Three years ago my wife had her knee totally replaced. She had good motion and pain-free service for about a year. Then she developed pain and the doctor xrayed and said that she had formed scar tissue within the incision - it was visible as a darkened spot on the xray. She has been using an anagelsic cream for about a year but the pain is very severe at times. What is a solution? We have tried massage etc.
Starting all over slowly on the exercises would be the 1st step. My guess is that when she obtained desired ROM she stopped. The analgesic cream ist a healing product for deep tissue only for pain. Try a Try a Vit E oil. Its a very thick product that treats scar tissue and heals. Warm the leg and massage it in with the thumb using as much pressure as she can stand. Apply about 15 min of heat afterwards. Do this 2 to 3 times daily. Along with the excercises she should feel the tightness loosen thoughout. Use it on the entire knee so that it softens the tissue in a large area. It might take a couple of weeks to start feeling the effects. I've had to rebuild my knee 5 times completely and have had 11 surgeries plus radiation. I didn't hear about the oil until I had the 555th surgery and radiation. Personally I've had really good luck. My scar is a foot long and only the middle 4-5 inches is really visable and none of it is really inflexible. Scar tissue is one of the nastiest parts of the process because of the internal stitches as well as the external. Other than that an invasive surgery to release them the natural oils is the most likely process of healing. I'm in the US and the oil I mentioned is available OCT at any pharmacy. Its sort of pricey as a bottle of less than an ounce is around $ 20 but it lasts a long time. You don't have to use mu c h each application as the massage part is really important.
5th surgery NOT 555th. (although some times it feels like it). I'm sure others will have some good ideas and another thought, hydrotherapy if you have access to a pool. Make sure the heat I previously told you about is moist heat as well.
Thank you for the information. I'll purchase the oil and give it a try right away. The formation of the scar tissue was really unexpected as her walking regime was constant from the very first days following her surgery. She reached a mile daily within a few weeks then reached and maintained at least three miles for the past 3-4 years. Her range of motion was (and is) good but she does get a lot of tingling around the knee. Her doctor said that this nerve damage would probably heal and the tingling would go away, but that hasn't been the case. Once I purchase the oil and start the massages I'm certain that I'll have additional questions. Thank you again for the information.
We do have a hot tub but that doesn't provide too much exercise! We will try the moist heat, however. Thanks again.
Hot tub isnt the answer as you need depth and the ability to hold on to the side as you go through a set of controlled excercises that are under the direction of a physical therapist. Just sitting in water with the water circulating around you won't help.
It seems like there is always popping up with the rehab. Like i said I've had to rebuild the leg completely 5 times an have had 11 surgeries which include a broken femur, 2 bouts of epi staph which required 2 months of antibiotic infusion, the last time the prosthesis had to be completely removed, 2months of infusion (2 x's a day) and the leg had to be immobilized for 4 months w/minimum weight bearing (toe touch) then the new appliance installed and immobilized for another month before restarting therapy. Its always something different every time. My problems started @ age 65.5 and I roll over the body odometer to 79 a month from today. It just takes an open mind to change and willingness to. Fight the battles as the come. This forum has been really good for information sharing. There are people from 10 different countries that have contributed do you get a lot of ideas and a better understanding of health care throughout the world as well as how the system works for various age groups. I'm in the U.S. and on the Medicare program for people over 65. Just keep asking questions and remember everyone on here is speaking from experience of either themselves or as in you case, someone very close and dear to them. One of the worst case scenarios is someone trying t o be an expert when they are just working from hearsay or minimum data because they have stumbled onto the site and have just enough information to be dangerous.
hi honestgeorge welcome !! i have to agree with OFG here ,he has been through much more than i have ,though ive been through the mill with tkr and have had one of my knees totally opened up 3times and a few small ops inbetween ,it takes its toll on your body and your mind there were times i was really losing my mind , but thank god i was stronger than id ever believe so i suprised myself and like OFG its all about fightening back and making it happen . its great you are there for her my husband has kept me going when ive hit the floor sometimes choice words ! but i forgive him ha!! but seriously the scar tissue is a problem most of us deal with in some way or other deep massaging is very important and keep excersising im using bio oil but i think il get vitiman E oil ,as ive used it awhile back and it is great so i would go down that road . severe pain i get that sometimes im afraid you just have to keep pushing on with excersises gym might help also get a rehab program but make sure the gym you choose are good at rehab and that they will support your wife through it ,ive found a gym whch have really supported me and are always keeping an eye on my progress and encourage me to go and ask for help anytime its been great for my self confidence good luck to you and your wife
Good information to know. I wouldn't have realized either that the scar tissue could develop after a year. Good reason to keep up with exercises and massaging with Vit. E oil. Thanks.
I didn't realize it either. That explains the tightness I still feel (11 months post op).
I also didn't realize that using vit e oil would still help so I had stopped using it. Guess I will restart!
....and I will continue using it and massaging. I thought of it as something to be used "now" as I'm healing and to help the scar's appearance. So good to know. I found it helpful to know.
im 16mths post revision and i still use oil maybe because im not the perfect revision or tkr for that matter more a work in progress !!!!! but when i get there i will continue with it for sometime my other knee was a sucess and i use it on that one too
Thank you for the response and information. What type of exercises were/do you do? My wife has been through the therapy offered but I'm sure that she would rather do them at home now.
I'm definitely going to purchase the oil and massage the knee. What is your (and others) opinion on the 'walking on the knee' method?
The idea of using one's body to break up scar tissue sounds reasonable - but it's not MY knee.
Emis Moderator comment: I have removed the link(s) directing to site(s) unsuitable for inclusion in the forums. If users want this information please use the Private Message service to request the details.
http://patient.uservoice.com/knowledgebase/articles/398331-private-messages
I've heard several people talk about "revision" - what exactly is that?
Replacing the prosthesis. Basically the same as a tkr with a little less chisling and chipping of the bone. Various reasons: 1st one was done incorrectly, the original just wore out. In my case the original tumor that caused my problem came back and eroded the bone and the hardware games loose and was moving around. The rehab is pretty much the same as the original. Dr's tell you the prosthesis is good for 10-15 years and then has to be replaced through a revision. I'm sure others will elaborate on my explanation.
OMGosh! Horrible! I hope I don't have to EVER indure that pain EVER again. You have replied with great advice to me before, thanks! I go to my Dr on Friday and have a few concerns. I am just starting (partial done on my left inner knee on Sep 8th) to go down the stairs but have been going up for a while. Still have tightness and pain when I lift my leg up (legs stretched out straight and then lift straight up). Have a small bakers cyst behind my knee which Dr said can go away by itself. This weekend while out with my hubby I could barely walk - it's like I am going backwards. And then today (I work full time) I was walking pretty great. Just want to feel painfree...
....incidently, the cream that the wife uses is Voltaron Gel. It's expensive but does serve as a effective pain killer. Only about 4% of the aspirin from the gel gets into the system, the rest is localized to the knee. This protects her stomach from harm whereas taking the aspirin directly upset her stomach. The orthopedic doctor gave us the impression that massaging the gel into the knee would eventually break up the scar tissue but this hasn't been the case at all, but it does provide some relief from the pain. Do you have an opinion on this gel? I now have the vitamin E oil so will compare.
I have a correction also - 2-3 miles per WEEK not daily. We walk the dog and neither the critter or I want to tackle that much daily anymore!
I'm not familiar with the product. Is it OTC or prescription only? Maybe I just missed it but where did you say you are located. This time of year is extremely difficult in my part of the world. Cold, damp, continually changing barometer just magnifies every pain.