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?

@kibe75

Hi. Just joined today after finding this thread while googling about scar tissue after knee replacement. I am 42 years old and 6 weeks out from a partial knee replacement, at my post op visit this week was basically scolded by the PA I saw about my flexion and extension (9-100) and was told with “only” a partial I should be back to my pre-op of 0-130 and break up the scar tissue. I left that visit so discouraged. I have been doing my physical therapy religiously daily, but the pain has been so bad that I’m in tears most days. The PA upped my physical therapy appointments back to 3x/week. My physical therapist said yesterday that he feels somewhat responsible in the development of the scar tissue because he should have been more aggressive from the beginning but because of the severe pain I was in backed off some hoping that as the pain subsided I would be able to tolerate more. Well, the pain hasn’t subsided but I’m still having to push more through the pain to try to get “normal”. I was in tears at physical therapy from the pushing he was doing on the knee to get it to bend further and to break up that tissue. I’m back on the Diclofenac I was pre surgery to try to help with the inflammation and was given Tramadol to take before PT and at night to help with the pain, unfortunately that doesn’t really help much. I feel like every time I call my surgeon’s office to ask for something more for the pain I’m treated like a drug seeker. I was told that if I don’t make significant progress in the next couple of weeks, I would probably be needing a manipulation. I’ve been through 3 surgeries in the past year (knee scope-where the severe osteoarthritis was discovered, the partial knee replacement, and gallbladder removal), that thinking about anesthesia again makes me ill – and I’m almost out of medical leave benefit. My emotions are all over the place these days. Thanks for letting me vent, for reading, and for helping me to realize I’m not so alone in this journey.

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@kibe75, I completely understand your frustration. I had a TKR in 2006 when I was 19. My initial recovery was quite frustrating and difficult. I had to have two manipulations from aggressive scar tissue formation. I was battling an atrophied knee joint from end-stage arthritis that started when I was nine years old. The muscle and ligament atrophy combined with aggressive scar tissue formation made for an extremely difficult recovery. It took well over a year that included manipulations, pain management, and physical therapy to get to my new normal, which I am happy to report is 0-110 degree ROM. I know the frustration you are experiencing, but it can get better, even if it doesn't seem like it will.

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@kibe75

Hi. Just joined today after finding this thread while googling about scar tissue after knee replacement. I am 42 years old and 6 weeks out from a partial knee replacement, at my post op visit this week was basically scolded by the PA I saw about my flexion and extension (9-100) and was told with “only” a partial I should be back to my pre-op of 0-130 and break up the scar tissue. I left that visit so discouraged. I have been doing my physical therapy religiously daily, but the pain has been so bad that I’m in tears most days. The PA upped my physical therapy appointments back to 3x/week. My physical therapist said yesterday that he feels somewhat responsible in the development of the scar tissue because he should have been more aggressive from the beginning but because of the severe pain I was in backed off some hoping that as the pain subsided I would be able to tolerate more. Well, the pain hasn’t subsided but I’m still having to push more through the pain to try to get “normal”. I was in tears at physical therapy from the pushing he was doing on the knee to get it to bend further and to break up that tissue. I’m back on the Diclofenac I was pre surgery to try to help with the inflammation and was given Tramadol to take before PT and at night to help with the pain, unfortunately that doesn’t really help much. I feel like every time I call my surgeon’s office to ask for something more for the pain I’m treated like a drug seeker. I was told that if I don’t make significant progress in the next couple of weeks, I would probably be needing a manipulation. I’ve been through 3 surgeries in the past year (knee scope-where the severe osteoarthritis was discovered, the partial knee replacement, and gallbladder removal), that thinking about anesthesia again makes me ill – and I’m almost out of medical leave benefit. My emotions are all over the place these days. Thanks for letting me vent, for reading, and for helping me to realize I’m not so alone in this journey.

