What is Arthrofibrosis & How is it Treated?
What is Arthrofibrosis?
Arthrofibrosis is quite a serious pathological condition that affects mostly the knee and the shoulder joints post an injury or a surgical procedure or both. The process of Arthrofibrosis begins when the injury or the surgery leads to the formation of excessive scar tissue. This excessive scar tissue causes shrinkage and tightening of the capsules of the joints and at times even the tendons which are surrounding the joint tend to get stiff due to this scar tissue.
This process of tightening of the tendons and ligaments continue to the point when the whole joint becomes stiff thus restricting the motion of the joints. In some cases, there may be permanent loss of range of motion of the joints as a result of Arthrofibrosis.
What Causes Arthrofibrosis?
The root cause of Arthrofibrosis is the formation of scar issue. After an injury or surgery to a movable joint like the knee and the shoulder, there is formation of some scar tissue around the injured or operated joint. This formation of scar tissue is quite common and does not affect the functioning of the joint. However, in some cases when the injury is quite severe or the surgical procedure done to treat the injury is quite complex then the amount of scar tissue formation is more than what is the norm.
The formation of scar tissue also increases depending on the period of immobilization of the joint. This formation of excessive scar tissue tends to freeze the joint and the surrounding tendons and ligaments which facilitate movement of the joint resulting in virtual freezing of the joint where the patient is unable to move the shoulder or the knees in any way. This is what causes Arthrofibrosis. Some people are more prone to developing Arthrofibrosis than others.
The genetic makeup of an individual also plays a role in development of excessive scar tissue in response to an injury or surgery. These individuals ultimately heal from the surgical procedure and injury but tend to heal far too much due to the excessive scar tissue formation making the joint way too much stable and stiff resulting in loss of motion of the affected joint as a result of Arthrofibrosis.
What are the Symptoms of Arthrofibrosis?
The main symptom of Arthrofibrosis is inability to move a joint post treatment of an injury or after undergoing a surgical procedure to the affected joint. The range of motion of the affected joint will be severely restricted and any attempts at moving the joints may lead to severe pain.
How is Arthrofibrosis Treated?
To begin with, patients with Arthrofibrosis have to undergo extensive physical therapy to include modalities like aggressive stretching and strengthening to loosen up the affected joint.
If this treatment approach fails to provide any sort of relief for the patient suffering from arthrofibrosis then a procedure called manipulation under anesthesia is done in which the excessive scar tissue is torn or broken up so as to make the joint more supple and loose such that the patient may get some range of motion of the affected joint back. The surgeon does this by strenuous joint manipulation. This method of treating Arthrofibrosis is by far the most preferred method for treatment. In some cases where the joint are acutely stiff, extremely stressful manipulation forces may be needed to break the scar tissue and get the joint moving again.
This comes at a risk since the joint has been immobilized for a considerable period of time and may have lost quite a bit of bone minerals making the bones weak. This may ultimately increase the risk for the patient to incur a fracture during manipulation under anesthesia.
Another procedure that can be helpful for treating Arthrofibrosis is surgical resection of the scar tissues and remove as much of the scar tissue as possible at the time of surgery and then do a manipulation so as to get the joint moving again and treat Arthrofibrosis. This approach is far more successful as most of the scar tissue has been removed before manipulation and not a lot of strain is put on the bones at the time of manipulation to free the joints and make them start moving again after treatment of Arthrofibrosis.