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Scar tissue removal - is it the right thing to do?

Posted by krenn @krenn, Jun 8, 2023

61 yr old active female - my story in a short summary
Right Knee 2019 Meniscus repair surgery - fail
2020 Partial Knee Replacement - fail
2021 Oct TKR
2022 Oct - was schedule for scar tissue removal, surgeon attempted MUA before opening up knee again, seemed successful, but went backwards due to scar tissues.
Currently my knee is stuck at 75 - 80 degrees flexion, extension is 100% (full extension). Cannot do stairs, cannot ride bike at all, cannot kayak (something I love- we live on a river in NC) In constant pain daily. My knee feels like it has cement sitting on top of it.
I am scheduled in 2 weeks 6/22/23 to have scar tissue removal.
I have read success stories and failure stories. I was so active, I am not willing to settle with my knee the way it currently is, I may have to but I want to try anything I can go get it moving. I have done Myofascial release therapy, cupping, needling.... I am at a loss.
Any thoughts would be welcomed and appreciated.

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mrnomad | @mrnomad | Aug 9 10:20pm
In reply to @mrnomad "Yes, I am headed for a TENEX procedure in the next few months but right now..." + (show)
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Yes, I am headed for a TENEX procedure in the next few months but right now I'm banking on UltraSound & Injections/excission to locate & remove dead patellar tendon tissue. My understanding is that if the patellar tendon was pushed aside during TKR, rather than cut, this wouldn't have happened but working around the tendon would have taken more time. However, I'm not an MD so seek local counsel.

My current surgeon (the fourth) craftfully excises the dead tendon and hopes that healing will rebuild it with vibrant tissue. That's the theory... but with age, tendons heal more slowly or not at all. However, it may be working because I am able to use the treadmill every other day versus not at all. After 15 minutes of treadmill the TKR knee is inflamed and heads toward pain level 10 so I stop. My dog cuddles next to my knee because it's so warm.

In a few days I have another UltraSound scheduled and will know if the excised tendon is growing back.

Tenex is a more aggressive approach and I declined because I'd have to use crutches for 7-10 days.

To the original question, the MUA didn't last long because of scar tissue that filled in but I briefly enjoyed ROM of 125. The scar tissue removal process didn't last long either, the scar tissue grew back again. I've resigned myself to persistent pain, an inflamed knee, limited ROM of 95 degrees, and endless rage that I agreed to the TKR procedure. I choose pain over couch potato but sooner or later the pain will win.

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It's been three years and 2 months since my TKR. I exercise daily, 60 min strength, 30 min cardio which includes 20 min treadmill. Standing for any length of time leads to pain level 10. Hiking uphill is OK, hiking down hill leads to pain level 10++ and that lasts for days. It is the additional weight from walking downhill or down stairs that really sets it off.

Less weight = less pain. If I allow my weight to climb 4-5 lbs, that's guaranteed to make it worse. ROM is limited to 90 deg. One a good day, maybe 93 degrees which allows me to ride my 10 speed. I have no words of wisdom to remedy the horrendous mistake I made agreeing to this procedure but feel free to write especially if you figure out an answer.

Thx.

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mboyce | @mboyce | Aug 10 8:10pm

Do you have an update after having scar tissue removed? Almost 3 years since my TKR. I have pain and momentary lack of function in my quad muscle after movement. The more I move the worse it is. I can still mow the lawn and generally get around, but if I sit down and then get up later, my quad acts up. I have good motion and x-rays look good. Had a bone scan and now blood work and a CT. CR shows minor scar tissue. I’m hoping that is the problem and it can be fixed.

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mgreen4732charliedav | @mgreen4732charliedav | Aug 12 7:41pm
In reply to @mboyce "Do you have an update after having scar tissue removed? Almost 3 years since my TKR...." + (show)
Profile picture for mboyce @mboyce

Do you have an update after having scar tissue removed? Almost 3 years since my TKR. I have pain and momentary lack of function in my quad muscle after movement. The more I move the worse it is. I can still mow the lawn and generally get around, but if I sit down and then get up later, my quad acts up. I have good motion and x-rays look good. Had a bone scan and now blood work and a CT. CR shows minor scar tissue. I’m hoping that is the problem and it can be fixed.

Jump to this post

Have you see a PT or need to go back to one? Does this happen after you mow the lawn but later on in the day?

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mboyce | @mboyce | Aug 12 8:34pm
In reply to @mgreen4732charliedav "Have you see a PT or need to go back to one? Does this happen after..." + (show)
Profile picture for mgreen4732charliedav @mgreen4732charliedav

Have you see a PT or need to go back to one? Does this happen after you mow the lawn but later on in the day?

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I went to PT after my hip replacement and that ended about the middle of May. Hurts after about any moving around, walking, mowing the lawn etc.

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mgreen4732charliedav | @mgreen4732charliedav | Aug 13 3:35pm

Me too. Mowing the lawn so soon?

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mboyce | @mboyce | Aug 13 11:02pm
In reply to @mgreen4732charliedav "Me too. Mowing the lawn so soon?" + (show)
Profile picture for mgreen4732charliedav @mgreen4732charliedav

Me too. Mowing the lawn so soon?

Jump to this post

Hip was replaced about December 20.

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mgreen4732charliedav | @mgreen4732charliedav | Aug 14 12:39am

Best of health to your.

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mboyce | @mboyce | Aug 14 7:28pm

Going to get arthroscopic surgery to try and remove any scar tissue that may be there and have it manipulated with intensive PT for a couple of weeks afterwards. Fingers are crossed it helps.

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bettyboop68 | @bettyboop68 | Aug 15 9:41am

No manipulation?
I had exact issue but after manipulation I was good

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enkhuizen666 | @enkhuizen666 | Aug 15 11:00am

I HAVE EXACTLY THE SAME ISSUES. MY SURGEON SAYS EVERYTHING IS PERFECT. MY DOCTOR DIDN'T BELIEVE HIM AND SENT ME FOR A DEEP ULTRSOUND. I HAVE MULTIPLE CALCIFIED BODIES SURROUNDING MY KNEE JOINT. DOCTOR SAID HE HAD NEVER SEEN THIS BEFORE. TOTAL REASON FOR EXTREME STIFFNESS, UNEVEN GAIT FOR LOWER BACK PAIN.. HE IS SENDING ME ASAP TO A NEW KNEE SURGEON TO SEE WHAT TO DO. I AM GOING TO TRY SHOCK WAVE THERAPY IF NO SUCCESS WITH NEW SURGEON.

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