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Thank you for sharing I applaud your courageDeb

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@kibe75

Hi. Just joined today after finding this thread while googling about scar tissue after knee replacement. I am 42 years old and 6 weeks out from a partial knee replacement, at my post op visit this week was basically scolded by the PA I saw about my flexion and extension (9-100) and was told with “only” a partial I should be back to my pre-op of 0-130 and break up the scar tissue. I left that visit so discouraged. I have been doing my physical therapy religiously daily, but the pain has been so bad that I’m in tears most days. The PA upped my physical therapy appointments back to 3x/week. My physical therapist said yesterday that he feels somewhat responsible in the development of the scar tissue because he should have been more aggressive from the beginning but because of the severe pain I was in backed off some hoping that as the pain subsided I would be able to tolerate more. Well, the pain hasn’t subsided but I’m still having to push more through the pain to try to get “normal”. I was in tears at physical therapy from the pushing he was doing on the knee to get it to bend further and to break up that tissue. I’m back on the Diclofenac I was pre surgery to try to help with the inflammation and was given Tramadol to take before PT and at night to help with the pain, unfortunately that doesn’t really help much. I feel like every time I call my surgeon’s office to ask for something more for the pain I’m treated like a drug seeker. I was told that if I don’t make significant progress in the next couple of weeks, I would probably be needing a manipulation. I’ve been through 3 surgeries in the past year (knee scope-where the severe osteoarthritis was discovered, the partial knee replacement, and gallbladder removal), that thinking about anesthesia again makes me ill – and I’m almost out of medical leave benefit. My emotions are all over the place these days. Thanks for letting me vent, for reading, and for helping me to realize I’m not so alone in this journey.

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@JustinMcClanahan what did you dibun terms if pain management? I think that is my biggest frustration right now, I'm on diclofenac twice daily, 1000 mg tylenol every 6 hours and neurotin at bedtime and it just isn't enough, my pain is still constantly at a 4-5 resting and 6 or so when walking, exercising.

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I also developed scar tissue, immediately following surgery, I was told it was genetic. I refused manipulation as I had such severe swelling and bruising after surgery. With aggressive and very painful PT I was able to get to 110 degrees, which I am at currently, at 11 weeks out. I have 2 PT sessions left and then will continue with my home exercising program. Hopefully all this snow will melt soon so I can begin some serious walking

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@kibe75

Hi. Just joined today after finding this thread while googling about scar tissue after knee replacement. I am 42 years old and 6 weeks out from a partial knee replacement, at my post op visit this week was basically scolded by the PA I saw about my flexion and extension (9-100) and was told with “only” a partial I should be back to my pre-op of 0-130 and break up the scar tissue. I left that visit so discouraged. I have been doing my physical therapy religiously daily, but the pain has been so bad that I’m in tears most days. The PA upped my physical therapy appointments back to 3x/week. My physical therapist said yesterday that he feels somewhat responsible in the development of the scar tissue because he should have been more aggressive from the beginning but because of the severe pain I was in backed off some hoping that as the pain subsided I would be able to tolerate more. Well, the pain hasn’t subsided but I’m still having to push more through the pain to try to get “normal”. I was in tears at physical therapy from the pushing he was doing on the knee to get it to bend further and to break up that tissue. I’m back on the Diclofenac I was pre surgery to try to help with the inflammation and was given Tramadol to take before PT and at night to help with the pain, unfortunately that doesn’t really help much. I feel like every time I call my surgeon’s office to ask for something more for the pain I’m treated like a drug seeker. I was told that if I don’t make significant progress in the next couple of weeks, I would probably be needing a manipulation. I’ve been through 3 surgeries in the past year (knee scope-where the severe osteoarthritis was discovered, the partial knee replacement, and gallbladder removal), that thinking about anesthesia again makes me ill – and I’m almost out of medical leave benefit. My emotions are all over the place these days. Thanks for letting me vent, for reading, and for helping me to realize I’m not so alone in this journey.

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Pain management was also difficult for me. I am one of the "lucky ones" that metabolize pain medications rather quickly, so they have a short period of effectiveness for me. This creates an issue because I not only require higher doses at times, but more frequent, which is less than ideal because higher doses of powerful pain medications can lead to addictions. I was on long-acting oxycontin as a base medication with Percocet for breakthrough pain, I believe, it was 12 years ago. Pain medications and the way we process them are so variant from person-to-person. Also I elevated my leg with constant icing to help with swelling, which helped the throbbing pains subside a bit.

