KNEE ARTHRITIS - Total Knee Replacement :

Arthrofibrosis after total knee replacement - - Posted by amnsmit (amnsmit), 21 October 2004

Hello,

I am a PT student doing research about arthrofibrosis and PT treatment of it. I am wondering if there is anyone who has experienced arthrofibrosis after the knee replacement. could you tell me about your treatment and is PT alone was enough to help. Also, where did it go wrong? Was the post-op PT too aggressive? Prolonged immobilisation?

I hope there is someone who can help.

Thanks,
annemarie
Posted by smokey3 (smokey3), 2 January 2005

I fit that topic to the letter. Let me know if your still interested and I will let you know the problems I am facing
Posted by Teresa_S (Teresa_S), 5 January 2005

Ihad a tkr in Oct. 2003, and then was denied ANY type of pt for over 6 weeks, by then the knee was is such bad shape, and covered in scar tissue. I had a MUA in Jan 2004, and again he ordered no pt for 5 weeks, and then went forward for 3 weeks, and then backwards, constant pain, loss of motion. In July 2004, the prosthesis actually broke off in my knee, and I had a revisison in Oct 2004. The knee is better, but the whole leg is worse, swelling, shaking, and hurts like crazy. Teresa
Posted by bubbables (bubbables), 16 January 2005

 Hello Annemarie,
        I am 7 weeks post surgery for my left TKR.  I am 48 years old, a Diabetic with all sorts of health problems. I had 4 blood clots 2 days after surgery to complicate matters.  After all these weeks of aggressive therapy which has been like torture to me, I have been diagnosed with Arthrofibrosis by my doctor.  He said that the Diabetes has been working against my healing process and caused massive scar tissue around the incision. My knee is bent at 15 degrees and will not straighten out.  I am in pain 24/7.  In a few days I have to go back to the hospital for my knee to be manipulated under anesthesia and then put on the motion machine. I will be staying overnight for all this and then once home, I will be back to the aggressive therapy.   I am so frustrated, scared, depressed, upset to say the least.  My other knee is suppose to be replaced in February but that may be delayed if the left knee isn't just so for the doc. I hope that all my setbacks and pain will be worth it in the long run. I would really like to be walking normal again and hiking up mountains.  I will keep you posted as to progress. Any and all feedback and encouragement is most welcome.  

Terry
           
Posted by Jan_L. (Jan_L.), 16 January 2005

Hello Terry,

I am so sorry to hear of your difficulties.  There are several of us here that are in a simular situation.  We have been exchanging information on two other section, which you may want to look at.  Under the section titled "Soft Tissue Healing Problems"  look at the sub-topic: "TKR? arthrofibrosis"

The other one which may be of interest to you is under the section: "Struggling with Rehab?  PAin Problems?"  sub-topic:  "Need advice on MUA".

If you read these you will see that you need to find out what type of surgery someone had before giving what they say much weight.  Post op care for someone following a TKR is VERY different from other surgeries.

I had a TKR 13 months ago and still have very limited (ROM) range of motion.  I have switched doctors, because now I feel as if I need a TKR specialist.  The doctor I am seeing limits his whole practice to joint replacements.  He is much more knowledgeable on TKR then my first surgeon, which makes sense because this is all he does.  What I have learned is that their are several things which can cause scar tissue to develop which leaves you with a stiff knee.  Much to my surprise I learned that you can end up with excessive scar tissue because the implant doesn't quite fit your bone structure or the implant was too big/small or it's mal-rotated.  If your problems persist you may want to switch to a TKR specialist if you are not seeing one already.  Let me know if I can be of any help.  I know first hand how awful this is and how painful it can be.  I wish you the best of luck.

Jan
Posted by bubbables (bubbables), 17 January 2005

Thanks Jan,
      I was wondering about the misfit myself but I will see how the manipulation goes to break up the scar tissue.  I will go from there if it doesn't work.   I will check out the sections that you mentioned.
Thanks so much.

Terry
Posted by Jan_L. (Jan_L.), 17 January 2005

Hi Terry,

MUA is always the first step.  Are you in a lot of pain and more importantly is your pain being controlled so that you are reasonably comfortable.  If you are in a lot of pain then it's very difficult to do your PT.  It's so important to get the knee bending so that you don't end up with a knee that won't ever bend.

The MUA can be done out patient or in patient for 3 days with an epidural.  I suggest you insist that this be done in patient.  With the epidural your feel no pain and you normally have agressive PT while you are in the hospital so that you make the most gains.  There are several of us here with knee that may never work, you are still early in your recovery so you still have a chance to turn this around.  

If you read the messages from others on MUA, keep in mind what type of surgery they had, if they didn't have a TKR then what they say may not apply to you.  

It sounds like you have had an awful time, I am so sorry for you.  99% of all knee replacements go off without any problems isn't it awful to end up in the dreaded 1%?

Jan

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