put. I also get a pain behind the knee. I tried home remedies but has not helped the scar much. I did PT for 6 weeks and I was also doing exercises at home. On May 20, 2020 I had TKR of my right knee and I am afraid that I am starting to develop scar tissue as the area around the scar is becoming hard. I still go for PT. I am getting the same kind of pain as the left knee behind the right knee too. The surgeon took X'rays of both knees and says there is nothing wrong. Any suggestions to fix the scar and pain behind the knees.

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@jnoronha

I had TKR of my left knee in October 2019. I had a raised scar after about 4 months which I was told is a keloid. I have an appointment coming up soon with a dermatologist and my surgeon told me that I will need to take a cortisone injection. I cannot bend the knee not even to 90 degrees. It is like 86 degrees. I also still have a pain on the right side of the left knee where the artificial knee is put. I also get a pain behind the knee. I tried home remedies but has not helped the scar much. I did PT for 6 weeks and I was also doing exercises at home. On May 20, 2020 I had TKR of my right knee and I am afraid that I am starting to develop scar tissue as the area around the scar is becoming hard. I still go for PT. I am getting the same kind of pain as the left knee behind the right knee too. The surgeon took X'rays of both knees and says there is nothing wrong. Any suggestions to fix the scar and pain behind the knees.

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Hello @jnoronha, Welcome to Connect. You will notice that we have moved your post to another discussion with the same topic. If you click the VIEW & REPLY button at the bottom of the email notification for this post it will take you to the discussion Scar tissue after knee replacement where you can meet other members discussing scar tissue after a knee replacement.

@contentandwell, @bill54321, @babette, @mwatts91757 and other members may be able to share their thoughts and offer some suggestions for you.

@jnoronha do you still have swelling with the TKR of your right knee done this past May?

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@jnoronha

I had TKR of my left knee in October 2019. I had a raised scar after about 4 months which I was told is a keloid. I have an appointment coming up soon with a dermatologist and my surgeon told me that I will need to take a cortisone injection. I cannot bend the knee not even to 90 degrees. It is like 86 degrees. I also still have a pain on the right side of the left knee where the artificial knee is put. I also get a pain behind the knee. I tried home remedies but has not helped the scar much. I did PT for 6 weeks and I was also doing exercises at home. On May 20, 2020 I had TKR of my right knee and I am afraid that I am starting to develop scar tissue as the area around the scar is becoming hard. I still go for PT. I am getting the same kind of pain as the left knee behind the right knee too. The surgeon took X'rays of both knees and says there is nothing wrong. Any suggestions to fix the scar and pain behind the knees.

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@jnoronha @johnbishop I have had two TKRs and not had a scar tissue problem or perhaps a very small one.

I have not been able to get my flex to more than 120 + or -. My orthopedist said he could do a Lysis treatment which is an outpatient procedure to take out scar tissue if I wanted to get a little more flex. I am not sure though if the problem is from scar tissue of if I just didn't do enough PT at home so I decided what I have is functional enough. I didn't dread the surgery as much as the recovery afterward. Your flex is much lower though so you should ask your orthopedist about that.

I have never heard of cortisone injections after TKRs but perhaps they do use them to treat your type of problem. I had them numerous times prior to my surgeries.

If your pain continues you may want to consider a second opinion from a highly regarded orthopedist. If you do choose to do that make sure you get one who is very well rated. Generally, the best are at the large university associated medical centers or other large hospitals in the city but there are some that are more local too. I live in southern NH and there are a couple of orthopedists up here that have had phenomenal success and are very highly regarded, both in different cities from where I live. I do go to Boston for most of my care, either at Mass General, or at Brigham and Women's which is now affiliated with Mass General. My orthopedist is there.
JK

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@contentandwell

@jnoronha @johnbishop I have had two TKRs and not had a scar tissue problem or perhaps a very small one.

I have not been able to get my flex to more than 120 + or -. My orthopedist said he could do a Lysis treatment which is an outpatient procedure to take out scar tissue if I wanted to get a little more flex. I am not sure though if the problem is from scar tissue of if I just didn't do enough PT at home so I decided what I have is functional enough. I didn't dread the surgery as much as the recovery afterward. Your flex is much lower though so you should ask your orthopedist about that.

I have never heard of cortisone injections after TKRs but perhaps they do use them to treat your type of problem. I had them numerous times prior to my surgeries.

If your pain continues you may want to consider a second opinion from a highly regarded orthopedist. If you do choose to do that make sure you get one who is very well rated. Generally, the best are at the large university associated medical centers or other large hospitals in the city but there are some that are more local too. I live in southern NH and there are a couple of orthopedists up here that have had phenomenal success and are very highly regarded, both in different cities from where I live. I do go to Boston for most of my care, either at Mass General, or at Brigham and Women's which is now affiliated with Mass General. My orthopedist is there.
JK

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2I am confused.As a retired PT, wha tis normal for flexion. 120 degree is a good target.If you have 120 degrees flexion,, Simple contract, hold to pressure and release repeated 5-10 times will easily get more motion,IF you had it before. My suggestion is to get your PT to give your a program YOU WILL DO at home. You will gain and improve to about 12 months, Don't have to do a lot at home. 30 minutes exercise and walk 30 minutes a day, if a walker is needed. stand erect.That is a minimum. Are you doing it?

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