WFD
graduate
United StatesLong time lurker here, this is my first post.
I had two arthroscopic meniscectomies on my left knee to deal with a torn meniscus, in 1998 and 2009. Recovery went well and I resumed all my sports and activities, though running and hiking had to go.
By October 2020 I was bone on bone, in pain, and my RoM was down to maybe 70°, so I had a full knee replacement. During rehab, RoM peaked at 95° warm and then rapidly went downhill as my knee filled with scar tissue. At five months I had 70° cold and 85° warm RoM.
In March 2021 I had an open arthrolysis to clean out the scar tissue. Initially things seemed better and I reached 105° warm before the scar tissue took over and I ended up back at 70°/85°.
In July of 2021 I went to a revision specialist in Boston and he performed a complete revision, removing all the scar tissue and putting in a new knee with a smaller spacer to give the knee more room to deal with scar tissue. The original femoral implant, which had been press-fit, wasn't loose per se but came right out without any force used. The new knee is cemented in place.
After the previous two surgeries I had pretty standard aggressive PT but after this one I found a new therapist that would work with me and backed way off on the level of force, sticking with mostly gentle stretches and motion-based activities such as using an exercise bike.
This time I peaked at 117° warm and things were looking up, but then the scar tissue came back with a vengeance, and I am once again at 75° cold and 88° warm. The difference this time is that at 3+ months, in addition to limited range of motion I still have a quite a bit of pain and it does not seem to be going away. After the other two surgeries I could at least be on my feet for a while and do things. Now I cannot be on my feet for more than about 15 minutes without having to rest my knee.
Luckily, I never had a problem with extension and can straighten my leg fully.
I am 61, in excellent health, and very fit. This limited range of motion makes it difficult to use stairs, a bicycle, or even walk without catching my foot on something. The scar tissue limits my range of motion enough even while walking that I can feel the stress in my lower back. Not being able to be on my feet for more than 15 minutes without an hour's rest keeps me from doing much that is useful or even pulling my weight around the household. A solid year of surgeries and rehab is really getting old.
I doubt that another open surgery would help me - I would just end up where I am already. About the only thing I can conceive of that would help is an arthroscopic debridement/mua with radiation pre-treatment to reduce the chances of the scar tissue coming back. There is very little in the way of research on the use of radiation, and what has been done is of low quality - no control groups and no blinding.
Does anyone have any experience with these kinds of approaches?
Can anyone recommend a surgeon in the Boston area I could consult with and that might do it?
Thanks.
I had two arthroscopic meniscectomies on my left knee to deal with a torn meniscus, in 1998 and 2009. Recovery went well and I resumed all my sports and activities, though running and hiking had to go.
By October 2020 I was bone on bone, in pain, and my RoM was down to maybe 70°, so I had a full knee replacement. During rehab, RoM peaked at 95° warm and then rapidly went downhill as my knee filled with scar tissue. At five months I had 70° cold and 85° warm RoM.
In March 2021 I had an open arthrolysis to clean out the scar tissue. Initially things seemed better and I reached 105° warm before the scar tissue took over and I ended up back at 70°/85°.
In July of 2021 I went to a revision specialist in Boston and he performed a complete revision, removing all the scar tissue and putting in a new knee with a smaller spacer to give the knee more room to deal with scar tissue. The original femoral implant, which had been press-fit, wasn't loose per se but came right out without any force used. The new knee is cemented in place.
After the previous two surgeries I had pretty standard aggressive PT but after this one I found a new therapist that would work with me and backed way off on the level of force, sticking with mostly gentle stretches and motion-based activities such as using an exercise bike.
This time I peaked at 117° warm and things were looking up, but then the scar tissue came back with a vengeance, and I am once again at 75° cold and 88° warm. The difference this time is that at 3+ months, in addition to limited range of motion I still have a quite a bit of pain and it does not seem to be going away. After the other two surgeries I could at least be on my feet for a while and do things. Now I cannot be on my feet for more than about 15 minutes without having to rest my knee.
Luckily, I never had a problem with extension and can straighten my leg fully.
I am 61, in excellent health, and very fit. This limited range of motion makes it difficult to use stairs, a bicycle, or even walk without catching my foot on something. The scar tissue limits my range of motion enough even while walking that I can feel the stress in my lower back. Not being able to be on my feet for more than 15 minutes without an hour's rest keeps me from doing much that is useful or even pulling my weight around the household. A solid year of surgeries and rehab is really getting old.
I doubt that another open surgery would help me - I would just end up where I am already. About the only thing I can conceive of that would help is an arthroscopic debridement/mua with radiation pre-treatment to reduce the chances of the scar tissue coming back. There is very little in the way of research on the use of radiation, and what has been done is of low quality - no control groups and no blinding.
Does anyone have any experience with these kinds of approaches?
Can anyone recommend a surgeon in the Boston area I could consult with and that might do it?
Thanks.
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