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 published reports on novel techniques like augmented soft tissue mobilization techniques (Eg: Graston Technique, Astym Therapy), deep tissue massage, hydraulic distension of knee, Botulinum toxin injection into muscles behind the thigh (hamstrings) for stiffness due to muscle spasm, and blocking the nerves with medications (sympathetic block) with variable results.
Many treatments are still in research stage like injection of biological agents (Anakinra, Rosiglitazone, gamma-interferon) into knee joint.
Different patients have tried different approaches but no one of them has given consistent and predictable results so that it could be recommended as a standard treatment. These include losing weight, staying off the knee, anti-inflammatory medicines, anti-gout medicines prescribed by rheumatologist, oral steroids like dosepac, repeated corticosteriod injections into knees, cryotherapy (ice packs or Game Ready), heating pad, aquatherapy (water therapy), swimming and exercising in pool, ultrasound, laser, shockwave, bike, stationary bike, rowing machine, floor pedal machine, flexion/extension brace like Dynasplint or JAZ brace, needling, acupuncture, chiropractic, Ilizarov method, amniotic membrane insertion, stem cell therapy, and PRP injection.
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.