I didn't get any benefit after 18 ASTUM sessions, but if you're improving you have to postpone whatever surgery until you'll hit the ASTYM benefits' plateau, then you'll draw a line and decide.
That's the right approach, definitely - whatever non surgical treatment is giviing permanent improvements has to be continued as risks are minimal compared to surgery

DeCruz......
Because I have had faster and better luck with one knee over the other, your scar tissue could be very dense and maybe Graston would be something for you to look into.....but I am no expert in Graston!  I've had about 60 Astym treatments!  My one knee is really in much better shape and my other one that was more difficult is, after this more aggressive Astym, responding and my PT said she has no doubt she can get my one knee as good as the other one.  I am now recovering from 2x a week treatments for 2 months.  My knees are so much thinner!  I can feel the lumps and bumps of scar tissue that still has to be broken down!  I am going to ask my therapist about heat before she does astym.....it makes sense that it might soften the scar tissue. 

It was Dr. Sevier (the doctor who developed these procedures) who gave her advice about my knees because arthrofibrosis is very uncommon and many pt's as well as orthopedics never see it!  He told her to start very gently with me and only do it once a week and give me rest periods.  Because our brains send the wrong message and we overheal (make too much scar tissue) he wanted her to be very careful not to trigger this in my treatments.  I think because I had so much scar tissue and I didn't make anymore during the treatments, they felt they could try to be more aggressive and I really have made progress!  It's been painful at times but nothing like the description of Graston.....I would be afraid if it hurt that much.  But perhaps it's worth a try....it's certainly less aggressive than surgery!  Living this long with AF really altered my life!  I had to quit working and life has been so limited!  Even though it's taken time, Astym is giving me back my life.  I'm anxious to see how I'll feel after the soreness and healing in my knees from this latest series is complete.  It takes approx. 5 to 7 days to really get around without the soreness.  I'd say my therapist was quite a bit more aggressive this last series and it's only been 2 days since my last treatment.

I think it's a very good idea for any therapist consult with the headquarters of Astym before working on anyone with arthrofibrosis in the knees because they probably have never had a patient and certainly they are gathering information from others like me who are having astym for this rare condition.

Decruz

Here is the Graston website and locate a provider. There are providers in the UK and other countries. You need to page down past locations in the U.S and Canada to see how to find in other countries.

http://www.grastontechnique.com/LocateaProvider.html

Pam