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MUA knee so stiff<<

Been quite awhile since been on here- My OH been to his surgeon who adamantly refuses to do his need -stating he has bad arthrofibrosis (stiff knee syndrome ) he stated chance the fibrosis will come back and even worse may lead to him losing leg below knee- and today he went to pain management and they sttated they cannot do anything for him
 
This is really too bad. I had arthrofibrosis with the first knee. I have very long legs and that long unbending leg was a big problem. My MUA didn't work so the surgeon arthroscopically removed the scar tissue.

A stiff knee is painful because any maneuvering involves bending it to the point that scar tissue limits it, and that pulls on the interior tissues.

I know in the UK any process to get this resolved is complicated. But a really good surgeon could do a revision. Well that's what ultimately happened to me. I mean, I did get decent bend the first time after the arthroscopy. But after a few years the components came loose and I went that time to an expert surgeon. The recovery from that revision was so easy by comparison to the first. I also had gotten tested for nickel allergy, on my own, and the results came back that I was very allergy to internal nickel. So my second knee was nickel-free. I had no arthrofibrosis -- what a miracle!

I think that is one way out of this for . . . is it your OH? Don't know what that means, but no matter.
 
@bland9 , as someone who also has severe arthrofibrosis, I can really sympathize with your OH.

Some of the top people in the US that work on cases such as these (Peter Millet at the Steadman Clinic in Vail, CO for example) say that revisions for people with arthrofibrosis will only generate more scar tissue, due to the trauma and inflammation that result. Instead they recommend arthroscopic lysis of adhesions, because it is so much less traumatic.

I had a revision (which filled up with scar tissue), then an arthroscopic lysis of adhesions (which did really well at first and then resulted in severe pain) and then a second revision (which has been very successful in terms of eliminating the pain, but my range of motion is still limited by scar tissue.)

It turns out that I caught an infection during the first revision which was not caught and acted on (though the post-op bloodwork showed it present) and this infection was present and untreated for the recovery from the 1st revision and throughout the surgery and recovery from the arthroscopic LOA. I believe this ruined the results from the first revision and the arthroscopic LOA. It was caught during pre-op for the second revision (which was not optional as the prosthesis had come loose and my leg was in danger of breaking) and treated with tons of IV anitbiotics. I had to infuse myself at home with antibiotics through a PICC line for six weeks.

If we knew more about your OH we could give better suggestions. Lacking that, I would say:
1. I assume he has had an x-ray to make sure that his existing TKR parts have not come loose or are misaligned. If this were true, then a revision to fix this (with a new surgeon) may very well fix the problem.
2. Have him get a metals sensitivity test (if he is allergic to nickel for example, this has to be addressed, and nothing else you do will matter).
3. Have him get a least a blood test to check for indicators of innflammation and infection. Aspirating fluid from the knee and culturing it to test for infection would be great too but the docs hesitate to do this for fear of infection (and rightly so - trust me, infections are no fun at all.) If there is an infection this has to be fixed, or nothing else you do will matter.
4. Consider an arthroscopic lysis of adhesions. You will need to find a specialist - these are difficult procedures and not every OS can do them.
5. Consider a revision with a specialist. I don't know how things work in the UK, but there are specialists in the US for example that deal with the most difficult cases. If you were in the US you could for example go to the HSS in New York City. The UK must some equivalents but whether or not your insurance covers it is a question.

The most important takeaway is that a patient with severe arthrofibrosis needs the very best specialist surgeon. Seeking out one of the best surgeons in the country is really the thing to consider.

One thing to keep in mind - what one surgeon says is impossible, a different specialist will do with ease. The first surgeon will speak in absolutes, as if he/she speaks for all surgeons, and that is just not true.

In the US, there are doctors in clinics researching all kinds of alternatives (such as IV steroids or anakinra/Kineret), and the UK must have people doing similar things. There are always alternatives.

Best of luck.
 
@WFD @maryo52 Thankyou for all you kind ideas thoughts and advice- My husband has had all the test regarding inflammation- came back slightly raised but nothing for concern- had several x-rays all looks ok ,nothing loose or misaligned- Surgeon adamant he will not do arthroscopic procedure. we did ask and stated it will not solve his problem and WILL make it worse- he did an investigated scope and tried to do a Mua some time ago- he shouted at my husband at the time that his knee is extremely stiff seemed to be very angry about it perhaps frustrated - he has not had a Nickel test we will ask next time, my husband now seem three different surgeons even a registrar (senior ) she stated the same- we are now coming to the end in which he will have to live with it- even today the lovely pain management Doctor stated there is no more they can do ,only talk therapy in a group setting but my husband do not get angry about it only frustration and pain. cannot see any benefit. Now even they have taken him off there list- so he will spend rest of his days with severely bent knee and unable to straighten it walking with crutches , even the pain management lady states he will perhaps end up in wheel chair.
 
