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Author Topic: Total knee replacement with scar tissue and pain  (Read 3384 times)

Offline theroyalkid

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Total knee replacement with scar tissue and pain
« on: March 28, 2005, 10:55:43 PM »
In Sept. 2003 I had a total knee replacement.  After extensive rehab., I was able to achieve about 110 degrees of flexion.  However, as scar tissue developed, my flexion decreased to about 80% on a good day.  Seven months after the tkr, I had a knee manipulation and scar tissue removed.  I gained some flexion, but lost it again within a month.  In October 2004, I had a revision done.  This time the doctor removed large amounts of scar tissue around the knee cap and soon after I achieved approximately 125 degrees of flexion.  Slowly, I began losing flexion.  I and am currently at about 85 degrees.

I have always had swelling and stiffness problems.  After 5-10 minutes of walking, my knee becomes inflamed and as a result can only flex to knee about 10-15 degrees.

Doctors tell me they don't want to remove scar tissue again because it can lead to even more scar tissue developing.  Doctors are also reluctant to give injections to reduce inflamation because of the risk of infection.

I'm 41 years old and I feel like a cripple.  I need to know of a doctor or procedure that can help me.

Larry 

Offline Heather M.

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Re: Total knee replacement with scar tissue and pain
« Reply #1 on: March 28, 2005, 11:43:14 PM »
Larry,

The problem you have is called arthrofibrosis.  It is very difficult to treat--as you've seen, you can't just cut the scar tissue out.  You have to rehabilitate the knee very carefully, so that the scar tissue doesn't come back.  There are a few doctors out there who have worked hard on researching this issue and developing protocols to KEEP the scar tissue from coming back.  There are just a handful of these kinds of doctors--I travel 1000 miles to see mine.

Another possibility to examine is whether your knee prosthesis is the right size and/or fit--there is some indication that if the implant is too large or is loose, this can create so much irritation in the knee that the body forms a lot of scar tissue in response to this constant stress and inflammation.

So I would really recommend that you get a couple of opinions from two types of doctors:  1) a doctor who has dealt with lots of arthrofibrosis cases and can guide you through the post-op protocol; 2) a doctor whose practice is exclusively limited to knee replacements and revisions.  This will take a bit of calling around and talking to other doctors who can point you toward the right TKR specialist.

If you post where you live, we can point you toward one of the doctors in your region.  It's a tough problem to deal with, and I can't tell you how great it is to see a specialist who says "I know what the problem is and I know how to fix it."  That alone is worth the travel, in my opinion.

Hang in there--we have a group of folks on this board with arthrofibrosis.  Some are TKR patients, some like me developed the scarring after a scope and have been fighting it ever since.  You will want to post your questions in the soft tissue healing problem section (just a few threads below this one on the main bulletin board section), because that's where the arthrofibrosis folks hang out. 

Heather
Scope #1: LR, part. menisectomy w/cyst, chondroplasty
#2-#5: Lysis of adhesions/scar tissue, AIR, patellar tendon debridement, infections, MUA, insufflation
#6: IT band release / Z-Plasty, synovectomy, LOA/AIR, chondroplasty
2006 Arthrofibrosis, patella baja
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Offline tre777

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Re: Total knee replacement with scar tissue and pain
« Reply #2 on: April 03, 2005, 02:35:00 PM »
I have this same problem! I am 28 and feel 100+ years old!! :-\ My doctor tried to take out the scar tissue, but like you it came back every time! My doctor now says I need major surgery---a capsular release. I still don't know much about it because I was just told this 2 days ago. When I find out more info I will let you know. Trust me, I know this is not fun!! Tracy

Offline queenie

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  • 2 min operations, 1total knee replacement,1 mua-re
Re: Total knee replacement with scar tissue and pain
« Reply #3 on: April 12, 2006, 12:09:38 AM »
i now have this problem-loads of scar tissue after a tkr, mua. i was told a zap of radation(500 rams) will hold off the scar tissue from forming so fast. has anyone ever heard of this- iam desperate to walk again- i am 49 very fit-does anyone know of a good doctor in the nyc area that does arthofibrosis?? any help would be soo welcomed. regards queenie ??? ???
Queenie

Offline Jaci

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Re: Total knee replacement with scar tissue and pain
« Reply #4 on: April 12, 2006, 05:39:51 AM »
Queenie,

If you haven't already done so you may want to take a look and post down in the TKR section. It's down in the "Arthritis department"

Here's a link that will take you down to that area. There's an active group that posts there, some have problems similar to what you are experiencing.

http://www.kneeguru.co.uk/KNEEtalk/index.php?board=37.0

Jaci

10/03 Twist injury
12/03 Menisectomy- tears ACL, MCL, & LCL missed by OS
Arthrofibrosis ROM 38-68
3/04- 4/08 Multiple scar tissue procedures:
6 scopes w/LOA, AIR, LR, chondroplasty, synovectomy, bone spur & plica removal
3 insufflations, many injections
Chronic AF, patella infera, IPCS

Offline Jan_L.

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Re: Total knee replacement with scar tissue and pain
« Reply #5 on: May 12, 2006, 02:59:54 AM »
For those of you struggling with a failed TKR you may want to get a second opinion.  My doctor recently explained to me how someone could locate a good surgeon for a TKR or a TKR revision in their area.

He said to check the "Knee Society " first.   

http://www.kneesociety.org/index.asp/fuseaction/memlist.main

The doctors in the "knee Society"  all do at least 100 - 150 knee replacements a year for many years.  These are the doctors with the  most experience in TKR and revisions.

If you can not find a doctor in your area that is in the "Knee Society" then check The  "American Association of Hip and Knee Surgeons"

http://www.aahks.org/

There are several things that can lead to massive scar tissue following a TKR.  Often the scar tissue is just a symptom of an underlying problem.   A mis-aligned or the wrong size implant and/or infection (to name a few) can all cause scar tissue.   So it is not enough to just treat the scar tissue unless you correct the origin of the problem, the scar tissue can just return.  You will need a doctor that specializes in joint replacement to determine what has caused the scar tissue to form in the first place, 

 My doctor is involved in research on TKR and he told me that research is starting to show that the acceptable amount of variation in the alignment of the implant is not strict enough.  He said that a knee could be put in correctly according to manufactures guidelines and yet someone can go on to develop scar tissue.  He believes in times these guideline will be tightened up.

Another possibility for dealing with a failed TKR may be a custom implant made to fit your own bones precisely.   I am seeing a doctor that is making a custom implant for me to correct the problems I have had with my TKR.  I had a CT scan and that info was sent to a lab that is making my implant.


Jan
« Last Edit: May 13, 2006, 03:38:59 AM by Jan_L. »
1985 - auto accident- both knee went thur the dash.
1985 - 1990 Four scopes left knee
2002 - Fulkerson TTT
2003 - Scope Rt knee
2003 - Right  TKR
2003 - MUA, 2004 - MUA
2005 - Right TKR  revision
2006 TKR - left knee, 2 MUA
2007 2nd TKR  revision - Rt knee

 















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