Losartan & upcoming lysis of adhesions again
I'm wondering how long someone is tentatively on Losartan after surgery? I had a knee scope done last September with no issues, then this March had a partial knee replacement. In May I had removal of lysis of adhesions and now I have to have another surgery due to arthrofibrosis this week. I've been using Dynasplints daily since July but It hasn't helped a great deal as I feel it was too long after surgery that I started using them. This time I will have them right off and also a CPM. I'm also a PTA so I've been doing my own PT at home. I never thought I was too aggressive as I've been working with patients for 24 yrs with no issues but haven't really had patients with arthrofibrosis. I will back off on strengthening and focus mainly on gentle ROM. I do wonder though approximately how long after surgery to gently start strengthening and more active stretching? My surgeon will also be using Seprafilm off label to put over the implant to also help prevent scar tissue. In the past Prednisone was the only thing that helped with edema. I'm very surprised to read the literature stating it can actually cause edema. My surgeon is thinking of prescribing Losartan for me, I'm wondering how long is someone tentatively on this medication after surgery? I'm in the US in Florida and there are not a lot of surgeons who are trained in arthrofibrosis.
Jessica
Hi Jessica,
I don't know for sure, but I doubt there would be much difference in terms of scar tissue and the different timing, so long as you take Losartan at the same time each day. Losartan down regulates the activity of myofibroblasts, which includes scar tissue and adhesions, but these can occur at any time. Although I guess that adhesions are more likely to occur overnight due to immobility, so an evening dose might be better, but several hours before bed because it might increase urine production in the short term.
Kayley