The REHAB DEPARTMENT => Soft Tissue Healing Problems - Arthrofibrosis => Topic started by: Beauzer on March 05, 2004, 11:35:49 PM

Title: Portal problems
Post by: Beauzer on March 05, 2004, 11:35:49 PM
Hey folks,

Anybody out there have problems with port-site scarring?  .  I've had a lot of problems in the past with extensive scarring at the sites medial and lateral to the patellar tendon.  I've had 6 scopes (5 through these same sites)  In the past I've had to be very aggressive with busting up this scar tissue, but always managed to get everything moving again and had no lasting problems.

With my last scope in January, my OS moved the port sites slightly, but now the medial one is a big stuck glob of scar, despite me massaging and mobilizing it repeatedly each day.  This side is now starting to get stuck under my patella sometimes when I extend my knee  :o and hurts like heck.  I have never had anything like this happen before.

I'm pretty sure that's what it is because the pain is very superficial and if I lift up on the medial side of the patella I can dislodge the stuck part (and the pain is different than with my meniscus and articular cartilage tears).

Yikes!  What now?  I see my OS on 3/24.

Title: Re: Portal problems
Post by: SarahSmile on March 06, 2004, 01:34:57 AM
Hi Danielle,

I have the exact same problem...I'm afraid it's because we tend to over-produce scar tissue.
I have quite a huge lump on the right side of my patella from the portal, and like you, I massage it and it doesnt seem to go away!!! Mine is about the size of a golfball :o

I showed my OS and PT and they aren't too concerned about it. I'm not concerned either, I just hope it goes away, as it's ugly!!!

I would ask your OS about this, but I don't think it's a cause for concern, and he will probably tell you that it will go away in time..

I know how frustrating this can all be though... I have always had problems with a ton of scar tissue in the portals and I can tell you that it's always gone away with time ;)

Good luck!!!
Sarah ;D
Title: Re: Portal problems
Post by: Beauzer on March 06, 2004, 02:37:14 AM
Well, if it was just a cosmetic issue, I really wouldn't care (my knee, after all, already looks like it got attacked by Edward Scissorhands! :)).  It's the pinching pain that is my biggest concern.  I hope that part will "just go away". :P
Title: Re: Portal problems
Post by: SarahSmile on March 06, 2004, 03:23:23 AM
Oh.....I'm So sorry to hear that!!!! :o  Although I have quite a large lump on my portal site, it is not causing me any pinching pain.....

So, I would definately call your OS asap-- before your appt because that is just too long to wait for an answer!

It could be pressing on a nerve or something... that's the only thing I can think of that would cause pinching pain?!?
Gosh, I'm so sorry it's causing you this much pain! I don't think that's normal, as I said mine doesn't cause me any pain... just a huge lump there but that's it!

Call your OS!

Hope you feel better soon!!!

Sarah :)
Title: Re: Portal problems
Post by: Beauzer on March 06, 2004, 03:29:21 AM
I think, actually, that the scar tissue is getting stuck under the edge of the patella.  The pinching isn't there all the time (and certainly isn't terrible, as I have had much, much worse pain before).  Also, I can pull the kneecap up and release whatever is catching.

Honestly, I don't think it's a huge deal :-/  I've had neuropathic pain (damaged ulnar nerve in elbow) before, and this isn't the same.

That being said, I don't think it's normal...

Title: Re: Portal problems
Post by: SarahSmile on March 06, 2004, 09:18:31 AM
Hi Danielle,

I was reading this on knee guru, and thought this could be your problem ...although you should still call your OS!!!

"Often the fat pad is damaged during arthroscopic (keyhole) surgery just because it gets in the way. If a portal (the cut in the skin) is made is a slightly inappropriate place, or if the fat pad is unduly large, the surgeon may find it difficult to see into the joint as it can obscure the view. In such cases a surgeon may burr away some of the fat pad. This may cause no problem or may lead to bleeding or scarring in the area, with consequent fat pad pain. Eventually, however, most fat pad symptoms from surgery will settle, but it may take many months."

Hope this helps!!! ;D
Sarah :)
Title: Re: Portal problems
Post by: agilk9 on March 08, 2004, 12:13:09 AM
Hi Danielle,

I just read your post about the portal scarring, and I think I have the same thing.  My scarring isn't big, but the "blob" in there does "push" against my patella making leg extension from a sitting position painful at times. I haven't tried moving the patella up and down around it to see if that gives relief. I don't know about you, but sometimes when I stand and put weight on the knee it almost feels like either patella or something is "knuckling" over something else.  (I know, great explanation, eh?)
What I have done (and at the time it hurts to do it) is to deep ice massage the portal area. (Dixie cup filled with water, then frozen...makes a great ice massager) I ice it til it hurts, then goes numb....then I massage the portal area, really squeezing up/down and sideways with thumb and forefinger.  Then I ice it again with a regular icepack til it calms down.  I usually do this at night, because it really does not feel great, but by the next morning, things seem a bit "looser".  I'd like to think it's getting a bit better, I have an appointment with OS on the 23rd and that's definitely on the top of my list right now.  I really think it's interfering with the patella...

All the best to you, hope it will slowly get better -

Title: Re: Portal problems
Post by: Beauzer on March 08, 2004, 04:35:32 AM
Thanks Aggie,

I know exactly what you mean about your kneecap riding over the top of something.  That's exactly what mine feels like!  I have scar there that doesn't hurt anymore but is very stuck down and hard.  

I am aggressively massaging it several times a day (it doesn't really hurt much) and I ice it down everynight after I work out.  The problem is it seems to be getting worse, not better and the kneecap catching is getting more often.  

I already have an OS appointment and don't think it's important enough to talk to him before then.  I'm glad to know I'm not the only one

Danielle :)
Title: Re: Portal problems
Post by: FieryMayhem on March 12, 2004, 06:03:30 AM
This may sound odd, and may have already been adressed and I simply missed it, but do your portals ever hurt even without any added pressure or anything.  Every once in awhile, mostly lately, mine are just achy and uncomfortable.  When I go to massage them they kill and I want to scream.  Wasn't sure if that was normal or not, and I'm not worried either, I'm just curious.