Treatment 2018-01-26T07:02:51+00:00

Treatment:

At present, there is no pharmacological or biological treatment available to prevent or cure arthrofibrosis.

The timing and the effectiveness of the various currently available treatment methods for arthrofibrosis following total knee replacement are controversial. Aggressive physical therapy, manipulation under anesthesia (MUA), arthroscopic removal of scar tissue (arthroscopic arthrolysis or arthroscopic lysis of adhesions), open removal of scar tissue (open arthrolysis or open lysis of adhesions), and revision knee replacement (revision arthroplasty) are the main treatment approaches currently available to treat arthrofibrosis following total knee replacement. Each treatment approach can be repeated or combined with another one as needed.

Other potential options are knee fusion (arthrodesis) and amputation but we do not have much literature evidence in favor of these approaches.

There are reports on novel techniques like hydraulic distension of knee, augmented soft tissue mobilization techniques (Eg: Graston Technique, Astym Therapy), Botulinum toxin injection into muscles behind the thigh (hamstrings) for stiffness due to muscle spasm, and blocking the nerves with medications (sympathetic block). But, these techniques are not widely used.

Many treatments are still in research stage like injection of biological agents (Anakinra, Rosiglitazone) into knee joint and amniotic membrane transplantation.

Prognosis:

Exactly when scar tissue matures is variable and remains a topic of debate. Fibrous tissue progressively matures and becomes resistant to more conservative treatment approaches with time.

The severity and duration of scar tissue and the presence of new bone formation within the soft tissue (heterotopic ossification) may affect the prognosis following treatment. Also, generalized arthrofibrosis leads to more severe stiffness and inferior prognosis than localized arthrofibrosis.