I think my pain was quite high (constant 6-10 range), which hindered my rehab, for the first year because I had to also have two manipulations. The manipulations were far more painful than the initial surgery. For me, from what I can remember, it was around the year mark when my pain really tapered off and my ROM found its new normal. I did not use pain medications for the entire year, I believe it was around 6-8 months and I was tapered off with the help of my physicians. I am happy to report that once a year or so passed, I have been nearly pain free ever since. I am 12 years out and my knee joint still looks the same structurally as it did in the first year – so no revision in sight as of now.

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@tudorbeach

I also developed scar tissue, immediately following surgery, I was told it was genetic. I refused manipulation as I had such severe swelling and bruising after surgery. With aggressive and very painful PT I was able to get to 110 degrees, which I am at currently, at 11 weeks out. I have 2 PT sessions left and then will continue with my home exercising program. Hopefully all this snow will melt soon so I can begin some serious walking

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Nice work! 110 degrees despite scar tissue and swelling is quite impressive. 110 is what I am at permanently after two manipulations and a full leg brace that had hand cranks in it that I would turn to force it to bend for my physical therapy. While I would have loved to have more, 110 degrees allows me to be physically active and does not hinder any of that activity. Keep up the good work.

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@kibe75

Hi. Just joined today after finding this thread while googling about scar tissue after knee replacement. I am 42 years old and 6 weeks out from a partial knee replacement, at my post op visit this week was basically scolded by the PA I saw about my flexion and extension (9-100) and was told with “only” a partial I should be back to my pre-op of 0-130 and break up the scar tissue. I left that visit so discouraged. I have been doing my physical therapy religiously daily, but the pain has been so bad that I’m in tears most days. The PA upped my physical therapy appointments back to 3x/week. My physical therapist said yesterday that he feels somewhat responsible in the development of the scar tissue because he should have been more aggressive from the beginning but because of the severe pain I was in backed off some hoping that as the pain subsided I would be able to tolerate more. Well, the pain hasn’t subsided but I’m still having to push more through the pain to try to get “normal”. I was in tears at physical therapy from the pushing he was doing on the knee to get it to bend further and to break up that tissue. I’m back on the Diclofenac I was pre surgery to try to help with the inflammation and was given Tramadol to take before PT and at night to help with the pain, unfortunately that doesn’t really help much. I feel like every time I call my surgeon’s office to ask for something more for the pain I’m treated like a drug seeker. I was told that if I don’t make significant progress in the next couple of weeks, I would probably be needing a manipulation. I’ve been through 3 surgeries in the past year (knee scope-where the severe osteoarthritis was discovered, the partial knee replacement, and gallbladder removal), that thinking about anesthesia again makes me ill – and I’m almost out of medical leave benefit. My emotions are all over the place these days. Thanks for letting me vent, for reading, and for helping me to realize I’m not so alone in this journey.

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Thanks for the reply. I was threatened with a manipulation, but with very aggressive, painful PT have thankfully avoided that. Now the only thing is my extension, I'm close but keep regressing about every other week. My surgeon and physical therapist think that when that comes the pain should go down, I sure hope so. I have a cruise planned in August and have cancelled the excursion we had planned one day because the description changed and said to expect 2.5 hours of walking on cobblestone roads, which could be uneven. I'm too afraid of either not being up to walking that far or tripping on the cobblestones and hurting myself. I am sad at the thought of not doing something with the rest of my family, but need to look out for myself and my knee too.

