Arthrofibrosis of the Knee Joint - the Current State of Knowledge. Literature Review

Ortop Traumatol Rehabil. 2019 Apr 30;21(2):95-106. doi: 10.5604/01.3001.0013.1545.

Abstract

The objective of the paper is to highlight the interdisciplinary problem of arthrofibrosis (AF) and to present this problem from the physiotherapy angle based on a literature review and the authors' experience. Arthrofi-brosis is a pain-ful condition limiting joint mobility due to pathological fibrosis involving scarring. The limited mobility is often ac-companied by pain. Arthrofibrosis may result in limited locomotion in everyday life or at work and withdrawal from physical activity. In severe cases, Severe AF can lead to patients' unemployability due to their inability to perform certain work-related activities. The problem is important from the clinical point of view, and therefore treatment of AF involves specialists, physiotherapists and psychologists. Our paper presents the definitions of AF, the most fre-quent causes and epidemiology of the dysfunction. This is followed by a classification of arthrofibrosis. Special attention is paid to problems connected with AF-related terminology. The consequences of the disease, such as pain, inflammation and impairment of joint function, especially joint range of motion limitation, are also presented. The relationship between AF and decreased muscle strength is discussed as well as the ways of muscle strength genera-tion and the issue of limited locomotion in patients with this condition. Some emphasis is given to the role of con-servative and surgical treatment as well as physiotherapy for the prevention or reduction of AF consequences. The next section presents the main guidelines for early physiotherapy. The goal of early physiotherapeutic intervention is to prevent excessive fibrosis within the knee joint and enable safe recovery of joint mobility. The conclusions high-light the need to conduct further research and develop a standard for physiotherapeutic intervention within a com-prehensive evidence-based treatment approach to arthrofibrosis.

Keywords: fibrosis; limitation of mobility; medical rehabilitation; pain; physiotherapy.

Publication types

  • Review

MeSH terms

  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Combined Modality Therapy
  • Fibrosis
  • Humans
  • Joint Diseases / etiology*
  • Joint Diseases / pathology*
  • Joint Diseases / therapy*
  • Knee Joint / pathology*
  • Muscle Strength
  • Physical Therapy Modalities
  • Range of Motion, Articular

Substances

  • Anti-Inflammatory Agents, Non-Steroidal