I don't remember your husband going for a second opinion. He needs to see a revision specialist. They deal with problem knees that no one knows how to fix. There is no reason your husband should have to live like this in this modern age of medicine.
 
My OH has now seen 4 different surgeons including a Registrar (senior surgeon a Lovely foreign lady at the hospital) and all say the same , all after I complained ,
 
The problem with this is that you haven’t had opinions outside your local hospital community. What you’re experiencing typically happens as you need an INDEPENDENT review of your husband’s case. This can only occur if you travel to a different hospital nowhere near where you have been going.

It’s my understanding this was not something you wished to pursue. So, sadly, I don’t expect that any amount of complaining will get you a different result. You need new eyes on your husband’s problems and that will require travel to a different hospital. Should you ever decide that is something you want to pursue, please let us know and we’ll help you find a good location as close as possible. @Jaycey is in the UK and can assist you if you need it.
 
Its been along while since my OH posted on here but just a update -both Hes knee replacement now are extremely bad and now confined to a wheel chair his pain is bad unsteady/ weakness , though with his other condition Surgeons have just about writ him off, even physios which he has seen more than a dozen and they too admitted no more help can they give
 
I am sorry to read this news about your husband. I am wondering if you were able to take the advice of, Jamie, from Administration (three posts above this one) to seek opinions outside of your local community hospital? If not, please consider that for the sake of your husbands health and future. Hugs to you both. :console2:
@bland9
 
I had that experience, but many do. I know how upsetting that can be. My physical therapist had different ideas than my knee about how far it should be bending, which didn't help.

I had surgeries where my knee was simply slow to bend, although my first TKA I had arthrofibrosis. In both cases, the best course of action was being gentle. If you push a post-operative knee, it will rebel with increased inflammation, pain and swelling, and those make bending even worse.

I ended up designing my own PT for bending -- five bends, twice a day, to the point of pressure but not pain, and holding the bend 30-60 seconds. The only other exercise that I decided was necessary were straight leg raises.

As far as when you can bathe after surgery, it should be in the notes they sent home with you from the hospital.

Good luck!
 
Doctor has stated my Oh has been placed on the list for knee revision "at last " due to his ever increasing pain at last firstly he has got to go for xray on knees and his shoulder which causing him pain and unable to lift his left arm up and pins and needle feeling in his hand- though I'm pleased I'm also concern about his cognitive problems whether it will make it worse
 
I'm so glad they are going to try to help him. Did he seek a different surgeon/hospital, or is this the same medical professionals he's been dealing with for years?
 
That's good news. I hope it's with a different group.
 
So annoyed today - OH went to GPs because he wanted to see results of his knee/shoulder X-rays - nothing to show loosening etc which is good, but we expected that - it's the Arthrofibrosis that not so easy to see on normal xray- his pain is getting unbearable. The young Doctor referred him again to physio suggesting more physiotherapy will sort problem out, no sign of him wanting revision, no letters etc so she stated, looks like after Christmas we got to go through the whole procedure of begging to see the hospital consultant again. He started to get annoyed and told the Dr he don't care if he loses his leg and that he should not have to put up with so much pain etc then stating to be resent to see the consultant-soon. Don't these Doctors read the patient history? She also got wrong some dates of his starting some important medication for other problems, then she stated give the medication time to work. If he has the problem more than a few months we then should be worried -well hate to stated he been on this medication for nearly six months, whats the matter with these young Drs- they are getting worse - he came home saying what's the point of going to see GPs - just look on Dr google we do better
 
OH again seen another physio - for another assessment - and yet again been told to keep up with some exercises and will again sent for another opinion by another consultant must be his 4th opinion , though must admit the young lady he saw did mention they were reluctant because of his other medical condition,
 
I hate that he is still dealing with this. I pray he finds a solution.
 
Update on OH still waiting for appointment with another surgeon - wait time is up to 23 weeks but now He even more struggling to walk - his cutches now hold his complete weight has both his knees are now so painful and he looks like they ready to buckle and fall at every step he walks with both knees bent he very unbalanced now, also sometimes he cannot lift his leg of the bed I have to physically move it for him he states he cannot move or lift it its a worry -
 
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