Adhesions are frond-like filaments which form in the knee in response to inflammation and/or prolonged immobilisation of the knee.

sites of arthrofibrosis in the knee
Adhesions tend to form in the suprapatellar pouch above the kneecap, in the envelope-like bursae below the kneecap and in the soft-tissue gutters around the sides and back of the joint.


Adhesions limiting range of motion

The sticky strands pull adjacent soft tissues together, binding the surfaces and limiting movement.

Initially they are easily broken with therapeutic knee movement - such as patellar mobilisations and manipulation under anaesthesia - but later the adhesion tissue matures into scar-bands and these thicken and make the knee stiff. When the knee is stiffened by adhesions the condition is called arthrofibrosis.


Patellar mobilisations

Simple but very important to prevent stiff knee after surgery.


A very popular and comprehensive coverage of the topic of arthrofibrosis (internal scarring in the knee joint) from Dr Frank Noyes of the Cincinnati Sportsmedicine and Orthopaedic Center.

Arthrofibrosis Rehab Tutorials

Mr Dirk Kokmeyer, physiotherapist at the Steadman Hawkins Clinic in Vail, Colorado presents a set of specialist tutorials on rehabilitation of knee patients with arthrofibrosis.

The editor's interpretation of a 2004 article highlighting the important anatomy associated with arthrofibrosis of the knee.

An 'interpretation' of a 1999 paper that gives a good overview of the subject of arthrofibrotic scarring in the knee.

An 'interpretation' of a 1994 article where the authors described their system of surgical management of arthrofibrotic scarring in the knee.




Update on the risks of complications after knee arthroscopy. Pajalic KF, Turkiewicz A and Englund M. BMC Musculoskelet Disord. 2018; 19: 179.

See also -



eBook on patellar mobilisations

eBook - How to perform Patellar Mobilisations

Practical illustrated guide to preventing and breaking down knee adhesions around the patella.