The Scar Tissue Came Back— And How TX-33 Could Stop It
When you have knee surgery to remove scar tissue (also called adhesiolysis or cutting of adhesions), the goal is to help you move freely again without pain. Scar tissue forms after injuries or surgeries and can limit your mobility, causing discomfort. Unfortunately, even after successful surgery, scar tissue often tries to come back (up to 40% of cases), leading to more issues. For an athlete, elite, competitive or recreational, it can hamper your performance, sucking the joy of what you love to do!
Athlete Perspectives and Quality of Life
The recurrence of scar tissue after adhesiolysis can have profound implications for an athlete’s quality of life and performance. Chronic pain, reduced mobility, and the need for additional surgeries can lead to frustration, decreased physical activity, and mental health challenges such as depression or anxiety. Therefore, preventing adhesion recurrence is not only a matter of physical health but also of overall well-being.
· Reduced Range of Motion (ROM): Knee injuries leading to scar tissue can cause a loss of up to 30-50% in range of motion if not treated promptly. This can decrease an athlete's ability to run, jump, and perform other sport-specific actions.
· Injury Recurrence: Athletes with significant scar tissue formation in the knee are more prone to re-injury. Studies show that athletes with knee scar tissue are at a 2-3 times higher risk of recurrent injuries compared to those who recover with minimal scarring.
· Performance Decline: The presence of scar tissue can lead to a reduction in muscle strength, proprioception, and overall stability in the knee joint. This can decrease sprint speed by 10-15% and vertical jump by 5-10%, impacting athletes in sports that demand high agility and power.
· Recovery Time: For athletes, recovery from knee surgeries that result in scar tissue can extend up to 6-12 months or longer, with additional physical therapy often required to break down scar tissue and regain full function.
One of the newest tools in early development by Temple ORTHOBiologics is TX-33.
Dr. Riley J Williams III, an attending orthopedic surgeon at the Hospital for Special Surgery says, “TX-33 is a game changer.” Dr. Williams, team physician for professional sports teams knows a bit about knee injuries and athletes and their desire to get back. “They want that feeling again of I’m back!”
TX-33 is a unique combination of advanced biomaterials and a derivative of a compound used for years by athletes for muscle recovery and repair. When injected into the knee joint, after injury or surgery, it works by promoting healthy healing. Combined with advanced rehabilitation techniques and a proper diet and lifestyle, it can accelerate recovery and support a quicker return to play.
"As an athlete, I’ve faced my share of injuries, and finding the right treatment options can feel overwhelming. Scar tissue coming back after surgery is frustrating—it restricts movement and can bring you back to square one. That's why it's so exciting to see advancements like TX-33, which could really help reduce that risk. Whether you're an elite competitor or just trying to stay active, this kind of innovation is a game-changer in keeping you pain-free and moving forward." Neville Wright, performance and recovery therapist and 3X Olympian
Understanding Adhesiolysis and Scar Tissue Formation
Adhesiolysis involves the surgical removal of fibrous scar tissue that binds the structures within the knee joint, limiting its mobility and causing discomfort. This procedure is typically considered when conservative treatments—such as physical therapy, medications, and injections—fail to provide adequate relief.
Scar tissue, or adhesions, forms as part of the body's over-exaggerated reaction following injury or surgery. While some scar tissue is beneficial for healing, excessive or improperly formed adhesions can lead to chronic pain and restricted movement. The goal of adhesiolysis is to restore normal joint function by removing these problematic adhesions or scar tissue.
Reformation Rate of Scar Tissue After Adhesiolysis
The reformation of scar tissue after adhesiolysis is influenced by various factors, including the underlying cause of scar tissue, surgical technique, postoperative rehabilitation, and individual patient characteristics.
Reported Recurrence Scar Tissue Rates
General Estimates: Studies indicate that scar tissue can reform in approximately 10% to 40% of patients following surgical removal of the scar tissue of the knee.
Surgical Technique and Expertise: Advanced surgical techniques and the surgeon's expertise play a significant role in minimizing scar tissue recurrence. Minimally invasive approaches, such as arthroscopic adhesiolysis, tend to have lower recurrence rates compared to open surgical methods.
Postoperative Rehabilitation: Adherence to comprehensive physical therapy and rehabilitation programs post-surgery is crucial in minimizing scar tissue reformation. Early mobilization and targeted exercises help maintain joint mobility and reduce the likelihood of scar tissue reforming.
Underlying Conditions: Patients with chronic inflammatory conditions, such as rheumatoid arthritis, may experience higher rates of adhesion recurrence due to ongoing inflammation that promotes scar tissue formation.
Patient Factors: Age, activity level, and overall health can influence the likelihood of scar tissue reformation. Younger, more active individuals may have different outcomes compared to older patients with comorbidities.
