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Sports Medicine

Scar tissue - both knees have been replaced!

11/14/2007

Question:

I am miserable - had left knee replaced 5/15/06 and right knee replaced 5/15/07 - I can`t walk - pain meds don`t work and haven`t slept in 2 years for more than 1 hour....both knees are filled with scar tissue - 4th doc wants to do another knee replacement and I don`t think I`ll make it through surgery...I`m 64, have had 3 mini-strokes, I take coumadin which means I have to bridge ....can they suck out the scar tissue through arthroscopic procedure? New doc says I have valgus but docs who did left & right knees says I`m right on the money with straightening degree. I will lose all the rest of my business with more surgery. Had left knee scoped 5 years ago - the pain is minimal than what I am currently experiencing. HELP!

Answer:

I would hope one of the orthopedic surgeons you've seen can give you some idea of why neither of your knee replacements helped your pain. Could at least some of your "knee" pain be referred from elsewhere, such as your hips or lower back?

Although you state "pain meds don't work," unless you've consulted with a pain medicine physician and have exhausted all pain management options, this statement may be premature and incorrect. There is a long list of multiple medications which may be beneficial, singly or more likely in combination, from such categories as:

Wearing a knee sleeve on one or both sides, trial use of a TNS unit (portable electrical stimulator), and partial off-loading by 1 or 2 cane(s) or a community wheeled walker (with a seat) may be worth considering. I would assume - and hope - you've undergone a course of PT, which would be useful to maximize range of motion and strength. If you've developed scar tissue following both of your knee replacements, it would seem more than likely that the same thing would happen if you undergo a repeat knee replacement surgery. I would defer to an orthopedist your question regarding whether there is any arthroscopic procedure to remove scar tissue from a knee replacement which wouldn't create more scar tissue as a result.

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Response by:

Brian L Bowyer, MD Brian L Bowyer, MD
Clinical Associate Professor
Physical Medicine & Rehabilitation
College of Medicine
The Ohio State University