I had serious pain in my knee cap area about two years post TKR. I went to see my doc and he diagnosed adhesions. He did an Open Lysis (Removal) of Adhesions and said that my kneecap was held down by extension adhesions. He removed them and the problem was solved. I was in pain for about 3 or 5 days. But, then had to have a really slow recovery. He told me at least 10 times that if I exercised on a hot, inflamed knee, I would cause the adhesions to reform. So, no exercise at all for 3 weeks. I did heel slides and leg lifts at home. Mostly lay on the couch or the bed and red or watched videos. it was boring!!! At three weeks until 6 weeks I did table exercises--no weighbearing while exercising---I did leg lifts, clam shells, quad sets, etc. My PT did a lot of massage and basically helped to keep me sane.
At one point he looked me in the eye and said, Look, if we wait to do anything big until after 8 weeks, we will at least know that we gave it our best shot. If the adhesions reform, we will know that we did what was best for you. So, at 8 weeks, we began to do gentle standing exercises that built up until at 12 weeks when we did serious strengthening exercises. At 12 weeks I began to ride my bike outside, did lots of 20 mile rides that summer.
The upshot?? I have some adhesions in that knee still and I make a point of trying to ride a bike everyday. It keeps the knee moving. However I have no more pain and really I do a lot of stuff---like 20-30 mile bike rides and hikes. Am I glad that i did it? yes.
Some folks have an arthroscopic Lysis of adhesions and it seems that might be best. My doc was not sure he could get all of it and he did change out the spacer at the same time. I think it is a good idea to take care of it myself. Please ask any more questions that come up for you.