Part 2: Understanding and treating knee arthrofibrosis

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About

Knee arthrofibrosis (KAF) is a post-traumatic or post-surgical orthopedic complication (even after minor procedures like a partial meniscectomy). It is characterized by an exaggerated and uncontrolled inflammatory response that results in excessive and abnormal formation of scar tissue, painfully limiting the range of motion (ROM) of the joint. This condition can progress to muscle atrophy, shortening of the patellar tendon, and generalized healing of the joint capsule, causing hyper-compression and patellar hypo-mobility. In severe cases, the joint becomes rigid, limiting flexion-extension and patellar mobility, and may damage articular cartilage.

KAF is often unknown to surgeons and physiotherapists due to a lack of adequate training. Specialized rehabilitation is essential, focused on the gradual and non-aggressive restoration of ROM, the management of inflammation, swelling, and central sensitization. A personalized approach and multidisciplinary cooperation are crucial for effective management, including home exercises using the principles of prolonged low-load stretching (LLPS). Strengthening is not a priority and aggressive rehabilitation can worsen the situation. High patient compliance and the use of specific devices are required to effectively treat ROM deficits.