by Gray Arrant MBA
My name is Gray Arrant. I have been associated as a member with the bulletin board of the KNEEguru website for some years as I struggled with a chronic knee condition called ‘arthrofibrosis’ or 'AFS', which stands for ‘arthrofibrosis syndrome’.
Background to my problem
My first knee injury occurred when I was in high school over 40 years ago when I tore my meniscus on both sides of my right knee playing football. Despite this, I spent most of my thirties and forties without any major issues. When I reached my fifties I started having trouble with both my knees. I had developed osteoarthritis and had small tags of meniscus that were floating in my knee. I had a number of arthroscopic surgeries to clean things up in my right knee. Each time I had arthroscopic surgery my knee would feel better. At first, I went months with my knee feeling better but over time the surgery began to produce only weeks of improvement. The pain due to osteoarthritis increased to the point I was only sleeping two or three hours at night.
Knee Replacement complicated by stiffnes and bleeding
Despite my following lengthy proper rehabilitation protocols the decision was made in November 2012 to have a Total Knee Replacement (TKR). A month later I required a knee manipulation because of joint stiffness. By January 2013 things began to go horribly wrong.
My knee was bleeding internally. After a battery of tests to determine if I had a clotting disorder, another arthroscopy was performed, and the two attending surgeons came out to the waiting room to tell my wife that they had never seen a knee like mine.
I then had a bone scan that indicated possible loosening of the prosthesis. Because of this, as well as concerns about being allergic to the original prosthesis, the decision was made to remove it and replace it with another TKR, referred to as a ‘Revision'.
The Total Knee Revision took place seven months after the initial TKR followed by another manipulation one month later and I was prescribed the normal course of physical therapy. At this point my knee flexion was 90 degrees but after the second manipulation and standard regime of physical therapy (PT) my knee began a downhill spiral to the point where I had only 30 degrees of flexion.
I was told I had scar tissue build up and need to work harder at PT which I did for a few more days. Then, realizing this was making things worse, I quit going to PT. I began to search for an answer not knowing what I had. None of my doctors mentioned arthrofibrosis or AFS, and I had never heard either of these terms, but one of my local surgeons was very well connected and referred me to several other doctors.
At last I understand the issue
I saw doctors initially at the Mayo Clinic, and later at the Rothman Institute and Steadman Clinic depending upon the availability of appointments. At one point I was told “this is your new knee, learn to live with it.” After seeing each doctor I ask for the clinical notes. In reading through the clinical notes of the first doctor I saw he indicated that I had signs and symptoms compatible with AFS. It is my personal opinion that most doctors will not diagnose AFS because there is no definitive test for the condition. Therefore they will talk around the issue. It was extremely important to me to put a name to my condition so that at least I knew what I was dealing with. I also received great advice from each doctor not to have any more surgeries; that another surgery would only make things worse. In fact, I saw Dr. Steadman days before he retired and his comment to me was “My ego tells me I can fix this but my brain tells me I can’t, so I have to go with my brain”.
So I made the decision I would not have any more surgeries, but I still was dealing with the loss of a lifestyle. I lost the ability to drive, the ability to enjoy my hobbies and the ability to perform daily activities. I went on full time disability at work. After months of not working I lost my job. I was isolated in my home and I begin to spiral downhill both physically and mentally even though I was seeing a counselor and pain doctor. After consultation with my doctors, counselor, friends and family I begin to seriously consider an amputation. I saw no other option.
Eventually some hope
The pain I was having is indescribable. By serendipity, when I had a TENs unit implanted in March 2014 to reduce the pain and allow me to reduce my pain medication, my wife was in the waiting room talking with the wife of a chiropractor. She said she was friends with a chiropractor in Georgetown who had a machine that would break up the scar tissue and help in getting my lymphatic system to trigger the healing process. I asked for a referral, and was thus referred to this chiropractor in Georgetown,Texas who has machine called the “Hivamat”. Georgetown is two hours away from my home (one-way), but given my desperation to find anything that might help I was willing to make the trip. When I saw the doctor in Georgetown, he was confident he could improve my condition in 12 weeks. After several trips to Georgetown, where the doctor and staff did everything they could to start me on the road of healing, they referred me to a physical therapist close to me who they knew had a Hivamat.
Now to the reason for this article - which is to tell you about the Hivamat. I have no business relationship with or vested interest in the Hivamat. I am just a patient who has found amazing results from this system. I have been given a portion of my lifestyle back, and I expect to see continued improvement going forward.
First let me give you some results I have personally experienced in this 12 week period. My pain is significantly reduced. I mentioned earlier that I had an implanted TENS unit and I had been on heavy pain medicine six times a day. As a result of having Hivamat treatments, I take one pain medicine a day if needed and go without the TENs unit being activated most of the time. I have seen amazing results in a short period -
- My swelling has gone down to a point where at certain times it is hard to see any difference between my left and right knee.
- My flexion has increased to 70 degrees.
- At times I am able to walk without a limp.
I have started using light weights to build back the muscles I lost.
After some treatments I see no improvement and some treatments have even triggered additional pain and a reduction in range of motion. Overall I have experienced positive results that changed my life of pain to a life of little pain. I am not sure what the future holds but at least I have hope for the future, and I am willing to see this to the end.
My own understanding of how this is working is that the Hivamat machine provides a deep oscillating massage that produces a pulsed electrostatic field. This breaks up the scar tissue in the first internal layers. It also has the ability to reach my lymphatic system allowing me to flush the dead by-products out of my system and further increases the healing of the lymphatic system. Some of the other steps I take to encourage healing include drinking only water all day, icing my knee four times a day and using a compression hose at night while sleeping.
The outcome to date has been amazing and life-changing both physically and mentally.
The Hivamat was developed in Germany and is sold through distributors. I understand that most of the US professional teams in Hockey, Basketball, Baseball, and Football use the Hivamat. Because it is hard to find clinics in the US that are using this device, the US distributor, when I enquired, graciously agreed that anyone who has interest in finding a clinic in their area should contact the following email address: [email protected] Please do not call the distributor (at their request).
What I have taken away from my whole journey is that knee surgery can become a disaster if stiffness intervenes because of the kind of scarring that I developed. In my case it was probably a combination of a number of surgeries, plus the internal bleeding, that triggered my body to over-react with extensive scarring. Some people seem to be more reactive than others, but what has become clear to me is that there is a general lack of awareness of this condition, and how it should be managed.
National Arthrofibrosis Chapter
I want to give back and help others who can relate to this story because of complications in their own rehabilitation resulting in arthrofibrosis. I also want to prevent others who are starting to notice symptoms from going through what so many of us have faced. I am working with a small group of people to start an Arthrofibrosis Chapter. If you have any interest in joining us in this work or if you have question concerning my treatment The KNEEguru has graciously agreed that it is fine to contact me directly at: [email protected]
As a side note, I would like to thank my dear wife Mary K. Although this is a battle each one has to fight on their own, without her strength, patience, wisdom, encouragement, and her role as a caregiver, I would not be at the point of hope once again.