Factors Influencing Adhesion Recurrence
Surgical Technique: Precision in removing all problematic adhesions without causing additional trauma to the joint structures is vital. Surgeons who employ meticulous techniques and utilize tools like arthroscopes can enhance outcomes.
Postoperative Care: Effective rehabilitation protocols that emphasize gradual mobilization, strength training, and flexibility exercises are essential in maintaining joint health and preventing scar tissue from reforming.
Biological Factors: The body's inherent healing processes and genetic predispositions can affect scar tissue formation. Some individuals may naturally heal with less fibrosis, reducing the risk of adhesions.
Adjunct Therapies: The use of adjunct therapies, such as anti-inflammatory medications, scar tissue inhibitors, and regenerative treatments (e.g., platelet-rich plasma [PRP] injections), can help minimize adhesion recurrence, although the evidence is of low quality on its effectiveness
Strategies to Minimize Scar Tissue Reformation
To reduce the likelihood of scar tissue reformation after adhesiolysis, a multifaceted approach is recommended:
Advanced Surgical Techniques: Utilizing minimally invasive arthroscopic techniques can decrease tissue trauma and inflammation, promoting better healing with fewer adhesions.
Comprehensive Rehabilitation: Engaging in a structured physical therapy program post-surgery is critical. Therapists focus on restoring range of motion, strengthening muscles around the knee, and ensuring proper joint mechanics.
Biological Interventions: Incorporating treatments like TX-33, which utilizes advanced biomaterials and pharmaceutical-grade derivatives to prevent scar tissue formation, can offer additional protection against adhesion recurrence. These treatments, when approved by FDA, work by enhancing the body's natural healing processes, promoting healthy tissue regeneration, and minimizing excessive fibrosis.
“Stiffness can cause pain, and pain can cause stiffness. Breaking this cycle is a key factor in optimizing recovery from knee injuries and surgeries.” Dr. Shaun Patel an orthopedic surgeon and Castle Connolly Top Doctor.
Patient Education and Compliance: Educating patients about the importance of adhering to rehabilitation protocols and lifestyle modifications can significantly impact outcomes. Encouraging consistent exercise, maintaining a healthy weight, and lifestyle (e.g. no smoking) and avoiding activities that strain the knee can aid in long-term joint health.
Monitoring and Follow-Up: Regular follow-up appointments allow healthcare providers to monitor the knee's progress, address any emerging issues promptly, and adjust treatment plans as necessary to prevent adhesion recurrence.
Clinical Insights and Research Findings
Recent studies have delved into the effectiveness of various interventions in reducing adhesion recurrence post-adhesiolysis:
Arthroscopic Adhesiolysis: Research shows that arthroscopic adhesiolysis, when combined with aggressive physical therapy, results in lower recurrence rates compared to open surgical methods. The minimally invasive nature of arthroscopy reduces tissue damage and promotes quicker healing.
TX-33 and Regenerative Therapies: Innovative treatments like TX-33, which combine advanced biomaterials with pharmaceutical-grade molecules, have demonstrated promising results in preventing scar tissue formation. Clinical trials focusing on pelvic surgeries have shown significant reductions in adhesion formation, and ongoing studies in orthopedic injuries aim to extend these benefits to knee surgeries.
Adjunct Pharmacological Agents: The use of anti-fibrotic agents and other pharmacological interventions during and after surgery has been associated with decreased scar tissue formation. These agents work by modulating the body's inflammatory response and inhibiting pathways that lead to excessive fibrosis.
Conclusion
Adhesiolysis in the knee is a valuable procedure for addressing debilitating scar tissue that impairs joint function. However, the reformation of scar tissue post-surgery remains a significant challenge, with recurrence rates varying widely based on surgical techniques, postoperative care, and individual patient factors. Current estimates suggest that scar tissue can reform in approximately 10% to 40% of cases, though this range can fluctuate based on specific circumstances and interventions employed.
Advancements in surgical methods, comprehensive rehabilitation protocols, and innovative treatments like TX-33 offer promising avenues to reduce the likelihood of adhesion recurrence. By adopting a holistic approach that combines precise surgical intervention with robust postoperative care and emerging regenerative therapies, healthcare providers can enhance outcomes for patients undergoing adhesiolysis in the knee.
For individuals considering or having undergone adhesiolysis, it's crucial to engage in open dialogue with orthopedic specialists to understand the risks, benefits, and strategies to minimize scar tissue reformation. Personalized treatment plans that address both surgical and rehabilitative needs can significantly improve long-term joint health and overall quality of life.
If you are interested in following the latest development of TX-33 and other if you find this type of information helpful for your journey, click here.
Medical Disclaimer
The information provided on this blog is for educational and informational purposes only and is not intended as medical advice. While we aim to provide accurate and up-to-date information, it should not be used as a substitute for professional medical consultation, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this blog.
If you think you may have a medical emergency, call your doctor or local emergency services immediately.
