Lysis of adhesions is the surgical procedure of breaking down the strands of material which can form inside the joint if the knee is inflamed; these strands are called 'adhesions'.
Page updated April 2024 by Dr Sheila Strover (Clinical Editor)
What are adhesions?
Adhesions are initially just sticky strands, and can fairly easily be broken with stretches and mobilisation massages around the patella.
If they become more intractable, it may be possible to break them with a manipulation under anaesthesia (MUA). If the knee continues to be inflamed and the adhesions are not broken, they may become more fibrous and turn into scar tissue that can contract and pull the soft tissue areas together too firmly to be broken with manipulations. At this stage they might yet be amenable to 'lysis of adhesions', where surgical methods are employed to break down the scar tissue.
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Quote from peer-reviewed paper:
Arthroscopic lysis of adhesions "...for knee arthrofibrosis significantly improves the knee ROM and functional outcomes and can be a successful alternative to open quadricepsplasty."
Citation: Abdelghafour KM, S Elkalyoby A, H Amer M, Abdelaziz MK. Arthroscopic Lysis of Adhesions for Treatment of Post-Traumatic Knee Arthrofibrosis: A Prospective Study. Cureus. 2023 Jan 2;15(1):e33275. doi: 10.7759/cureus.33275. PMID: 36606104; PMCID: PMC9809041.
Forum discussions
- Sway's lysis of adhesions
A patient gives her early experience of LOA.
- Re: knee manipulation
A discussion of both manipulation under anaesthesia and lysis of adhesions.
- Advice needed on LOA/AIR after Vail visit.....
An athlete finds his life upside down after adhesions complicate surgery.
- Compilation of Arthrofibrosis Success Stories Timelines
A group of patients try to determine a timeline for recovery from knee arthrofibrosis.
Relevant material -
2008 -
2006 -
Journal interpretations -
- 2003 - Rehabilitation of the arthrofibrotic knee - Authors: Millett PJ et al. and summarised for you by Dr Sheila Strover (Clinical Editor)
- 1999 - Joint debridement and soft tissue release as a salvage procedure for the severely arthrofibrotic knee - Authors: Millett PJ et al. and summarised for you by Dr Sheila Strover (Clinical Editor)
eBook - Arthrofibrosis and patella baja
Easy-to-read eBook explaining how the scarring of arthrofibrosis results in the patella being pulling into a lower painful position. Written by Dr Sheila Strover (Clinical Editor).