2011 Internship project

1. Arthrofibrosis 2011 Internship Project By: Meghan

2. What is Arthrofibrosis? Usually occurs after a knee trauma or surgery. Trauma includes sports injuries, torn ligaments, sprains; ACL surgery. It is an inflammation and rapid growth of scar tissue which prevents normal range of motion from occurring. Along with scar tissue build up, shrinkage of the joint capsule around the knee occurs, which stiffens the joint.

3. Cont’d If not correctly treated, permanent loss of range of motion can occur. Genetics also plays a role. Some people “over heal”, which means excessive scar tissue forms. Knee is over stable and becomes “frozen”. People favoring the knee after surgery or with low pain thresholds are also at greater risk.

4. Prevention Arthrofibrosis can almost always be prevented. Moving the joint as quickly as possible following surgery prevents scar tissue from building up and causing Arthrofibrosis. Strengthening the knee before undergoing surgery helps prevent arthrofibrosis. Knee unable to straighten due to arthrofibrosis

5. Treatment Methods Physical therapy Manual therapy can help break up scar tissue and increase range of motion at the joint. Specific exercises and stretches also prevent scar tissue from building up. Excessive stretching. Helps regain full extension and flexion of the joint. Surgery Manipulation Under Anesthesia (M.U.A.) Arthroscopic

6. Manipulation Under Anesthesia (M.U.A.) Surgical approach used to break up the excess scar tissue. The person is placed under anesthesia while the surgeon breaks up and tears the scar tissue so the knee can bend and move freely. Strenuous manual joint manipulation. The surgeon forces the knee to bend and straighten completely.

7. Arthroscopic Surgery An arthroscope is inserted into the knee by a small incision, making it less invasive because only a portion of the joint has to be re-opened. The surgeon removes as much of the excess scar tissue as possible before bending the knee. Reduces the amount of work required to manipulate the knee

8. What to Know Only some people suffer from arthrofibrosis, not every person undergoing knee surgery. The less severe the injury the less likely a person is to develop arthrofibrosis. Excessive at-home exercises and out-patient physical therapy is required after either type of surgery.

9. Success Rates of MUA Range of motion improved significantly in the joint. First time success rate was 74%, some had success after multiple M.U.A.’s. Knee flexion success rate was 90% after M.U.A.

10. References Cluett, J. (February 2004). Arthrofibrosis. Retrieved from http://orthopedics.about.com/cs/aclrepain/g/arthrofibrosis.ht m Manipulation Under Anesthesia. (July 2010). Retrieved from https://www.oxhp.com/secure/policy/extremity_joint_pelvic_ manipulation_anesthesia_710.ht ml Noyes, F. (April 2008). Arthroscopic Surgery9 (for arthrofibrosis). Retrieved from http://www.kneeguru.co.uk/KNEEnotes/node/1235. Sapega, A. (2007). Arthrofibrosis (Stiff Knee Syndrome). Retrieved from http://www.kneeandshoulder.md/arthro_01.html.