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Author Topic: scar tissue removal  (Read 585 times)

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Offline liegh5

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scar tissue removal
« on: March 31, 2018, 12:24:00 AM »
Hello everyone. Just a quick question in regards to the recovery process  of scar tissue removal. I will need some intracapsular scar tissue removed this summer post ACLR. I am just trying to figure out the recovery process I should expect from this surgery. Will my knee completely atrophy again, or will I be up and moving within a couple of days. I need to schedule this around my medical school rotations. So i was hoping to not need more than one week of down time. And I just am really hoping that all of my hard work in PT wont drop back down to zero like when I had my initial surgery with all of the muscle loss.  Thanks!

Offline youngbodyoldjoints

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Re: scar tissue removal
« Reply #1 on: March 31, 2018, 04:27:37 AM »
Hello everyone. Just a quick question in regards to the recovery process  of scar tissue removal. I will need some intracapsular scar tissue removed this summer post ACLR. I am just trying to figure out the recovery process I should expect from this surgery. Will my knee completely atrophy again, or will I be up and moving within a couple of days. I need to schedule this around my medical school rotations. So i was hoping to not need more than one week of down time. And I just am really hoping that all of my hard work in PT wont drop back down to zero like when I had my initial surgery with all of the muscle loss.  Thanks!
I just had my surgery for arthrofibrosis about a month ago, so I can give some feedback on mine, although I understand that everyone's scar tissue presentation and surgical experience are different. This recovery was much longer and more difficult than previous knee scopes to clean up my meniscus and articular cartilage. I regained a good amount of knee motion, making my soft tissues tight and painful. I also had tons of swelling that took a while to go away. I was on at least one crutch through 3 weeks. I'm at 4 weeks now and can do basic office work okay, but still have difficulty with stairs and being on my feet for a while. However, my muscle atrophy was not as bad as my ACL reconstruction.

I don't want to scare you with any of this, just give you my experience. You could have a smaller amount of scar tissue and a less irritating surgery, and be on crutches for 1-3 days then moving around okay. Or, you could have a more protracted rehab like me. It's really hard to tell with scar tissue until they get in there. I would plan for the longest accommodations possible- as much down time as you can work out, and maybe a light rotation after? Good luck, keep us posted.
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Offline Clarkey

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Re: scar tissue removal
« Reply #2 on: March 31, 2018, 05:46:55 PM »
Knee arthrofibrosis is a very difficult knee condition to control that can start from a simple routine surgical procedure opening a whole can of worms and future knee problems. Had my 1st scope on my right knee in November 2009 after falling onto my right knee felt catching and discomfort and was not able to run. Went for a diagnostic arthroscopy and had medial plica excision and trimming of the fat pad!  if I attempted to run felt heaviness gradually building up inside the knee the more I ran the heavier the knee got so stopped running. Took 18 months until I was able to run again at a competitive pace then slipped on black ice in January 2013 and have not been able to run since the fall.

July 2014 had scope #2 of anterior interval release (AIR) surgery with the patella tendon and fat pad gunged up with excessive scar tissue from scope #1 that is likely to have been kick-started after the trimming of the fat pad. Once trimmed seems to lead to scarring that can cause extensive damage inside the kneecap. Now I am coming up to 11 weeks post-op after scope #3 with my 2nd AIR surgery, decompression of the patella tendon and unexpected latera cartilage repair. What did not help was wearing a knee brace for 7 weeks post-op with ROM set at 90 degrees. Can get up to 110 degrees max if I try to push it further straight away feel pain and tightness around the 3 main portals lined up at the bottom of the kneecap. If it was not for the pain and discomfort around the portals recovery would be smooth and easy. Fear having the knee brace for so long could have produced excessive scarring again? Walk with one crutch in public try not to use it in the house with knee giving out at slightly if I try to walk further distances without a crutch.

The best advice I can give is to listen and respect what your knee is telling you if the physio exercises you have been given starts to causing too much pain and discomfort around the portals stop straight away! Find that the back of my hamstring is painful going up my calf muscles if I overdo after doing too much walking in the streets and shops.

Hope both of you find a way around arthrofibrosis, once it starts it is hard to control the scarring of the patella tendon that takes a lot of the strain. An important anatomy of the kneecap holding your kneecap and shinbone. Acts like an elastic band rubbery that can snap if you have too many cortisone injections will weaken the patella tendon. If you have been diagnosed with patella tendonitis 'jumper knee' be very cautious towards injections around the tendon.

