TKR Recovery Journey Continues

Can you post some photos of the scar tissue?

The scar tissue (which is more correctly called adhesions) is very rare, and one of the easiest ways to develop it is to work your knee too hard. Over-worked knees get inflamed and hot, and hot tissues become drier than normal and more likely to stick together and form adhesions.

This article explains the difference between scar tissue and adhesions:
MUA (Manipulation under Anaesthetic) and Adhesions

You need normal scar tissue. That's what holds your incision together, and it's part of the normal healing process. Without it, you'd always have an open wound.
 
Here are a few.
 

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Over-worked knees get inflamed and hot, and hot tissues become drier than normal and more likely to stick together and form adhesions.

This article explains the difference between scar tissue and adhesions:
MUA (Manipulation under Anaesthetic) and Adhesions
That piece by Josephine is really interesting, I hadn't read it before. One paper she quoted gave a MUA rate of just over 1% but just from reading here it seems much more commonly used/ offered. I wonder how frequent it is or should be?
 
One paper she quoted gave a MUA rate of just over 1% but just from reading here it seems much more commonly used/ offered. I wonder how frequent it is or should be?
The best study I know of followed nearly 10,000 TKRs. They found that about 3.6% had problems with stiffness and 2.6% underwent MUAs.

See Acquired Idiopathic Stiffness after Contemporary Total Knee Arthroplasty: Incidence, Risk Factors, and Results over 25 Years, by Aaron Owen, et al, J Arthroplasty. 2021 Aug; 36(8): 2980–2985. PMCID: PMC8292170

If you search carefully you can find the full text version (the official journal version is not full text.)
 
@WFD Interesting paper- just read it. Very large study and done by Mayo clinic- so very reputable. The figures for stiffness and MUA still seem much lower than the impression I get from this forum. It seems a lot of people here are told they have stiffness and " threatened" almost literally with MUA. I accept that BoneSmart may not be totally representative as those with problems are more likely to seek advice- but it still seems high here.
This paper did say that definitions of stiffness vary and some studies claim up to 38% have stiffness. I do wonder if BoneSmart is right and a lot of what is called post operative stiffness is actually just swelling.
 
I think my situation was unique in that I didn’t have stiffness at all. My ROM was very good. I look forward to my follow up in a week to get anymore insight. I’m feeling good after the procedure. Just some tenderness and mild swelling.
Thanks for sharing that information, it’s so interesting.
 
Glad it went well and you are making a good recovery.
 
I wonder how many surgeons threaten the MUA just to try to ‘motivate’ their patients (as if we needed more motivation to get better!) and then don’t go through with it in the end. It seems like everyone I talk to even in my day to day who’s had TKR has been frightened by MUA threats from their surgeon. It makes me kind of angry…it seems unnecessarily cruel.
 
wonder how many surgeons threaten the MUA just to try to ‘motivate’ their patients (as if we needed more motivation to get better!)
That's the impression I am getting from reading here and it just seems counterproductive scaring people.
 
Sadly, it does seem to be that surgeons, for whatever reason, do use the threat of an MUA when it’s not necessarily needed. We’ve seen this for the entire time that BoneSmart has been in existence….almost 15 years! It’s the primary reason we advise people to just slow down and give their knees a chance to heal and slowly gain ROM at their body’s own pace. The “stiffness” that people often report can last a long time - over a year in some people - and it normally just takes time to resolve.

In the rare cases where a patient does develop adhesions, an MUA can improve things. But the patient must be careful to keep inflammation at the lowest level possible following the procedure in the hopes that new adhesions will not develop as a result of the MUA trauma.
 
I had my follow up with the surgeon who did my arthroscopy. He was very pleased and feels confident that scar tissue won’t return with a vengeance. I hope he’s right. I feel good, swelling is directly related to how long I’ve been standing or walking. I ice and elevate several times a day. I’m being conservative with my recovery approach and still hanging back from most things outside of my house.
It feels like a miracle that I can bend and extend without all of that crackly interference, I’m SOOO grateful.
 
A little update: On Monday I called my doctor’s office to leave a message for my surgeon that I was feeling some crackling in my knee again. No pain or swelling. I asked if I should pull back on activity or go forward in spite of it. I have this crazy fear of generating excess scar tissue again. He said “go forward and walk a little more each day.”
The crackling went away after two days and my knee feels GREAT! By that I mean I go about my day not even thinking about my every move. I’m almost back to where I was at 4 1/2mos. post op (before I injured my knee by popping and jarring it).
I feel on top of the world because I can release that fear about not getting better. I thank God for my recovery. Who knows what tomorrow may bring but I’m so grateful and excited to get my life back!
That feeling of hopelessness is worse than pain. And I would recommend to anyone suffering in that limbo to not give up and to definitely hold on to that hope. I appreciate all the responses and words of encouragement and hope to reciprocate on this forum, which is no less than a lifeline for us.
 
A little update: On Monday I called my doctor’s office to leave a message for my surgeon that I was feeling some crackling in my knee again. No pain or swelling. I asked if I should pull back on activity or go forward in spite of it. I have this crazy fear of generating excess scar tissue again. He said “go forward and walk a little more each day.”
The crackling went away after two days and my knee feels GREAT! By that I mean I go about my day not even thinking about my every move. I’m almost back to where I was at 4 1/2mos. post op (before I injured my knee by popping and jarring it).
I feel on top of the world because I can release that fear about not getting better. I thank God for my recovery. Who knows what tomorrow may bring but I’m so grateful and excited to get my life back!
That feeling of hopelessness is worse than pain. And I would recommend to anyone suffering in that limbo to not give up and to definitely hold on to that hope. I appreciate all the responses and words of encouragement and hope to reciprocate on this forum, which is no less than a lifeline for us.
Great news! I'm very excited for you. I can definitely relate to the feeling of hopelessness that things won't get better and it's as tough mentally as physcially.
 
I feel on top of the world because I can release that fear about not getting better. I thank God for my recovery. Who knows what tomorrow may bring but I’m so grateful and excited to get my life back!
I am so happy for you! I love your grateful heart. Thanks for your kind thoughts in regard to BoneSmart. There are lots of awesome members on the forum and support and encouragement is never in short supply.
Happy One Month Anniversary! I hope you have a lovely Spring! :)
 
Happy Two Month Anniversary!
I hope all is still going well for you. Have a great week! :)
@RaeRae1
 
Hi Layla! Thank you for that. I’m doing very well, I’m part of water exercise classes at our new fitness center and go about my day NOT thinking about my knee every step of the way. I so appreciate the encouragement and wish all the best healing to all bonesmarties on this journey. ❤️
 
Yay! That's what we like to read!
 

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