Treatment options for knee arthrofibrosis

Posted by gustbe @gustbe, Jul 27, 2021

I had a severe knee injury due to a car accident ~14 years ago. At the time, my Patellar Tendon was ruptured along with my ACL, PCL and MCL. My LCL remained intact.

My Patellar tendon was repaired first, however after the repair I needed to keep my knee immobile for 6 weeks. During that time Arthrofibrosis set in. There was one manipulation done to break up scar tissue but it returned and the cavity in my knee joint is filled with scar tissue. The ligaments have never been repaired.

I worry that my knee stability will lead to excessive wear on the joint and requiring knee replacement surgery at a young age. I don't currently have pain in the knee but I do have limited motion. Thankfully, I can get about 100 degrees of flexion so it's not limiting in normal, day to day life.

I'm wondering if there have been any advances in scar tissue treatment, what options currently exist for treatment, and if it would be worthwhile to pursue a consult with a specialist. I currently live in the Minnesota but would travel for treatment.

I sincerely appreciate any advice on this

Interested in more discussions like this? Go to the Bones, Joints & Muscles Support Group.

@gustbe Hello and welcome to Connect. My physical therapist tells me that maintaining proper knee alignment is important for preventing the wear and tear that leads to knee replacement surgery. It isn't just the knee, but the hip, ankle, and feet as well. When you have tight hip flexors or thigh muscles, those pull on the joints. If you add a twisted pelvis into the mix, it puts uneven stress on the body. I have had my pelvis twist a little bit out of shape, and guess where that gave me pain? On the inside of my knee! So look at this as a whole body problem of keeping everything in alignment to save your knees….. and what is a good way to do that? Myofascial release with a physical therapist. This is something I have done a lot of and still do. It's a way to stretch the fascia that gets tight and stuck. It also can help break up scar tissue with noninvasive treatment.

The first pages of our Myofascial Release discussion have lots of links to information about MFR treatment and there is a provider search on the MFR website. This treatment was developed by John Barnes and his methods are gentle enough that they didn't cause further tearing of fascia or guarding within the body. Perhaps @artscaping Chris Trout will share some of her experiences with knee surgery and myofascial release.
https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/
http://mfrtherapists.com/
Does this sound like something you would want to try?

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Good evening @gustbe. A huge welcome to Connect and a thank you to @jenniferhunter for this introduction. Your injuries in the accident are frightening. I am sorry that you are living with more than vivid memories of your recovery. Trauma from injuries has also been a major cause of my small-fiber polyneuropathy. My accidents included several rear-end collisions, at least one major fall from my horse, and a disastrous tumble down a mountain.

Surgeries do often initiate the accumulation of scar tissue. My first diagnosis was chronic myofascial pain syndrome. Now I not only know what that means…….I know how to make it tolerable. MFR, myofascial release, is a hands-on therapeutic treatment that can find and release restrictions created in the fascia. I discovered MFR when a previous TKR (total knee replacement) became painful. It took some time and attention from my MFR therapist before the built-up scar tissue completely disappeared.

During that time I also received a diagnosis of small-fiber polyneuropathy (SFPN). There is no cure for that condition but there is MFR. I actually moved to Minnesota because my MFR therapist is here. I now have two sessions a week and we are getting ready for a second TKR in a couple of weeks. I plan to not have to deal with scar tissue this time.

You mentioned that you are also in Minnesota. May I ask where? I am in St Cloud and so is my MFR therapist as you might have guessed. Would you like to have an introduction to my MFR therapist for a consultation?

May you be free, safe, and protected from inner and outer harm.
Chris

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Im trying to get into this discussion group concerning arthrofibrosis. i'm a senior who had total knee replaced locally 9/2019, and a revision of knee 10/2020 at HSS and then at Mt Sinai, i had arthroscopic surgery to get rid of scar tissue on 10/2021. So now i'm going on 3 years…My extension of my leg nor my flexion is right. i limp and the limp causes chaos in my back. So i do accupunture, deep tissue massage, accupuncture, regular pt (3Xs week) and ePAT therapy. my scar tissue is not disapearing…in fact, i think its getting worse. feels like someone poured cement allover my knee and behind it…i can not bend or straighten my leg…i'm now on anti depressants that i never thought i would need. IS THERE ANY HOPE FOR ME…..??? Thanks for reading…..

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I have severe arthrofibrosis from a 2020 knee replacement. It was difficult for me to bend my knee more than 70% before the surgery. On a good day I will have only 70% bend. I am active which means the leg stiffens up during the day where it is maybe a 30% bend. I take tizanidine extremely sparingly because it causes extreme tiredness. I never drive with tizanidine in my system. My leg gets so stiff that at times I stumble and proned to fall. I am 77 years old, 138 lbs, 5'7" and in excellent physical condition except for my knee. I exercise five days. Is there anything on the horizon to cancel out severe arthrofibrosis?

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Hi @bob999 and welcome to Connect. First of all, bravo for you getting a knee replacement at the start of the pandemic. That is brave! @brucen123 has arthrofibrosis. And he is a senior who had total knee replacement a year before you.
You'll see that I moved your post here so that you could connect with these members about arthrofibrosis.
Treatment options for knee arthrofibrosis
https://connect.mayoclinic.org/discussion/treatment-options-for-knee-arthrofibrosis/?pg=1#comment-741949
What did your doctor say about the level of pain you are in?

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I have not taken anything for pain since my knee replacement surgery and about eight weeks of physical therapy.

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