Does anyone know if surgeries in other parts of the body can increase scar tissue response in the knee? I have a deviated septum and have had arthrofibrosis (extension and flexion loss) for 8 years, my ent doctor wants to do surgery on my nose, could this increase the scar tissue response in future knee surgeries? I'm probably just being extra worried lol just wondering if anyone has any knowledge on this
I was wondering if anyone knows what the success rate of the EUKAF centre in Switzerland is.
Also is there any updates on new medications that are being researched for the treatment of AF
There is sufficient evidence that semaglutide (Ozempic, Wegovy) has powerful anti-inflammatory and anti-fibrotic effects, that I included it in my presentation at the Sports Medicine Congress in Copenhagen earlier this year. I'm planning to write a blog on this topic after the Arthrofibrosis Awareness Day.
I think semaglutide could help with post-op recovery, but unfortunately, it's unlikely that it will be a cure for established AF, as this has not yet been achievable for any form of fibrosis. However, anecdotally it may provide some relief from symptoms. There aren't any studies investigating it for AF at this stage.
Kayley
Has anyone had any success with medications? My rheumatologist put me on metformin before the last surgery. I have only been on for 3 months - which all my doctors say isn't long enough to assess. But the way the adhesions came back after the arthroscope I am really questioning if it is really doing anything.
My rheumatologist doesn't want to try Losartan as I tend to have low blood pressure. My good orthopedist (not to be confused with my ortho surgeon) mentioned some new research on GLP-1 and AF.
Hi Erika
I had 5 surgeries. After the 3rd one I learned a lot about AF and went to a different surgeon ( Dr. Noyes & Dr. Erlichman in Ohio) who truly understand AF. The mindset, treatment, and care was SO different than my other surgeon in FL who had a " oh well some people just get AF attitude and willing to do another surgery".
I got a blood test from Orthopedic analysis and found out I was reactive to Nickel so I had a Total knee revision with no Nickel in it.
To answer your question one of the biggest differences I experienced in OH was the medication realm after surgery.
In my previous surgeries I was on 5 mg of Prednisone and Celebrex which didn't help as I always had AF return before 2 months.
My last surgery was different ( of course having the implant changed helped) but I was put on 20 mg of Prednisone which is a lot but it helped and I stayed on it for a couple months while I was meeting my Rheumatologist and figuring out a plan. It took several months to wean off. Surgeons don't like you to be on steroids that long but it helped and my Rheumatologist helped me wean off it and and at 7 weeks after surgery I started Methotrexate 20 mg injections once a week I did at home.
This is something a lot of Dr. Noyes patients do ( some others do PRP injections). I did that for 11 months and was completely off the steroid. It worked very well.
I decided to get off of it at 11 months because of the side effects and started taking Sotyktu (off label) as it targets cytokines that promote fibrosis.
It's a lot stronger than Methotrexate so I had to play around with the dosage. I went from everyday to twice a week and it was working well but as some medications cause your immune system to suppress a got a few infections like a yeast infection and covid so I stopped it for a moth, however it was keeping scar tissue away.
I'm trying once a week now and i'ts been a few weeks since I've been back on it.
My ROM is great but I do get a lot of edema still which I have for a year and a half since surgery. Some people still get edema after for whatever reason.
I tried Losartan after the first couple surgeries I had and it didn't help at all. I wouldn't do Metformin because I have a B12 deficiency.
In answer to your question I strongly feel the Medication realm is super important and hopefully someday it'll be proven.
Anything can happen to anyone at anytime but I'm blessed a year and a half out the AF hasn't returned and when I did stop the medication while I was clearing up the infections I had more edema and it didn't feel as good. Hope this helps and best of luck!!!
Also what else was a huge difference was the PT in Ohio was extremely different and gentle. Mostly stretching for awhile more frequently not to the point of pain and gentle quad strengthening. I rented an ERMI for a month it loos archaic but works so good!!!
Hi .. I have just discovered this site in my search for possible answers for my symptoms.
I have had knee issues all my life. I had my first arthroscopy age 17. Seven more followed over the years with chondroplasty, debridement and lateral release procedures, then PRP injections and finally a TRKR in July 2023 (at 46 years old) as my OA was very advanced by this stage (bone on bone with spurs).
I lost all quad function for 5 weeks and struggled with my bend. I had intensive physiotherapy both with the NHS (I'm in the UK) and privately, with little improvement. I achieved around a maximum 70 degree bend before an MUA at 17 weeks post op. After this MUA I halted at 90 degrees and then went backwards, again despite ongoing intensive manual therapy and sport massage,
I underwent a revision procedure at 10 months post op…
Hi Susanne,
I'm glad that you've found the IAA helpful! I can't vouch for anybody in particular in the UK, but I have heard that Glyn Evans performs arthrofibrosis surgery. I don't know his methods, but you could ask him if he uses the methods in the Surgery Checklist. I've also heard that the NDORMS, a part of the Medical Sciences Division of the University of Oxford, does arthrofibrosis research, so they might be able to help.
In my opinion another MUA would not be wise, due to the risk of complications.
All the best, and please feel free to ask questions.
Kayley
There isn't a simple answer to this great question, since it depends on many factors, however, in general an inflammatory stimulus elsewhere in the body can increase current arthrofibrosis symptoms in a joint. For example, getting the flu, or menstrual inflammation, can create worse joint symptoms. This is due to inflammatory cytokines (signaling molecules) and cells being transported via the blood to other locations. Usually, this increase in symptoms will resolve.
However, it's unlikely that surgery to another part of the body will increase the risk of (new) arthrofibrosis developing in the future, unless there is a significant and ongoing inflammatory response.
Kayley