Lessons I have learned about arthrofibrosis
One of the first lessons I learned about Arthrofibrosis:
KNOWLEDGE - Learn as much about this condition as you can possibly find. Your knowledge on Arthrofibrosis will provide you with the information needed to make the correct decisions regarding your medical care. Many a time, I have said, " If I only knew then, what I know now". This can apply to any medical problem you might face.
The second and equally important lesson:
PROFESSIONAL'S KNOWLEDGE - Many medical professionals don't know about this condition. THIS IS VERY CRITICAL. They are the professionals you are reporting symptoms to. They are the ones you rely on and trust to correctly diagnose and provide treatment, when you are experiencing a problem. If they are not knowledgeable about this condition - the triggers, symptoms, and interventions, this can be very detrimental to the patient, even life changing. It is very important to seek out a doctor who has knowledge of this condition, has seen many patients with Arthrofibrosis and knows how to go about treating it. In my situation, knowledge about arthrofibrosis from the medical team would have caught this process early. Steps could have been taken, before permanent damage had occured
TIMING - Timing is critical. Early recognition would have helped in my situation , to prevent permanent damage. Recognised early and treated early, I most likely would have been able to continue with my active life and most likely would not have had a TKR while in my 40's.
REHAB - Doing the correct rehab.
People with Arthrofibrosis need to do specialised PT. I found out that my PT was constantly being monitored as to how my knee would react, during rehab and afterwards. If I was having increases in pain, swelling and heat after therapy, the rehab was modified to keep the irritation down. By keeping the irritation down, this in turn keeps the inflammmation down, which keeps the heat down, which helps to keep scar tissue from forming.
I learned the importance of using ice, elevation, ROM techniques, patella mobilisation. I learned how important the quad was, pertaining to knee function. I learned about quad exercises such as quad sets,straight leg raises and wall sits.I also learned how to use e-stem on the quad. For flexion and extension, I learned how to use over-pressure by using the ERMI flexionator for flexion and hanging weights for extension.
To control inflammation, I used ultra sound, iontophoresis, ice, prescription anti-inflammatories, cortisone shots and medrol dose packs. Early on ,I was not doing the correct rehab for my knee. I was doing exercises that caused irritation (increasing the scar tissue cycle) and possible harm (damaging the cartilage) to the knee.
IMMOBILIZATION - I learned how prolonged immobilization can affect the knee. In my case, I was immobilized a total of 5 1/2 weeks in a cast and plaster splint. When the immobilization was finally removed, I had suffered extreme quad atrophy, ROM deficits, pain. To make matters worse, part of the immobilisation period involved surgery thru my patella tendon. Prolonged immobilization is one of the triggers of Arthrofibrosis.
PATELLA MOBILISATION - I know this might be considered part of the rehab, but this particular exercise is very important and needs to be stressed. I learned how important it is to keep the patella mobile. I did patella mobes many times /day, moving the patella in all directions. This keeps the patella mobile and from adhering down. If I had been shown this very simple procedure after my accident, this would have helped keep the patella mobile.