The REHAB DEPARTMENT => Soft Tissue Healing Problems - Arthrofibrosis => Topic started by: swayball on May 01, 2008, 06:32:32 AM

Title: lysis of adhesions (I guess)
Post by: swayball on May 01, 2008, 06:32:32 AM
I was in auto accident three yrs ago - had knee pain swelling, etc.. first doc kept saying it was arthiritis and would get better. a yr and half later, went to second doc. he said I had meniscus tears and cartilage damage - after artho surgery to clean up meniscus and shave cartilage - he said cartilage damage was severe. did lots of PT - did well at first, then downhill. Doc kept saying it was a bad injury and would take a long time. last summer did supartz injections, kept waiting for them to help - did more PT. Pt suggested a second (which was actually third) opinion. Several months later (March 08) saw newest doc who oredered mri. he says i have lots of scar tissue and i am now schedualed for arthroscopic scar tissue removal in two weeks. i am not sure exactly where the scar tissue is or what my condition is called.
What can I expect for recovery and rehab? he said about two weeks on crutches (graduating to weight bearing), start PT two days after surgery (although my PT is off that day so I am scheduled for 5 days after surgery - which physician's assist says should be fine). I will have CPM machine at home - and will do whatever they say no matter how much pain. Any clue when i can expect to be able to drive and what the overall recovery should be (ideally)?
Title: Re: lysis of adhesions (I guess)
Post by: Shine on May 01, 2008, 06:51:19 AM
Hi Swayball,
I just had one of those about 2 1/2 months ago. So I am still in the recovery phase. From my understanding recovery times are extremely individual. Also, for this surgery too be a success the right pt must be adhered too. If I were you, I would check out Recovery Timelines posted by Ed, in the arthrofibrosis section. So far for me, I am doing alot better than before surgery. Intially the OS thought I would be on crutches on 2 weeks, but he ended up putting me on them for 6. I started weaning off then. I am weaned off now, but cannot do tons of walking yet. Just walking around the house and to pt. I started off with no pain after surgery and getting more pain after I started walking. But most of that has to do with my lack of quad muscle according to the OS and the fact that I finally had good patella mobility. So now, my patella is moving around too much and in the wrong direction, causing pain. I am still not on the strengthing phase of rehab. Still doing the basics patella mobes, bike(0 resistence) straight leg raises etc. The recovery for this can be along one, just cause you are not supposed to do things that irritate the knee. However, so far I would say it has been well worth it. Feel 1000X better than I did before. Good luck! Summer
Title: Re: lysis of adhesions (I guess)
Post by: swayball on May 01, 2008, 07:18:39 AM
Thanks Summer, I will check out that thread. Do they distinguish amounts of scar tissue and where it is? I am only wondering because that first surgery was supposed to be one week recovery so I've learned not to trust what they say as it is really only "ideal". My big worry is that I care for an elderly lady doing her food shopping and driving her on errands and appointments. I also do wedding photography and have a wedding in July. Hopefully, all will go well but I guess I should be semi-prepared for a longer rehab than expected.
It does seem frustrating that although rehab really starts almost immediately after surgery, full weight bearing could take much longer and since it is my right knee, I imagine I need full weight bearing to drive and be able to brake if needed.
It would be nicer if I could stay oput of work and lie on the couch doing nothing for several weeks!
Title: Re: lysis of adhesions (I guess)
Post by: Janet on May 01, 2008, 02:40:24 PM
I was non-weight bearing on crutches for two weeks, then gradually added weight until I was off the crutches at 6-7 weeks. Then I used a cane for several more weeks. I was told it would be 6-8 months before we could tell if the surgery was successful, and my OS was right on. I didn't start to see any  improvement until about 4 months post-op. I had PT for about 8 months, then continued rehabbing at the gym for about another year. This was not an easy recovery or rehab, and I needed a lot of patience and hard work. But it was worth it in the end because I finally stopped the AF cycle. This was my third LOA, finally with an OS who knew what he was doing.

I am concerned that you won't start PT for five days. I always started the day after surgery. If that's not possible, make sure you know what you should be doing at home in the meantime. Just having the CPM is not enough.

Title: Re: lysis of adhesions (I guess)
Post by: missmyknee on May 01, 2008, 03:22:51 PM
When I've had scar tissue removed, PT is started the next day, but if your PT is not available the things my PT had me do are things you can do yourself.
 I did  Calf stretches
         hamstring stretch
         quad sets
         heel slides
          patella mobes several times a day
         e-stem to the quad and TENS for pain and swelling
         passive flexion on end of table by sitting on end of table with leg dangling. Use good leg to pull leg into flexion, hold and then              use good leg to straighten
         Leg extension ,Prop ankle up on rolled towel about 4 inches and just let leg rest in extension for about 10 minutes

My OS has always put me on prescription anti inflammatories after surgery to help keep the inflammation down. I used crutches for as long as it took to keep from becoming swollen, increased pain and heat in the knee with walking.


Title: Re: lysis of adhesions (I guess)
Post by: Shine on May 02, 2008, 01:23:40 AM
Hey There,
I agree with Janet with the pt thing. I started pt the morning after my surgery and had it everyday for 3 weeks. Then 3x a week, and doing the exercises/mobes at home. My OS did say where the scar tissue was. For me it was almost in every location so I had alot. Also I had quite a bit of cartiledge damage from the MUA. I was and still am on anti-inflammatories and ice several times a day. The rehab for this takes alot of patience just cause it is so slow. Like for example, I know I would be physicially be able to start the strengthing part of my rehab that includes weightbearing activities and resistence on bike. But am still not allowed to because it will cause pain/swelling and Dr. doesn't want to do this because the risk of scar tissue. So rehab is really really slow. So I am going to pt and doing pt with just the basics, when I see newbie knee surgery patients doing harder things at 6 weeks post op. Part of my problem right now with the swelling/pain is lack of muscle and kneecap moving in the wrong direction because of this. So until, I gain more muscle it will continue to give me problems. I would say so far so good though(although I know it is early). The surgery was totally worth it for me so far. Good luck and let us know if you have any questions.
Title: Re: lysis of adhesions (I guess)
Post by: swayball on May 03, 2008, 08:29:49 AM
Thanks Janet, I too am concerned about starting PT late but my PT is off on friday and I really like him so don't want to go somewhere else.  I will be sure to find out what i should be doing, though I am not sure whether to ask doc or PT (or both). I hope my progress moves more quickly but am prepared with my job to be out longer. (Doc told me to plan on taking two weeks off - but I learned from last surgery that they don't really know)
Did you have a drain after surgery? I'm kind of freaking out about that as Doc said I would pull it out myself.

Thanks Pam, whether or not i get instructions, I will look into those exercises. I understand with this surgery that the key thing is to get moving asap. So much for lying on the couch recovering, sounds like I'll be quite busy. From reading of old threads, I understand to push the movement unless there is redness, swelling, in which case to cut back a bit to avoid more inflammation and scar tissue formation?

Sgandhi, thanks for your info, I am (after doing much reading) planning on this not being a real fast recovery. My main concern is when I will be able to drive and do food shopping for work. I'm dying to know what doc sees when in there since previous doc said I had lots of cartilage damage yet it didn't show ion mri.