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@kibe75

Hi. Just joined today after finding this thread while googling about scar tissue after knee replacement. I am 42 years old and 6 weeks out from a partial knee replacement, at my post op visit this week was basically scolded by the PA I saw about my flexion and extension (9-100) and was told with “only” a partial I should be back to my pre-op of 0-130 and break up the scar tissue. I left that visit so discouraged. I have been doing my physical therapy religiously daily, but the pain has been so bad that I’m in tears most days. The PA upped my physical therapy appointments back to 3x/week. My physical therapist said yesterday that he feels somewhat responsible in the development of the scar tissue because he should have been more aggressive from the beginning but because of the severe pain I was in backed off some hoping that as the pain subsided I would be able to tolerate more. Well, the pain hasn’t subsided but I’m still having to push more through the pain to try to get “normal”. I was in tears at physical therapy from the pushing he was doing on the knee to get it to bend further and to break up that tissue. I’m back on the Diclofenac I was pre surgery to try to help with the inflammation and was given Tramadol to take before PT and at night to help with the pain, unfortunately that doesn’t really help much. I feel like every time I call my surgeon’s office to ask for something more for the pain I’m treated like a drug seeker. I was told that if I don’t make significant progress in the next couple of weeks, I would probably be needing a manipulation. I’ve been through 3 surgeries in the past year (knee scope-where the severe osteoarthritis was discovered, the partial knee replacement, and gallbladder removal), that thinking about anesthesia again makes me ill – and I’m almost out of medical leave benefit. My emotions are all over the place these days. Thanks for letting me vent, for reading, and for helping me to realize I’m not so alone in this journey.

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I ride my bike a lot as walking becomes painful. When I walk my leg swells and it’s been 5 years. Dr stopped my p/t as was not doing me any good. Just lots of pain. Tend to ignore the pain , ice works somewhat. Golf causes pain and swelling. Comes down to what you are willing to put up with.

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@tudorbeach

I also developed scar tissue, immediately following surgery, I was told it was genetic. I refused manipulation as I had such severe swelling and bruising after surgery. With aggressive and very painful PT I was able to get to 110 degrees, which I am at currently, at 11 weeks out. I have 2 PT sessions left and then will continue with my home exercising program. Hopefully all this snow will melt soon so I can begin some serious walking

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Thanks

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@kibe75

Hi. Just joined today after finding this thread while googling about scar tissue after knee replacement. I am 42 years old and 6 weeks out from a partial knee replacement, at my post op visit this week was basically scolded by the PA I saw about my flexion and extension (9-100) and was told with “only” a partial I should be back to my pre-op of 0-130 and break up the scar tissue. I left that visit so discouraged. I have been doing my physical therapy religiously daily, but the pain has been so bad that I’m in tears most days. The PA upped my physical therapy appointments back to 3x/week. My physical therapist said yesterday that he feels somewhat responsible in the development of the scar tissue because he should have been more aggressive from the beginning but because of the severe pain I was in backed off some hoping that as the pain subsided I would be able to tolerate more. Well, the pain hasn’t subsided but I’m still having to push more through the pain to try to get “normal”. I was in tears at physical therapy from the pushing he was doing on the knee to get it to bend further and to break up that tissue. I’m back on the Diclofenac I was pre surgery to try to help with the inflammation and was given Tramadol to take before PT and at night to help with the pain, unfortunately that doesn’t really help much. I feel like every time I call my surgeon’s office to ask for something more for the pain I’m treated like a drug seeker. I was told that if I don’t make significant progress in the next couple of weeks, I would probably be needing a manipulation. I’ve been through 3 surgeries in the past year (knee scope-where the severe osteoarthritis was discovered, the partial knee replacement, and gallbladder removal), that thinking about anesthesia again makes me ill – and I’m almost out of medical leave benefit. My emotions are all over the place these days. Thanks for letting me vent, for reading, and for helping me to realize I’m not so alone in this journey.

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You will do just fine on the cruise. I am in the industry and leave for Hawaii…on a 6+ hour plane ride. I am optimistic. Will wear a knee brace, take advil and got a seat with extra room. But walking on cobblestones and in August? You should go for it. I will be doing the same in Italy and Croatia the end of May. I am hell bent to do this trip in particular which also involves a 10 day cruise on a small ship with 200+ passengers. No opiods for me. Just OTC stuff. Just do it. You can always cancel a shore excursion 24 hours in advance. Better to have your spot reserved.

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@homebrew

I have been through it all. Now I have been taking spinal pain shots. They haven’t worked at all. So I am going to have a pain implant put in and will see if that helps. I don’t want a revision done on the TKR.

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You deserve a medal for sure. I am assuming you do home exercises and move around as much as you can?

