MUA knee so stiff<<

The Surgeon stated he going to do open surgery to remove scar tissue -could anyone explain what involved in this

I had this done. In my case at least, they open up the full incision, evert the kneecap (twist it to the side to get it out of the way), and then explore the joint, removing all the scar tissue that can be removed safely, then stitch everything back together. I found that recovery was about 90% as hard as the original TKR.

If he is just doing an open lysis of adhesions (LOA), then the prosthetic parts are not removed, which reduces trauma but there can be scar tissue in the back of the knee that cannot be removed as the prosthetic parts are in the way. I had some issues with the back of my knee afterwards and this may be the reason, but I am not sure.

If he does a full revision then all the prosthetic parts are removed, all the scar tissue that can be removed is removed (even at the back of the knee) and all new prosthetic parts are put in. Beside allowing the surgeon to get at more of the knee, it allows the surgeon to adjust any issues such as the thickness of the plastic spacer. I had one of these done too and my surgeon put in a thinner spacer in an attempt to give me more flexion (didn't work - I did get more extension, which I didn't need). I found that recovery from a full revision was about 110% as hard as the original TKR.

I have pretty severe arthrofibrosis (spontaneous scar tissue formation in joints subjected to trauma) and neither of these surgeries worked for me. What did work for me, a little, was an arthroscopic lysis of adhesions combined with an MUA (the MUA part was pretty minor) and that gave me another 20° of flexion. Note that this was not a washout but an actual removal of scar tissue with an electrocauterization tool, followed by a manipulation to get the spots he couldn't reach.

Anyway, that was my experience. I am sure your husband's situation is different - it certainly sounds tougher than what I am going through. Best of luck.
 
OH now wash he knee and took dressing off to replace with new clean ones and WOW noticed the surgeon must had tried several entry points has several open wounds
Your husband had arthroscopic surgery. It requires multiple small incisions (usually three) since the surgeon uses one for the surgery itself, another for the tiny camera or scope he uses to see what he’s doing, and a third to allow for a tool to irrigate the area as he works. The surgeon needed to make multiple incisions. It wasn’t that he “tried” several entry points. What you describe is normal for arthroscopy, so don't let it worry you.

WFD's description of the procedure is excellent, although he's right that each case is somewhat unique depending on how extensive the adhesions are and where they are located. It can be quite tricky to deal with them.

If your husband still has a lot of scar tissue (adhesions), an open lysis of those adhesions is a treatment option. It is not always successful, but it can be. It involves opening up the knee and cutting the scar tissue away to free up the normal tissue. Since his hardware is okay, it would not be replaced. However, this condition and treatment need to be done by a surgeon who specializes in dealing with adhesions. The surgical techniques and rehab afterwards are critical to ensuring that the scar tissue does not return. I strongly recommend that you seek an additional opinion of a specialist at one of the larger Centers of Excellence. I’m going to tag my co-admin, @Jaycey, who possibly can help direct you to a specific surgeon. I know some GPs make it sound like a difficult process to get appointments with another surgeon, but you are entitled to see whatever surgeon you like. You may have to be a bit forceful to get the referral from your GP, but you don’t have to justify anything other than that you want to see a different doctor to get another opinion. NHS allows for this.

If you choose not to seek the opinion of another surgeon and stay with this doctor, I recommend that you talk with him about the recovery process. With knee adhesions, aggressive therapy is normally not a good plan. Better results can usually be obtained with a more gentle approach of bending and stretching exercises several times a day for several weeks. The reason for this is that adhesions occur when tissues are inflamed, hot, and dry. When this occurs (as when you work your knee really hard), the soft tissues that would normally be moist and glide across one another, are hot and dry. They stick together in places where they should not and tough bands of tissue (adhesions) form that tie them together, restrict movement, and cause pain. This is what has happened following your husband’s first surgery that caused the adhesions. You want to keep the knee swelling and inflammation minimized to prevent this….particularly in the first few weeks and months of recovery.

