I had what is called an "Open Lysis of Adhesions and a Spacer Exchange" . Basically my knee was opened along the old scar line. The doctor removed extensive scar tissue and put in a slightly larger spacer. I had pain for three or four days and then just the boredom of yet another recovery!! I also had extensive adhesions around the knee cap, it had "scarred down" and that was the source of most of my pain.
My doctor stressed that if I exercises a hot, inflamed knee I would cause more scar tissue to form---especially since I had already had a large amount of scar tissue. So, for the first two weeks, I just stayed home on the couch with my knee elevated and iced. I did a few heel slides and some leg lifts, but that was about it. He told me if I do any activity that increases the swelling, I was to put ice on it immediately until the swelling went down.
At three weeks, I began formal PT, but my PT agreed with my doctor. His advice, we will go very slowly until 8 or 10 weeks. If the scar tissue reforms, at least we will know that we did everything we could to prevent it.
If I had limited insurance coverage for PT, I might have waited another week or two to even start it.
We did only table exercises---leg lifts, clam shells, heel slides for another two weeks--no weight bearing exercise at all. I did ride the bike for 15 min prior to PT. If we did anything that made the knee warm, we stopped and iced it. It was a long and boring recovery, but I have had no problems since, so I am glad that I listened to the doc and the PT. I would not do anything at all that makes your knee more inflamed.
I was so impatient!!! I hated the forced inactivity, but I was determined to give the knee the best chance I could give it. We started light exercise at 8 weeks. step ups---very small lift. bike for 20 min. no squats or serious weight on any machine.
I am now eight years out from that surgery. I have some scar tissue there, but it does not impair my movement like it did prior to surgery. I have pretty good rom---138. Most of all, my knee is much more stable with the bigger spacer. My doctor told me that since the knee was moving a little too much with the first spacer, that alone might have caused some of the scar tissue. Am I glad I did it? Yes.
The biggest hassle was the slow recovery. The pain was really nothing compared to a TKR. But, take the long view, you do not need to worry in the beginning about it freezing up. Just do quad sets, light leg lifts---no ankle weights for 8 weeks. Right now, just rest.
I hated the cpm, did not like being tied to a machine, if you use it use it on slow and do not force the bend. Forcing the bend is the wrong way to go, that is what will inflame you knee. You are just going to have to go slowly and not do anything too drastic.
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