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@cobweb

I had my tkr done 5 years ago, still swells especially in water therapy. That is why i went to stem cells for the other knee. All i can say is live with it and try to strengthen the leg as best you can. My surgeon just shrugged his shoulders and said move on. I noticed in my years of dealing with it is some really do well and others do not and they have the same surgeons. Pain pills and i do not get along so working out and doing my exercises is all i can recommend. If i had do overs i would never had the tkr done. Next life will be different.

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I agree 100% with you. Had no clue it was going to be this tough after a TKR. Exercises and ice is all I know now after 3 months out. AND my life will be different, next time, too.!

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@kibe75

Hi. Just joined today after finding this thread while googling about scar tissue after knee replacement. I am 42 years old and 6 weeks out from a partial knee replacement, at my post op visit this week was basically scolded by the PA I saw about my flexion and extension (9-100) and was told with “only” a partial I should be back to my pre-op of 0-130 and break up the scar tissue. I left that visit so discouraged. I have been doing my physical therapy religiously daily, but the pain has been so bad that I’m in tears most days. The PA upped my physical therapy appointments back to 3x/week. My physical therapist said yesterday that he feels somewhat responsible in the development of the scar tissue because he should have been more aggressive from the beginning but because of the severe pain I was in backed off some hoping that as the pain subsided I would be able to tolerate more. Well, the pain hasn’t subsided but I’m still having to push more through the pain to try to get “normal”. I was in tears at physical therapy from the pushing he was doing on the knee to get it to bend further and to break up that tissue. I’m back on the Diclofenac I was pre surgery to try to help with the inflammation and was given Tramadol to take before PT and at night to help with the pain, unfortunately that doesn’t really help much. I feel like every time I call my surgeon’s office to ask for something more for the pain I’m treated like a drug seeker. I was told that if I don’t make significant progress in the next couple of weeks, I would probably be needing a manipulation. I’ve been through 3 surgeries in the past year (knee scope-where the severe osteoarthritis was discovered, the partial knee replacement, and gallbladder removal), that thinking about anesthesia again makes me ill – and I’m almost out of medical leave benefit. My emotions are all over the place these days. Thanks for letting me vent, for reading, and for helping me to realize I’m not so alone in this journey.

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pain management for me is 2 advil every 4 hours with food. I tried 3 different kinds of opiods. Just couldn't do it in light of todays political climate. Ice is my best friend as well as a heating pad. I also have a LED lite therapy wrap I use from time to time on the knee. I truly feel like a warrior.

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I’m 53 and had a double total knee replacement 3 1/2 months ago. I knew it was going to be hard work, but it’s been an agonizing winter. My Dr opted to do an early manipulation when I could only get 90 degree flex.
The manipulation allowed me to get to 125 degrees, but progressively my flex lessened even though I did daily, brutal PT. After being treated like a failure by my surgeon and enduring screaming crying PT sessions, I opted to go with a gentler approach. I’m praying I’m making the right decision as everyone has scared the crap out of me that I have a limited time before scar tissue can’t be moved.
I see a massage therapist twice a week who specializes in lymphatic drainage and a PT person who doesn’t force my knees to bend, but has me use gravity to improve flex and strength. I also use theCMS machine even though studies say they don’t help.
Ok- that was a long winded intro to ask if anyone has ever used the pulsating massagers that supposedly can break up scar tissue . Thinking about getting one, but seems to good to be true.

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I had tkr on January 29,2018. I had 10 therapy sessions with the Pt. I had my pt manipulate the scar tissue with her thumbs on every sessions, I did my exercises at the gym. She also did dry kneedling when ever she found a tight spot on the thigh that was hindering the bend. The last few days I was instructed to bend my knee every 30 minutes even if I was sitting in a chair. I had a steady progress with many hours of hard work. She finally discharged me yesterday. I was very fortunate to be able to measure at 142 degree bend. I owe my success to lots of scar tissue manipulation by the Pt and the spinning bike. I was also very religious doing all the exercises I was told to do. I still can feel little snapping of the scar tissue in the knee while I’m biking. I had my other knee replaced in 2011 and it has a bend 146 degrees. I just wanted to share my success story so it might be an inspiration for someone.

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