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Hinged Joint Revision Complete, recovery continues

Hi Chris, just caught up with you. It sure is a long old road. Most interested to learn about the removal of your scar tissue. Does this mean that the misalignment will be tackled without further surgery?
 
Hi Chris I am trying to find out the difference between an arthroscopic arthrolysis and an arthroscopy. I have tried google but I'm still unclear. Could you help? From what I think I've picked up arthroscopic arthrolysis refers to keyhole surgery to correct a knee problem eg, removal of scar tissue. Arthroscopy seems to relate to a keyhole technique for diagnostic purposes.???????
 
patient 99 said:
From what I think I've picked up arthroscopic arthrolysis refers to keyhole surgery to correct a knee problem eg, removal of scar tissue. Arthroscopy seems to relate to a keyhole technique for diagnostic purposes.???????
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My understanding is Arthroscopic arthrolysis for the removal of scar tissue with key hole surgery. Arthroscopy is an umbrella term for any surgery performed using an arthroscope, such as for a partial meniscus repair, ACL repair, gall bladder removal, diagnostic, etc, and would include scar removal. The first word is describing the surgery would be arthroscopic the second word would describe what was done during the surgery.

The past week has been stressful thinking about having the scar tissue removed, working on my gait, massage therapy, arranging injections into my iliotibial band, and figuring how I should proceed.
Now have cold sore to show for it.
After much thought I have come to the conclusion that there is no need to rush into the arthroscopic surgery to remove scar tissue. I am going to continue with the massage therapy, gait training, arranging the injections, then decide if I need to have arthroscopic removal of my scar tissue.

I had some superficial adhesions on the lateral surface of my knee, over an old incision, that my massage therapist was able to release last week. My knee feels better, I am sleeping better with less pain since this release.
The appointment with my physiatrist on the 21st for an evaluation, then they will set up the ultrasound guided injections. I am hoping by the end of April or early May I will know if the injections have helped, and will move forward from there.

Yesterday I walked quite a bit, so far no increase in pain or discomfort. Taking easy today, no need to see how far I can push before I have problems.
 
Thanks Chris, very much appreciate your taking the time to provide such an informative post. What does the injection into your iliotibial band contain?

You do have a lot to think about and they are important decisions so its no wonder your stress level has risen. There's a lot out there to help with stress - eg meditation, but you know that already. Regarding massage to release scar tissue. Can it happen at any time or is it generally thought to be best when done in the early stages before the scar tissue has had a chance to mature?
 
The injection I will be receiving will be one of the steroid injections, not sure exactly which one. I will ask at my appointment next week.
patient 99 said:
Can it happen at any time or is it generally thought to be best when done in the early stages before the scar tissue has had a chance to mature?
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Complex question, the answer is not straight forward. "scar tissue" takes many forms, from the normal healed soft pliable scar tissue over your incision, to the tough tissue of arthro fibrosis or keloids, that have to be surgically removed, or medically managed. For everything in-between, you first have to find it, and that is when it is ready to be start being released. Your challenge is finding someone who has the talent, skills, and ability to find and release these tissues. And being patient.
 
Hi @Pumpkln

I'm reading with great interest about your forthcoming steroid injection. You've really thought this through long and hard. I think decision making in the recovery process is so hard.

I will look forward to seeing how you get on with the injection and massage therapy. I can understand why you're trying the none surgical route first. I don't blame you.

I wish you luck
love Nana moon 27 xox
 
You can feel the denser areas of tissue, and the slight sounds coming from my knee when walking, and of flexing my knee. Sounds like the gentle rumble you get in your car on rough surfaces.
Early on there was a loud velcro ripping sound, it is gone now. (for the most part)
Your OS or PT or Massage therapist etc should be able to palpate this type of tissue.
 
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Interesting. Perhaps my problem isn't scar tissue. I cannot feel any denser area, nor is there any sound. What there is is a tightness when I'm on my feet. I can feel that without a doubt. It feels as if there is a 2 inch leather belt sitting just above my knee. It sits horizontally. To a lesser extent the same feeling sits vertically on the medial side. When I try to achieve flexion greater than around 110 the leather belt cuts into me. Perhaps what you call `dense area' is similar to what I am calling `leather belt'.

