Cosmetic treatment for internal knee scars- is this a thing?

psaljf

This is a question that I have never plucked up the courage to ask my consultant or even voice to those around me. If I am honest, I'm not sure how comfortable I feel acknowledging this to other people who also live with arthritis. I guess that I am ashamed that I have allowed the appearance of my knees to bother me. I am not generally someone who thinks much about my appearance; I don't wear make-up, rarely get my hair cut and have never felt the need to cover up my psoriasis. The appearance of my fused fingers and toes don't even bother me and I don't feel the need to hide them. However, for some reason, I am very conscious of the size of my knees. They are wider than my thighs and calves and people comment on them (in a sympathetic way, not to be cruel). I also find them awkward and the shape of them causes trousers to wear through quickly at the knee, even if they are baggy or stretchy.

Since having children (and therefore having 2 stints of 9 months off medication), the rheumatology team has struggled to get on top of my knee symptoms and this has left me with permanent scarring inside my knees. My youngest is nearly 8 so I've been back on biologics for a while but there hasn't been an improvement. I did have a synovectomy on my right knee due to a persistent rupture which caused my leg to fill with fluid, and although this fixed the latter problem for a short while, it did not change the overall appearance of my knees. New biologics work for a short while; they reduce the additional inflammation and allow for some additional movement but my knees still remain visibly large.

I do struggle with the pain of my arthritis but work incredibly hard to stop this from getting me down. It does impact my life but I have come to terms with this and have been able to adapt. Hope is the thing that keeps me going. The hope that there's a medication out there that will improve my overall condition or at the very least stop it from getting worse as well as the possibility that the size of my knees could be reduced.

In short, I guess that I would like to know whether cosmetic treatment to remove internal knee scar tissue is a thing and also would a rheumatologist take this request seriously. I would never expect the NHS to pay for such a thing due to it being for cosmetic reasons and may never go through with an operation. However, knowing there's an option would just give me that bit of hope that I look for to keep me going.

Also, does anyone else have similar PSA symptoms to me and do they have any top tips?

noddingtonpete

Hello @psaljf and welcome to the Community.

It is good to read that you are keeping above the conditions and remaining hopeful. Research and treatment breakthroughs are happening all the time and hopefully one will happen which helps you.

It might be worth talking to your GP or Consultant about this as it is obviously important to you and they will know if any cosmetic treatment is available and chances of it working. If it affecting your life you may find that the NHS would pay - always worth enquiring.

I hope you get some progress on this, please let us know.

Best wishes

Peter

stickywicket

This is a difficult one, isn'-t it?

I'm wondering several things.

1. You write of rheumatology and biologics so I guess you have an inflammatory artHritis. You also say the meds are not controlling it. I'm wondering what your blood tests say. If they're bad then you're right but, if not, then we're talking pain. It's possible that, with longstanding inflammatory arthritis, you might also have acquired OA. (You would not be alone!) If so, could the pain be from OA not scar tissue? I'll be honesr, I'd never heard of internal scar tissue and I've had borh knees and hips replaced. I did look it up and it seems surgery is the last option offered. Physio and massage come to the fore.

2.If you decide to go ahead (I don't think the NHS does it even if you wanted them to.) do your research about both the private hospital and the surgeon. Is he qualified to work in the NHS? (Presumably he does other ops too) Not all private surgeons are. How successful is the op? What will it achieve? For how long?

Basically, just proceed with caution😆

psaljf

Thank you both for your responses, it is very kind of you to take the time to comment. I have Psoriatic Arthritis which was diagnosed about 20 years ago when I was in my teens. Since then I have been on methotrexate, anti-inflammatories, and biologics. which have all worked to some degree. Because my condition is fairly active, I see the rheumatology team a couple of times a year and they are very good at taking action and switching to new drugs when I get antibodies to the current ones I am taking. I did have an MRI before I had a Synovectomy a few years ago and my knee joints were healthy and I am sure that they still are, which is certainly a positive, it's just the inflammation and scar tissue that causes the pain and restricted movement. I will pluck up the courage to discuss this when I see the consultant in a few weeks.

Stickywicket, thank you for suggesting physio, this is something I will look into.

Best wishes,

L

stickywicket

I think discussing it with your rheumatologist would be a good place to start. Don't be afraid of this. It's what they're there for. Frankly,, I'd be interested to know the rheumatologist's opinion on how the scar tissue originated.. i got RA at 15 and, back then, there were no modern DMARDS let alone biologics. It was aspirin at first odd bouts of steroids and then years of NSAIDS before I reached the nirvana of methotrexate. . I also had two, meds-free pregnancies. (Great first time. Nightmare second.) but - and here's the thing - no scar tissue such as you describe. Maybe I just got lucky.

I certainly would try physio. Also, a friend, with severe, long-standing PsA, used to find sports massages very good. Just for pain relief. She found no benefit from ordinary massage but loved the real, digging in, sports ones.