from previous threads i wrote, ive had 2 open knee surgeries to remove scar tissue. After the first i worked very hard in physio and home to get some ROM. i just had a second surgery a month ago and it basiclly didnt get me any more ROM then before, in fact a little less. so once again im working very hard with painful physio and stuff at home. Ive spent alot of time and money on my recoveries. My doc who is an onchologist specialist whom took my tumour out of my knee and fixed me up very well, has a colleuge who is the one of the docs for the toronto maple leafs and they have been talking about possibly going in a third time, but this time with the scope. im worried that all the time again im spending on ROM will be lost and maybe i wont get further with this 3rd scar removal surgery and my 4th knee surgery in 8 months.

what do you think i should do? my ROM is 20 extension and 80 flexion

Hi there,

I had scar tissue in my knee after being immobilized for a month after a surgery to realign my patella, fix a tendon and remove bone fragments in late August.  I got stuck with my ROM in October and had an LOA,LR and MUA on November 1st.  The procedure was arthroscopic so I have one big long scar down the front of my knee and two small ones from the arthroscopy.  I had PT the day after the 2nd surgery, as my OS said it was important to move right away.  I got 80 degrees that day and gained 16 more degrees over the next week, and have gained around 8-14 degrees per week since then.  I am up to 128 passive and need about 7 more degrees to match the other leg.  I have a lot of muscle atrophy so I don't take stairs properly and my knee does give out a bit once in awhile.  Scary in ice and snow!  My point is that MUA is totally worth it, but I think it is important to do the LOA first.  Mine were done in that order, same procedure, LOA then MUA.  He got 120 on the table and I had only 20 degrees the day of surgery.  I know that your problems are likely more serious than mine, but I wanted to say that if MUA comes up, please don't be too afraid.  It might help get you a more functional ROM.  I had intense pain for a few days but I had three procedures and my first surgery was less than two months earlier so my knee was irritated I am sure and that likely doesn't help.  I dont know a ton about AF, but wanted to share my scar tissue experience.  I really hope that your next surgery resolves your issues.  Best of luck to you!!! I really hope you get better soon.  I am so sorry to hear that you are going through all of this.  My thoughts are with you.

Take care and big hugs!

Sarah

thank you all for the support, but what do all these terms mean, like mua? and loa?
im new ahah

Hello Borycki,

You have a very complicated problem with your knee. If you've read through the info in the tutorial, clinical casebook, and literature reviews you probably noticed that the doctors who wrote the materials recommend that you seek treatment from someone who is knowledgeable about treating arthrofibrosis (AF). Recurring arthrofibrosis is relatively rare, according to Dr. Noyes' tutorial about 1% of people develop it, so most doctors see few, if any, cases of arthrofibrosis. It's great that your oncologist's colleagues treats the Maple Leafs, however team affiliation does not guarantee that the OS has significant experience with arthrofibrosis.

I will give you the same recommendation that I give most people who come to this board looking for info: You need to learn everything you can about arthrofibrosis so you can be an effective advocate for proper care. By learning about AF you will be better equipped to interview your OS to determine his level of knowledge and whether he really understands what AF treatment should involve. This is not a situation where you can simply ask "Do you have experience treating arthrofibrosis?" You need to ask very specific questions about surgery, pain management, control of the inflammatory process, physical therapy, post-op goals, and means of intervention should scar tissue form again. And, you have to know enough about arthrofibrosis to determine whether or not the OS is giving you the "right" answers to your questions.

I provided links in another post, but I'll put them here again:

Dr. Millett’s article/ clinical casebook

http://www.casebook.kneeguru.co.uk/index.php/knee/issues/arthrofibrosis_of_the_knee/

Dr. Noyes’ arthrofibrosis tutorial and Dirk Kokmeyer’s rehab tutorial

http://www.kneeguru.co.uk/KNEEtutor/doku.php

KneeGuru’s literature review (look under problems with healing)

http://www.kneeguru.co.uk/insights/doku.php


Here's a link that I didn't post before-- It will take you to a page on the Community Hub called "Arthrofibrosis-- Great threads on the bulletin board." It includes a long list of links to other people's arthrofibrosis stories. Thanks to missmyknee (Pam) who submitted the list.

http://www.kneeguru.co.uk/KNEEnotes/book

(Edited to add: If the above link doesn't work. Go the the community hub, then look over along the upper left hand side for "Editorial Sections" click on it and you'll get an index. Click on "Great threads on the bulletin board", then select "Arthrofibrosis---...")

Anyway, read the tutorial and other info. Go back through some of the old posts on other KNEEgeeks stories. When I first found this website, I went all the way back to the very first threads on AF and read my way forward.  I learned a lot in the process about both what to do and what not to do. The bulletin board has grown significantly since I joined it, so the 'great threads' link will make it easier for you.

None of us are qualified to tell you what you should do. We can, however, help you through the process of learning about AF, interviewing OS, and making a decision that feels right to you.

Best wishes to you,

Jaci