Arthrofibrosis

Arthrofibrosis (from Greek: "arthro-" joint, "fibr-" fibrous and "-osis" abnormality) is a complication of knee injury or surgery where an excessive scar tissue response leads to painful restriction of knee motion, with scar tissue forming within the joint and soft tissue spaces and persisting despite routine rehabilitation exercises and stretches. The term may involve flexion loss, extension loss or both.

The consequent pain may lead to the cascade of quadriceps weakness, patellar tendon adaptive shortening and scarring in the tissues around the patella—with an end stage of permanent patella infera—where the patella is pulled down into an abnormal position where it becomes vulnerable to joint surface damage. In severe cases of arthrofibrosis the disorder becomes progressive and the whole capsule may become thickened and tight with almost no movement possible in the joint.

Despite this potentially disastrous cascade of events, patients with developing arthrofibrosis and early patella infera may avoid the necessity for surgical intervention by participating in a closely supervised therapy programme. The key is early recognition and referral to a unit experienced in dealing with arthrofibrosis.

References

* citation
first=PJ | last=Millett
first2=RJ | last2=Williams
first3=TL | last3=Wickiewicz
title=Joint debridement and soft tissue release as a salvage procedure for the severely arthrofibrotic knee
journal=Am J Sports Med
volume=27
pages=552-561
year=1999

* citation
first=FR| last=Noyes
first2=S | last2=Berrios-Torres
first3=SD| last3=Barber-Westin
first4=TP | last4=Heckmann
title=Prevention of permanent arthrofibrosis after anterior cruciate ligament reconstruction alone or combined with associated procedures: a prospective study in 443 knees
journal=Knee Surg, Sports Traumatol, Arthros
volume=8
pages=196-206
year=2000

External links

* [http://www.kneeguru.co.uk/KNEEnotes/node/632 Arthrofibrosis Part 1] , Frank Noyes (course in several parts)