Revision TKR arthrofibrosis

[Bionickneegirl]

Hi. New to this but wondering if anyone has been diagnosed with arthrofibrosis after tkr? What has been your experience? I am almost 10 months po. Thanks!!

 

[Jaycey]

@Bionickneegirl Welcome to BoneSmart! Can you please tell us the date of your TKR and which knee. I'll put the information in your signature for you.

I'm going to tag my colleague @Pumpkln to come and chat with you. She has been working on an article for our Library on Arthrofibrosis.

 

[brentsmith]

I have it..................bad. 2 different surgeons have told me that I have to live with it. Had a MUA and had my knee scoped, but it came back both times. I am looking into FSM treatments.

 

[Jockette]

Hi and Welcome to Bonesmart!

Tell us more about your recovery. Did you have pain and swelling for a long time? What kind of things did you do in PT? What kind of activities have you been doing? If you work, how long did you take off to recover?

Even though it’s been10 months, I will leave you our Recovery Guidelines, so you can see the approach that we recommend. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Knee Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
2. Control discomfort:

rest​

elevate​

ice​

take your pain meds by prescription schedule (not when pain starts!)​

don't overwork.​

3. Do what you want to do BUT

​

a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you​

b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​

4. PT or exercise can be useful BUT take note of these

​

the BoneSmart view on exercise​

BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

Activity progression for TKRs​

6. Access to these pages on the website

​

Oral And Intravenous Pain Medications​

Wound Closure​

The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling
Heel slides and how to do them properly
Chart representation of TKR recovery
Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in the majority of BoneSmart’s forums, we ask that each member have only One Recovery Thread. This policy makes it easier to go back and review the member’s history before providing advice, so please post any updates or questions you have right here in this thread.

 

[Bionickneegirl]

I thankful to have stumbled across this site. I had my tkr on my right knee in Sept. 2019. Im still figuring out how to respond to each person ...lol. So briefly as stated i had my tkr in Sept. 2019. 6 weeks later, Nov. 1, 2019 my surgeon did MUA. I was only at 66 degrees rom. After MUA, I did well for awhile but always struggled to maintain my rom. My best was roughly 110 w help. In pt we focused on waking up my quad which took quite some time. Rom exercises, strength came later. I plateaued in pt. In March, I started noticing increased pain and was losing rom quickly. My knee is very tight feeling, increased pain with any activity, swelling, warm to the touch. I also feel pinching which I believe to be impingement. I was referred to a arthrofibrosis clinic. I have advanced arthrofibrosis, rom is now 85 at very best. Surgeon suggest lysis of adhesions, however she also diagnosed me now with patella baja, which she herself cannot fix. This upcoming surgery will be my 15th on my right knee. I also have RA, fibromyalgia, Rsd, which further complicate my case. Please bare with me as I learn to navigate this site. Without fixing the patella baja, I will still struggle with Tom, pain, etc. Current dr feels it would be to risky to do anymore major surgery at this time due to all the trauma me knee has been through.

 

[Bionickneegirl]

@brentsmith what are FSM treatments? I'm sorry to hear you as well ate struggling w AF.This being a new diagnosis I am still learning...

 

[Bionickneegirl]

@Jaycey cey, I would greatly appreciate that and look forward to hearing from her!

 

[Jaycey]

Bionickneegirl - if you want to reply directly to a member just put an @ sign followed by their user name like this @Bionickneegirl . As you type the user name a drop down menu will appear that includes the user name. Just click on the user name in the drop down menu and your tag will be created.

There are lots of "how to" threads in our How to use this forum area.

 

[Jockette]

Thank you for all that information, it really helps to know your history.

And you are navigating this site just fine, and replying just as you should.

Current dr feels it would be to risky to do anymore major surgery at this time due to all the trauma me knee has been through.

Personally, I agree with this. Sometimes it’s good to just let things settle for now and let healing continue. Some doctors are too quick to rush in and try another procedure.

Healing from a TKR takes an average of a year. The operative word is “average.” I had a partial, it hasn’t gone well, but in spite of that, I not only saw improvements after the first year mark, but also after the second year mark.

I also suspect that the type of PT you had was too aggressive for you.

 

[Bionickneegirl]

@Jaycey thank you!! I will look into that.

 

[Bionickneegirl]

@Jockette yes, sadly I am now learning that my pt was probably to aggressive for me and with AF while you want rom you should never be pushed to the point of more pain, added inflammation etc. You also need to have a pt that is well trained in scar tissue and techniques.

 

[Jockette]

So briefly as stated i had my tkr in Sept. 2019. 6 weeks later, Nov. 1, 2019 my surgeon did MUA.

Please give us the exact date of the TKR and we’ll make a signature for you.

 

[Bionickneegirl]

@Jockette tkr Sept 20, 2019 mua Nov.1 2019

 

[Jockette]

You also need to have a pt that is well trained in scar tissue and techniques.

Scar tissue is another operative word and many people, including medical professionals, use it too freely. Often, especially in the beginning, it’s more likely swelling, rather than adhesions. (adhesions and scar tissue are two different things. )

 

[brentsmith]

FSM is frequency specific micro current. Insurance does not pay for it at about $55 per treatment. I am going to go to a pain treatment Dr. first since that is covered. They won't tell you how many treatments you need, which is a Red flag. We'll see.

 

[Pumpkin]

@Bionickneegirl ,

Here are some resources about Arthrofibrosis.

E-book available on Amazon
Noyes F, Barber-Westin S. Knee Arthrofibrosis: Everything You Need to Know to Recognize, Treat, and Prevent Loss of Knee Motion after Injury or Surgery, 2013, e book available on Amazon

kneearthrofibrosis.com, Saravanaraja Mutusamy MD

Resource:
The Arthrofibrosis Foundation | Helping people with Arthrofibrosis

You can also check out this list of arthrofibrosis experts.
Arthrofibrosis: Names of US surgeons with experience in arthrofibrosis

 

[Bionickneegirl]

@Pumpkln thank you so much.

 

[Celle]

This upcoming surgery will be my 15th on my right knee.

I'm sorry to hear how many problems you've had with your poor knee. If you can remember them, please will you list your knee surgeries and their dates, so we can add them to your signature.
Thank you.

It's very likely that the multiple surgeries, as well as over-aggressive PT, are the cause of your arthrofibrosis.

One of our members, @skigirl , had an open lysis of adhesions, which helped her. I believe she was advised afterwards to go very cautiously and gently with PT.

 

[Pumpkin]

I also have RA, fibromyalgia, Rsd, which further complicate my case.

Bionickneegirl,
For your chronic pain, here are some resources you may not have seen.
Curable app, fee based after a free trail
Retrain Pain, short slide presentations about chronic pain
and
Pain Reframed pod casts available on iTunes.