TKR scar tissue removal - Pros and Cons

I've had 3 TKA's in six years, the last revision was six years ago. Each time I developed too much scar tissue (arthrofibrosis). My advice is too get the proper physio plan. My surgeons told me that I had to work thru extreme pain in order to get good results. The thinking on that has completely changed. You have to gradually work at increasing flexion and not the extreme physio that I put myself through. The result of my physio is that by bending the knee so hard that I was tearing up the scar tissue resulting in the knee producing or laying down even more scarring. I now have about 55° of flexion and constant pain. So, it's all in the physio. I would get mine redone but with so many surgeries and now having a very long-stemmed prosthesis, there are so many risks involved in new surgery I'm not sure if my surgeon will operate. Good luck to you as arthrofibrosis is very debilitating as I've sure found out. One last thing is that I'm no expert but I would definitely advise making sure the physio is done properly.

I have had the same experience. And now I have patella baja with 75deg flexion which I will have repaired next month. And you are exactly right with respect to physical therapy. It is necessary to do knee exercises with frequency and with small increments of progress. This can be exhausting so I recommend a passive motion machine and an exercise bike. This has been very helpful for my arthrofibrosis. Pain does not equate to gain when you are dealing with massive scar tissue. I hope this helps for those suffering with arthrofibrosis.

I'm scheduled for my third TKR in July. I have okay flexion but can't straighten my knee and have onerous pain all.the.time. As you all know, it is quite debilitating. I believe I have an overabundance of scar tissue as well. Dr. Trousdale says he can straighten my leg, and I am hoping the third time's a charm. Some days I'm ready to just get it amputated, but of course that would be awful, too.

Hello. I am very interested in responses to your question as well! I am 3 years post TKR. I’m 43 years old, I am the perfect rehab patient always did all my exercises worked extremely hard to get back… and it didn’t really work. My flexion range of motion has gone to 90 degrees despite having 135 at 3 months post TKR, and it continues to decrease despite ongoing ROM work. I’ve also had pain all three years with no explanation from the docs why.

I saw my doc recently and due to my lack of ROM and pain he proposed scar tissue removal + swapping out the plastic shim piece in the middle to something a little thinner. He said it’s a 50/50 chance it will help and as we all know it’s a major open surgery. Would love to hear others thoughts or experience with this procedure, if you’ve had it??

Good luck …praying 3 time charm for you….

Actually, that's what I had the second time because my Ortho guy said the parts were just fine. He also had me wear a brace for 6 months to try and keep it straight, but after I stopped wearing it, it gradually went back to 30° flexion all the time. This time I'm going to Rochester and replacing everything.

Update had a Dr appointment today …. Been in therapy about 12 weeks measure was moving somewhat….. had to take two visits off went down 5 degrees… Dr told me today I am at flexion 70 extension 10 before revision two years ago I was 65 flexion close to same extension….dr explained to me that no surgery can fix this he went down two sizes and still my knee went back to where it wanted to be … he said simply the tissue around the knee is where it wants to be … he said scar tissue removal I go right back , if he removed the knee and but a hinge it would go back to this ….. it is bad luck but it happens …. But I am happy he explained and showed me the pictures …. I felt my body did not like the knee now I know it doesn’t ….. all I can do is exercise to keep any flexion , and pain away…..I respect him he could have used me as a cash cow but I appreciate his honesty….,good luck to everyone my surgery journey is over ….. I hope everyone finds there Dr and there answers

I have had 2 knee replacements. A partial and TKR in the last 3 yrs. Results were 90 deg ROM and 13 deg extension. ROM was still limited so I had the polyethylene spacer replaced. Thats when they found my kneecap had dropped an inch. (Patella Baja). There was no way my knee would bend passed 90 deg. So, after the poly replacement, I got a $12 ham string stretcher and used it to straighten my leg. This device straps to your foot and allows you to pull on it to straighten leg and knee. It worked! I got my leg/knee straight but still have problem with extension (75DEG).
I will undergo a minor surgery for patella baja soon and hopefully gain more extension. The hamstring puller and bicycle machine have been most helpful for me to regain ROM. Arthrofibrosis is difficult to deal with and excessive pain while rehabilitating is not necessarily advantageous. In my experience, it causes more scar tissue and loss of movement. I will resubmit findings after next surgical procedure. Don't give up!