scar tissue removal by a local doctor: am I foolish?

[Douglas_Firs]

I know kneeguru has a short list of scar tissue 'gurus' and specialists around the US and EU. But it is a pretty short list and none of these surgeons is within 1000 miles of me, nor are any of these great doctors on my insurance plan. (I'm in Florida.)

If I could find a local doctor willing to 'scope' my knee to see if he can give me the last few degrees of extension, is this at all advisable? Or is it always a horror story and a mistake that ends up requiring revision by the Steadmans, Noyes, Shelbournes, et al, of the world?

I'm seeing 2 different OS this week and I am trying to get one of them to point me towards someone who can get my knee straight? Is this a bad idea? Should I just save up the 30 or 50K I will need to pay in cash to one of the Scar Removal Superdocs and get it right the first time?

One way or another, I simply MUST get my knee extension back in the next year. It has already stolen 6 years from me.

Any opinions welcome.

[The_KNEEguru]

So many factors determine the recovery of range of motion after a severe injury like a tibial plateau fracture. After six years it may not be simply a matter of posterior capsulotomy to release scar tissue or removal of hardware. For my money I would suggest an outpatient evaluation at a centre of AF excellence, with the specific question of ‘what is causing this final extension loss?’, and make your decisions from there.

[Douglas_Firs]

Thanks, KNEEguru.

It's an interesting point about 'other factors' potentially preventing my knee extension. I recently heard an orthopedist say that 5 years of knee contracture can cause anatomical changes (in bone surfaces, etc) which may prevent full ROM from returning.

I only have a slight 2-3 degree extension deficit. I'm hoping this isn't enough to cause any gross structural deformity. Hopefully there are no other factors?

I 100% agree that consulting with an AF authority is ideal. I am having an MRI this week from a local OS. My plan is to send the MRI for review and consult (via telemedicine) with some of the recognized AF OSes in the next month or so.

I recently learned that Lonnie Paulos (a Kneeguru 'Who's Who in Arthrofibrosis' certified expert) is now located in North Florida. He has retired from surgery, but offers telemedicine consultations.

Thank you again.

[The_KNEEguru]

Let's hope it gives you some more answers...