Glossary
Arthrofibrosis
Quick answer
Arthrofibrosis is an excessive build-up of scar tissue inside and around the knee joint, usually after surgery or a major injury, that leaves the knee stiff and unable to fully bend or straighten. Early recognition improves the outcome, notes Doha knee surgeon Dr. Pablo Gelber at Aman Hospital.
What it is
All healing produces some scar tissue. In arthrofibrosis the body overreacts, laying down thick fibrous tissue that tightens the joint lining, fills the spaces around the kneecap and can tether the fat pad. A cyclops lesion is a localised form of it.
It can follow ACL reconstruction, knee replacement, fracture surgery or a severe ligament injury. Risk is higher if the knee stays swollen and painful for a long time or if early movement is limited.
Why it matters
A stiff knee changes how you walk, climb stairs, sit on the floor in a majlis or kneel for prayer. Losing even a few degrees of straightening can cause a limp and front-of-knee pain, while poor bending makes getting in and out of a car difficult.
Range of movement is usually easiest to regain in the first few months after surgery; established scar becomes harder to stretch.
How it is treated
The first step is intensive, guided physiotherapy with good pain control, sometimes with a short course of anti-inflammatory medication. If progress stalls, options include manipulation under anaesthesia and arthroscopic release, in which the surgeon removes scar tissue through keyhole incisions, followed by immediate rehabilitation.
Frequently asked questions
Is stiffness after surgery always arthrofibrosis?
No. Some stiffness is normal early on and improves with physiotherapy. Arthrofibrosis is considered when movement stops improving despite good rehabilitation.
Can arthrofibrosis come back after release?
It can, which is why rehabilitation starts straight after the release and pain and swelling are carefully controlled.
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