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Bilateral TKR Post-TKR Scar Removal Scope

Hi...I already have a thread going, but don’t know how to combine them and I’d like this new title to be the title. With that...

I’m 5 months bilateral tkr, Dec 21st I had bilateral MUA. I have decent flexion (120 & 125), decent extension (0-/-4) BUT I have insane concrete, cinder block tightness in both knees, anterior only. It keeps me limited to no more than 5 minutes walking or standing before the heavy, cinder block tightness and pain become too much to bear. I can do the NuStep just fine and an upright bike well also. Treadmill, however, 5 Minute max. Can do endless walking on a treadmill in a therapy pool.

At my post-op last week, my surgeon said I have Arthrofibrosis and I just need to keep grinding on them. What?! Might consider arthroscopic lysis of adhesions after 1-year post-op. Again, what?! He also doesn’t think I need any more pain meds, maybe Tramadol, but he is hesitant. Currently, I maybe take 1-2 Hydrocodone a day.

Can anyone help me here? I truly feel like I’m losing my mind. I’ve done everything I’ve been told to do. I’ve followed the PT, gone to water therapy, got a bike for my house, massage, laser therapy, supplements, etc...

The pain is excruciating and it NEVER goes away. I never get a break. I barely get any sleep. I don’t know how to continue this. Each morning, I wake back up to this reality, and I don’t know how to go forward. The frustration has become despair. Emotions are shot. Nervous system barely functioning. I don’t know where to turn next.

Thank you, to anyone, who can help me here.
 
I am so sorry you are still in this much pain. :console2: It’s sounds like all your exercising is not having the effect that the professionals say it will. Instead it is keeping you inflamed, swollen and in so much pain.

If it was me I would stop it all and rest your poor knees so they can settle down and heal.

An advisor will come along to find your other thread and blend the two.
 
To still be in pain at this point has to be frustrating. :sorry: Do keep in mind that you had an MUA just a month ago, and that can set your recovery back a bit. Your knees are in an earlier stage of recovery again, so that would be one possible reason you're feeling this pain and stiffness.

Another reason, and even more likely, are the exercises you are doing. You're trying so hard, and doing so much. Too much. The soft tissues inside your knee are trying to heal and the exercise is yanking them back, again and again. If the exercise was working, you would be on a good track... but it's not working. Your knee is telling you this.

You have really excellent flexion at 120 and 125 (not just decent, but excellent at this stage of recovery). You don't need to push for more. More is going to come.

If you want your knees to settle down, become less painful, and the stiffness (which is from internal swelling) to abate, subject your knees to less exercise and much more resting. Give your knees a month long break from exercising and see how that goes. Just rest, elevate and ice, and do your daily activities, maybe a little walking. You can always return to doing exercise for building strength later. Trying to do that now is just setting you back.
 
Thank you thank you for your reply. They are telling me, with Arthrofibrosis, that I have to keep Movement in the joints or the scar tissue will adhere even tighter. This is why I’m so confused. It just doesn’t seem to matter what I do, they keep, getting tighter. I’ve done days without any exercise, didn’t seem to help much either. Today, I thought of this analogy...it feels like I have foam insulation in the joints and it just keeps spreading and getting harder. And the heaviness and pain of it is excruciating. I did nothing but cry this morning, simply because I’m worn out, my system can’t take this 24/7 pain without a break or even a little hope. Just a little...
 
SusieShoes said:
Give your knees a month long break from exercising and see how that goes.
Click to expand...
Susie's advice is correct but don't confuse 'no exercises' with 'doing nothing'!
Kimbies said:
They are telling me, with Arthrofibrosis, that I have to keep movement in the joints or the scar tissue will adhere even tighter.
Click to expand...
Of course you have be mobile and active but walking and stretches are quite sufficient. You could do Hamstring stretches for a start. And try short but frequent walks, no more than 10-15 minutes each way.
 
Actually my surgeon said to keep “grinding”on them, but I disagree. The problem with short, frequent 10-15 Minute walks is I can’t do that. I am not able to stand or walk for about 5 minutes before the cement feeling becomes like concrete blocks, with axe blade edges, around both knees, and I can’t tolerate the weight bearing and the pain. I can walk that long in the hydrotherapy pool, but can only do that once a day. This is limiting my ability to cook for myself, shower, get groceries, etc...

I’m sorry if I sound like I’m simply complaining and whining...I’m just reaching out for help.
 
Hi...I am 15 months post-op, bilateral TKR. I had an MUA 4 months later. It feels like I have volleyball knee pads, made of setting concrete and soaked in acid, in both knees! I have good ROM, but I can’t stand or walk for more than about 15-30 minutes without both knees feeling like complete concrete blocks. Both knees are insanely sensitive to touch and feel very “nervy”. The Neurologist has ordered an MRI of my spine around the spinal block as she thinks there might be sensory nerve damage from the block. They have doubled the dose of Lyrica to 150 mg 2x/day and I am seeing some relief. Has anyone had a similar experience? Any input, thoughts, advice, hellos would be greatly welcome. I feel like I’m losing my mind! No pain meds help, at all. Thank you!
 