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« Last Edit: March 31, 2018, 10:56:15 PM by Clarkey »
RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline James NZ

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Re: scar tissue removal
« Reply #3 on: April 01, 2018, 07:51:53 AM »
Clarkey, sounds like I've had what you had done. They debrided my plica and fat pad as well as doing a microfracture on my patella. I've since had another MRI which showed scaring and swelling.
10 months later and my quad has all but disappeared. I'm only 32 and was highly active before this surgery. Symptoms before surgery was only painful running and descending stairs. Now it's all the time. I think it gets swollen behind the knee cap which makes the whole knee sore also getting a painful hip and ITB.
Not sure what to do from here. Very reluctant for more surgery as I'd hate to make it any worse. But I can only take it a day at a time how it is.
I'm looking at a natural approach for the rest of this year before looking for a new OS if need be.
I'm hoping there's no extra damage being done in the mean time.

Offline Clarkey

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Re: scar tissue removal
« Reply #4 on: April 02, 2018, 08:50:21 PM »
Hi James,

Was at a similar age to you when my right knee problems really started to become a real problem in my early 30s with my 1st surgery at the age of 31. Starting with minor anterior pain and discomfort while running that you think it normal when you into your 30s are bound to feel some discomfort while running long distances. Yours sounds more advanced than my 1st scope with a microfracture mine was purely soft tissues problems rather than a weakening of the cartilage.

Takes time to build up the quads that will never be the same size again, quad shrinkage as the none operated knee even after intense physio sessions over a long period of time. Seems to be a chain reaction once the knee becomes a problem it impacts the hip as well. Was surprised to have a labral tear on my MRI scan on my right hip. Hopefully, physio will help to stop going through a hip arthroscopy to repair the tear and smooth over the cam socket.

Tightness in the muscles can cause severe pain and discomfort, a foam roller can help reduce some of the tight and knotted muscles. Dry needling or intramuscular stimulation IMS is great for loosening tight knotted muscles that helped me breathly after 18 months post-op after scope #1 to run at a competitive speed.

Good idea not to rush into surgery right away after going through a microfracture need to conserve the cartilage from further damage. Do now know trying to run again is never a good idea! Members on here have managed to achieve running after a microfracture but will end up wrecking the knee and are likely to go through knee realignment surgery that is never an easy surgery to recover from.

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« Last Edit: April 02, 2018, 08:56:40 PM by Clarkey »
RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline James NZ

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Re: scar tissue removal
« Reply #5 on: May 29, 2018, 06:31:37 PM »
Thanks clarkey,

How are you recovering from your last op now?

Offline LisaWilliams38

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Re: scar tissue removal
« Reply #6 on: May 29, 2018, 10:13:06 PM »
If you are still experiencing severe quad atrophy, I would check with your OS about a device made by NeuroTech called the Knee Hab. It's about $500-700 out of pocket, but my insurance luckily covered half. I had 4 procedures on my right knee in 2015/16 due to a 2-part ACI procedure (Surgery 1 was the harvest, Surgery 2 was a 7 inch  arthrotomy for the implantation of cells). I was immobilized in a straight-leg brace for 7-8 weeks and developed not just loads of adhesions in my knee, but also adhesions in my Quadriceps. :( So surgery 3 was the Lysis of Adhesions, and then they did a 4th procedure 8 days later--the manipulation under anesthesia. All of this started on Oct 14 and ended On Mar 9-----my quad not just severely atrophied but freaked and swelled to twice it's size after the MUA----My Physical Therapist and surgeon agreed my leg basically said "Enough!!!" Thus, the atrophy  worsened due to laying off of ALL rehab for an additional 3 wks to allow the swelling of my quad to go down. I did major bending every day to maintain my hard-fought flexion while we waited....

In case you're not familiar, The Knee Hab is like a tens device but it is NOT a normal tens device. It was made specifically for the right leg or left leg---meaning my right-leg device is not interchangeable. The pads are specificly built in and located/sized to rebuild your VMO, and 3 other areas of your quad. It's A LOT of coverage. It didn't get me my entire quad back over the next year, but it improved things a lot to where I didn't look so freaky. :) I still have to do loads of leg presses, Bosu Squats, ball squats, etc or that leg wants to shrivel a bit. During rough weeks/months, I have to lay off the normal strength training and se the KNee Hab to give my knee a break from weight-bearing (we're nearing the TKR point, but I'm only 45). It's so freaking frustrating and I feel your pain.

If the KNeeHab isn't an option for you because of location or money, I get it. I'd just hate to not mention it. :)

--Lisa
« Last Edit: May 30, 2018, 01:23:55 AM by LisaWilliams38 »
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'02 R  meniscus tear
'10, R meniscus tears, Bursectomy
'13, R 3 meniscus tears, Grd 3 Biocartilage fil
'15 R Oct-ACI harvest,
'15 R Dec-ACI implant
'16 R Mar-lysis of adhesions
'16 R Mar-MUA
'18 L 3 menis tears, Grade 4 Biocartilage fill















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