Knee Arthrofibrosis

Knee arthrofibrosis is a complication in which an excessive amount of scar tissue forms that limits the knee’s normal amount of flexion (how far the knee bends) and extension (how far the knee straightens). This problem occurs when the body’s normal healing process after an injury or operation is greatly exaggerated and an excessive amount of scar tissue is produced. If untreated, arthrofibrosis eventually causes permanent dysfunction of the limb and severe arthritis.

There are many conditions or factors that may cause arthrofibrosis. These include a serious injury to the knee (fracture or dislocation), an infection, an operation that has been done incorrectly, poor or non-existent physical therapy, and so on. Arthrofibrosis triggered by these conditions or problems is referred to as secondary arthrofibrosis because the scarring is a local problem that occurred from a specific cause and is not part of a generalized healing disorder. The vast majority of patients treated for arthrofibrosis are in this category. However, in rare cases, arthrofibrosis occurs without an inciting event in patients who have a general problem with scar tissue biology, and who tend to normally produce excessive scar tissue in response to any injury or surgery anywhere in the body. This problem is referred to as primary arthrofibrosis.

Permanent arthrofibrosis is a disaster because patients suffering from this complication never have a knee that resembles normal. Trying to deal with arthrofibrosis is extremely time-consuming and affects all portions of a patient’s life. The loss of the ability to participate even in low impact activities brings on depression and tremendous anxiety. Fortunately, knee arthrofibrosis can be prevented 80-90% of the time because the majority of cases are secondary in nature. This complication is certainly easier to prevent than it is to treat, especially when it becomes a chronic condition. The early detection of excessive scarring leads to successful resolution in most (but not all) patients, provided the treatment is done correctly and the patient complies with the rehabilitation program.

Currently, no eBooks exist that provide detailed information on the diagnosis, treatment, and prevention of knee arthrofibrosis. After treating patients for nearly 4 decades with this problem, two medical professionals have written this eBook to help patients understand this complication. Dr. Frank Noyes, an internationally renowned orthopaedic surgeon, and Sue Barber-Westin, Director of Clinical Research at the Cincinnati SportsMedicine Research Foundation, team up to provide the most current information regarding the diagnosis, treatment, and prevention of knee arthrofibrosis. Our goal is to help individuals understand basic knee anatomy, what knee structures may be affected in the arthrofibrosis process, how arthrofibrosis happens and how it is diagnosed, prevention of the problem, and conservative and operative treatment options. Two other serious medical issues that may either cause arthrofibrosis (complex regional pain syndrome) or occur as a result of arthrofibrosis (patella infera) are also discussed in detail.

About Sue Barber-Westin

Sue Barber-Westin has been a member of the Cincinnati Sportsmedicine Research and Education Foundation staff since its establishment in 1985 and serves as Director of Clinical and Applied Studies. She has co-authored over 120 articles in peer-reviewed medical journals and textbooks, focusingon the clinical outcome of various knee operative procedures and on neuromuscular indices in young athletes. Sue is the associate editor, along with editor Dr. Frank Noyes of the orthopaedic textbook, “Noyes Knee Disorders: Surgery, Rehabilitation, Clinical Outcomes” published in 2009. In 2004, Sue and Dr. Noyes were members of the research team that won the Clinical Research Award from the Orthopaedic Research and Education Foundation, the highest clinical research honor bestowed annually in orthopaedics.