Last edited:
@kimbles ,
You'll notice that I have merged your newest thread with your original recovery thread. For several reasons, we prefer that you only have one recovery thread:
  • That way, we have all your information in one place. This makes it easier to go back and review your history before providing advice.
  • If you keep starting new threads, you miss the posts and advice others have left for you in the old threads, and some information may be unnecessarily repeated
  • Having only one thread will act as a diary of your progress that you can look back on.
So please post any updates, questions or concerns about your recovery here. If you prefer a different thread title, just post what you want and we'll get it changed for you.
If you need an urgent response to a question, just tag a member of staff.
How to tag another member; how to answer when someone tags you

Here are the instructions on finding your thread, How can I find my threads and posts? . Many members bookmark their thread, so they can find it when they log on.
 
Kimbles,
Recommend you seek out a MD that specializes in pain medicine.
Ask if they have someone on staff educated in Pain NeuroScience Education, it can help.

Also recommend you seek a second opinion for your TKR, from a surgeon specializing in Revisions, they have the education and background to determine what is happening with troubled knees. Look for a surgeon specializing in complex joint reconstruction or revisions. They should have no relationship with your present OS, not even golf buddies.
 
I only had one knee done, and a partial at that. My knee gets very upset immediately when I put pants on. It feels like something big and hard expands in the knee. I wear shorts as much as I can.

I had general anesthesia, no spinal block.

No one has an answer for me.
 
Hi @Kimbies - I do sympathise with you. I am 5 months post op and still suffer pain, although I can walk short distances and I only had one knee done. Some time ago my OS suggested I might have complex regional pain syndrome (CRPS), although I have not had a definite diagnosis. I see him this week so I hope to hear something more definite.
Please update us with the result of your mri and whether you get any further with diagnosis or treatment.
Also I tend to agree with pumpkin about seeing a pain doctor and seeing anther OS for a second opinion.
Take care.
 
Thank you, ladies. I have seen a pain management specialist, they did a Genicular nerve block, it didn’t help. I’ve had CT scans, ultrasounds, Lymphoscintography, nuclear bone scan, cryogenics, acupuncture, cold laser, e-stem, spiritual healing session, massage, xrays, Rheumatologist, allergy testing, etc, etc, etc...

That’s what is so frustrating, Lyrica and massage are the only things that have given me any relief at all. I swear I don’t know how I’m still sane, I seriously don’t know how much more I can handle.
 
When I had a partial knee replacement in June, 2017 and failed to recover well, I was diagnosed with complex regional pain syndrome (CRPS). My leg was always hot and red and had different rashes going on. I was referred to a pain management specialist who did a series of lumbar nerve blocks. I had an injection in the back to block the nerves to my knee. I had one about every other week for a total of 6 injections. It cured the CRPS. They say it can’t be cured, only put into remission, but I have had no issues since and that was a year ago now. I’ve since had the partial removed and now have s total knee replacement which was done on 10/2/18. I’m 8 weeks today and doing very well. No signs of CRPS whatsoever.

If it were me, I would see a new pain management specialist as well as find a surgeon who specializes in revisions, preferably neither of them will be associated with those you have been seeing so they can have a new perspective on what’s going on with you.
 
Hi Sue, Thank You for your input, I greatly appreciate it. I’m seeing a new Ortho tomorrow and I’m scheduled for a lumbar MRI on Dec 5th. They considered CRPS with me, but ruled it was out as I didn’t have a lot of the symptoms. I’m really leaning towards damage from the spinal block, as while the anesthesiologist was doing it, I was shocked twice, enough to throw me off the hospital bed. He actually asked me if I had scoliosis because he was having problems. The second tkr spinal block went perfectly fine, I didn’t even feel it. So, we’re leaning towards an issue there. I like the idea of lumbar nerve blocks! The Lyrica is helping, which lends me to believe this is a nerve thing. I might reach out to the pain management specialist I saw, to get his input. My guess is everyone will wait on the MRI results. I’m just so over this already!

I’m glad your tkr is going well! It can be a great thing when it works well...life changing actually!
 
Kimbies said:
They are telling me, with Arthrofibrosis, that I have to keep Movement in the joints or the scar tissue will adhere even tighter. This is why I’m so confused. It just doesn’t seem to matter what I do, they keep, getting tighter.
Click to expand...
Just a little point: With flexion at 120 and 125, you do not have arthrofibrosis. There's no need to keep exercising your knees. They will get all the exercise and movement they need, just with your normal activities of daily living.

It's not arthrofibrosis that is making your knees stiff and tight - it's swelling, caused by doing too much.
 
Hi Celle, I agree with you. I think that was just my surgeon's "catch all" diagnosis. I'm seeing a new Ortho tomorrow. It's looking more like nerve damage and scar tissue. MRI Dec 5th.
 
Sigh...no MRI, my insurance denied it! I’m so frustrated, this is so unacceptable!
 
Oh no. Can't you dispute it?
 
I have to have my Neurologist schedule a Peer-to-Peer review. And so far, she hasn't scheduled that. I have 14 days or it is canceled completely. And, now the Pain Mgmt Doctor I was referred to is "reviewing" my case to see if he'll even take it on. "If" he does, he won't schedule until the end of January.

I'd like to know how the "system" expects us to just go day-to-day, in this excruciating pain, and just be "ok" with their "no urgency" schedule? I've fought this for 16 months now, I'm Going To Lose My Mind! I'm not kidding!
 
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