Perhaps I expect too much, but wouldn't you think an OS would diagnose it without difficulty. Neither my lst OS nor my second opinion have shed any light on it.
 
@RunA42K Hi Bonnie When you feel up to it would you look at the 2 posts above. Does what Chris and I describe sound anything like what your scar tissue felt like?
 
[Bonesmart.org] Revision Complete, recovery continues
How fast did that last year go? I cannot believe it's a year already!!!
Happy Ankeeversary @Pumpkln
Love Nana moon 27 x (still shocked at timescale!) x
 
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patient 99 said:
@RunA42K Hi Bonnie When you feel up to it would you look at the 2 posts above. Does what Chris and I describe sound anything like what your scar tissue felt like?
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@patient 99 Carol...you are describing my knee...both times! First off I've had the same Physical Therapist all these years, he could not tell the difference in the tissues being denser. I had my first OS totally dismiss me with scar tissue calling it "highly unlikely." My revisionist I went to for help 9 months post op asking about scar tissue and he said he'd not evaluate me for that till one year post op. So I went back two more times and he basically blew me off. I told him I'd be back when my knee was totally non functional. Well I didn't go back, both times I got help for my scar tissue from Dr. David Lintner who does not do knee replacements but is an expert and teaching doctor in Arthroscopic surgery. He has been the one and only medical professional who could feel my tissue and tell me what I already knew to be true and that there was scar tissue.

I can tell you that my knee never made a sound, I felt like I was being strangled with that tight belt all the time. It felt really tight across the entire front and top of my knee and medial side in particular although they told me it was in lateral side as well. It felt full and trying to bend it I'd get pain behind the knee on the lateral side because it was thick sheets grabbing onto everything. No amount of massage would have ever gotten rid of it, it was crippling!

Read about my doctor, David Lintner in Houston, Texas .I know you are in the UK but perhaps you can find someone like him who will listen to you. I'll post more about it on my thread because I saw Dr. Lintner today and got pictures. All I can say is OMG!!!
 
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Thanks Bonnie! @RunA42K
:goodpost::thankyou:
That should be very helpful for Carol who has been looking for answers for the last year+.
I think what I am experiencing, palpable scar tissue, crunching, velcro ripping, burning under my knee cap, is closer to @skigirl s experience. My ROM is better than before revision.
Interesting how scar tissue, arthrofibrosis, adhesions, etc are all so different.
Hoping you can post photos of Dr. Litner's photos of your knee in your thread.
 
Pumpkln said:
Thanks Bonnie! @RunA42K
:goodpost::thankyou:
That should be very helpful for Carol who has been looking for answers for the last year+.
I think what I am experiencing, palpable scar tissue, crunching, velcro ripping, burning under my knee cap, is closer to @skigirl s experience. My ROM is better than before revision.
Interesting how scar tissue, arthrofibrosis, adhesions, etc are all so different.
Hoping you can post photos of Dr. Litner's photos of your knee in your thread.
Click to expand...
I forgot to say that I felt like my knee was also burning inside...always warm to the touch too. I'll scan my pics to post but right now I am a prisoner to the CPM and ice machine! Not complaining one bit! Enjoying the rest for a change.
 
RunA42K said:
I know you are in the UK but perhaps you can find someone like him who will listen to you.
Click to expand...

Bonnie, much appreciate your reply. When I raised the issue of excessive scarring with my OS he said you are not bad enough for open arthrolysis and arthroscopic arthrolysis has a poor success rate. Don't know where to begin in trying to find the right man. But thanks again for giving such a clear account.
 
So how do they know if this scar tissue is there without going in
To look


Sent from my iPhone using BoneSmart Forum
 
Wberry,
Some scar tissue can be felt, and has a ripping velcro sound, some restricts ROM, some cause swelling, and can be painful. Reading from post 2110 to 2116 will give you more information.

Carol,
You do not have to rush into anything, and have plenty of time to find the right OS, it could be an OS outside of the TKR business.
 
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