Re: surgical removal of adhesions that developed after knee

From: Mark in Seattle (
Thu Aug 10 17:19:22 2006


>Shortly after knee replacement surgery, my wife developed a case of
>adhesions which started to place limits on her physical therapy regimen.

>She went back to her surgeon who then recommended manipulation of the
>knee...this was done and she received some relief..but only short term...

>Her knee joint and back of the leg is now stiff and painful and we are
>wondering about surgical removal of the adhesions that seem to be causing
>her problems...

>What advise and experience do you have for her...Thanks so much...

>David Nordin.. Michigan

Dear David,

It sounds like your wife's surgeon is reluctant to do more surgery. That's a common reaction from surgeons. And it may be the appropriate one. Surgery is very risky. Some surgeons are willing to do it. Others hesitate. It seems that on the whole, the state of the art techniques cannot guarantee a successful outcome.

The good news is that this is about to change. When the ongoing trials are completed and assuming all goes as expected, Doctors will be able to administer the drug Celebrex during the 10 days after surgery. This has been shown to prevent the formation of adhesions in laboratory mice.

Something else that seems to do the same thing are proteolytic (fibrinolytic) enzymes. An August 2000 study in the Netherlands shows reduced adhesion formation in rabbits. What's more, there are people who will claim that these fibrin digestion helpers actually enable the body to break down fibrin that has already formed into an adhesion. I'm not qualified to say how they know this and I could find no studies to support this claim. Nor do I expect there ever to be one, since enzymes are not patentable. (Oh the joys of living in a free-market economy...) However, there are people on this forum who say that it works, albeit very slowly. It can take months and even years before benefits are realized. It's takes a bit of faith, but for those of us to whom surgery is denied, what can we lose. Cost is about $500 for a 10 month supply. Brand names include Fibrozym, Neprinol, Vitalzym, and Zymactive.

Mark in Seattle

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