Also, tell your surgeon you’d like to have him use the Geko device immediately after surgery or purchase it directly from the link I gave you. Your GP can help you learn how to properly place it on the leg....it's not that hard, but you do need to know the proper spot in order for it to work. It’s a small electronic impulse device that looks kind of like a watch. It adheres to the leg near the incision. It is used in the UK after joint replacement surgery to minimize swelling. It works and can make a huge difference in the success of a recovery as the electrical stimulation of the peroneal nerve greatly increases circulation throughout the body. The Geko treatment involves 10 days of wearing this device right after surgery.

All the best to you as you face this new challenge.
 
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@Jamie = many thanks for your in-depth advice and the Geko device- my OH was also told he will be placed on a
CPM machine for a few days after the OP- though strange today my OH been asked to have a X-RAY on his hip. his Surgeon never mentioned this
 
That’s interesting about the hip x-ray, but they may just be trying to rule out all possibilities for problems.
 
My OH complaining and its very noticeable that since he had the arthroscopic procedure he in a great deal of pain. leg very swollen and he cannot bare much weight on it ,don't know what's going on with it. hopefully his operation on that knee will be in the very near future
 
Dont know what surgeon done on his arthroscopic procedure but since then his pain and stiff is considerably increased he can hardy lift his leg up without shouting out with pain and also he can hardly walk now, also developing some ulcers on his legs too, poor soul he is certainly suffering
 
I am so sorry that your husband is going through this and that you are having to watch him be in such terrible pain. I know nothing about the NHS, but I wonder whether patient advocates can help you to navigate the system. I found The Advocacy Project (advocacyproject.org.uk) online, which is an independent charity and helps patients file complaints against medical care providers. The organization may be able to help you figure out what to do. NHS has an advocacy program called PALS (https://www.nhs.uk/service-search/o...nd-liaison-services-(PALS)/LocationSearch/363). Again, I’m so sorry.
 
Poor Husband - he in so much pain - he spoke of asking Surgeon if he can have his leg removed- he did mentioned going to tell him he can not take anymore pain and difficulty in walking - he suffered for nearly 5 years now and been using his crutches in all that time and now he developed severe pain also in neck and arms because of the need of crutches and he putting all his weight on his arms and he been told he may have hip problems too associated with his knee
 
My OH tried his medication that pain management gave him which he was reluctant to use but with pain increases he thought he try them - Burprenorphine 5m patch- he commented that he might has well stick a paracetamol on his arm for how good Burprenorphine is- in another words they are useless
 
I'm sorry to read that the pain patch didn't help. I pray for his comfort.
 
I‘m so sorry to hear this. I hope you have let his doctors know this so they can make adjustments to the medication.
 
He got to see his Surgeon tomorrow so hope there is some moment forward- we certainly put our point strongly across tomorrow - he been messed about too long now.
Plus he need new crutches his old ones nearly has bad has his knees falling apart :rotfl:.
Also got to see his GP on Tuesday has he got ulcers on both feet now, he will ask for more better pain relief- though last time he asked he was sent to pain management who prescribed the patches, but he had to wait quite awhile before that appointment. we can only hope that soon we an see something positive
 
I hope these doctors will finally be of some help to you. Good for you for being firm. This has gone on way too long.
 
Wow got the third degree from Surgeon- he stated that all metal was good and he really stated that he will make things worse - and I got a high chance of infection ,more pain and it will take a 5 hour operation to do a revision, he strongly stated not to go through with another operation and was not best pleased when I said I got to do something. he sent me for more physio - so not sure what to do anymore0 any suggestions has now frighten that my body will not take it
 
You need to see a different doctor, one that is far away and has no contact with your current doctor. Your knee needs fresh eyes to look at it.
 
You need to see a different doctor, one that is far away and has no contact with your current doctor. Your knee needs fresh eyes to look at it.
Yes you might be right- the Surgeon was not in good mood - he also stated that was not going to be responsible if it all went wrong, thought that was a strange statement to make - the only good thing to take away from this visit is he got another pair of crutches and seeing a physio whom recommended treatment for his nerve impingement in neck and pain radiating down arm- poor husband he going through some, how he putting up with it no one knows
 
His current doctor has had way too many chances to fix his knee. It is obvious that this doctor is not qualified to take care of your husband and that he needs to see a revision specialist. These doctors are specially trained to deal with problem knees that normal surgeons have no idea what to do with them.

Please look for a revision specialist for your husband. His quality of life depends on it.
 

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