Arthrofibrosis means internal scarring of the joint, with possible consequent stiffness - 'arthro' means 'joint' and 'fibrosis' means 'scarring'. 


Arthrofibrosis of the knee

Arthrofibrosis of the knee is a complication of injury or surgery where an excessive scar tissue response leads to painful restriction of knee motion, with early adhesions and later scar tissue forming within the joint and soft tissue spaces, and persisting despite routine rehabilitation exercises and stretches. The term may involve flexion loss, extension loss or both.


Arthrofibrosis and patella baja (patella infera)

As the soft tissues behind and below the kneecap (patella) become involved in the scar tissue process, the kneecap may be pulled into an abnormally low position (patella baja) which may result in considerable pain with walking.

normal knee, before onset of arthrofibrosis sites of arthrofibrosis in the knee Advanced arthrofibrosis of the knee
Side view of section through a normal knee, where there are no adhesions locking up movement. Adhesions developing in the suprapatellar pouch, posterior capsule and anterior interval. Matured scar tissue has contracted, closing the important spaces that normally allow movement, and pulling the kneecap right down.
Internal scarring


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.

Who's Who in arthrofibrosis surgery?

A list maintained by bulletin board member 'missmyknee' of surgeons with a special interest in arthrofibrosis of the knee.

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.

An 'interpretation' of an article from 2007 discussing problem that interfere with joint function after knee replacement.

Dr Peter Millett chats about his experience with infrapatellar contracture syndrome and the importance of recognising it early before the shortening of the patellar tendon becomes irreversible.

Dr Peter Millett discusses why knee surgeons need to be aware that arthrofibrotic scarring can occur in this area because of the position of their arthroscopic portals (cuts).

An explanation of the need to calm the arthrofibrotic knee when new surgery is indicated.




Open debridement and soft tissue release as a salvage procedure for the severely arthrofibrotic knee.. Millett PJ, Williams RJ 3rd, Wickiewicz TL. Am J Sports Med. 1999 Sep-Oct;27(5):552-61.

The role of capsular distention in the arthroscopic management of arthrofibrosis of the knee: A technical consideration. Millett PJ, Steadman JR. Arthroscopy. 2001 Sep;17(7):E31.

Treatment of Knee Arthrofibrosis and Quadriceps Insufficiency after Patellar Tendon Repair: A Case Report Including Use of the Graston Technique. Black D. Int J Ther Massage Bodywork. 2010; 3(2): 14–21.

See also


Who's Who in Arthrofibrosis Surgery?

Arthrofibrosis and patella baja - ebook

How to perform Patellar Mobilisations - ebook

Cornerstones of early knee rehabilitation - ebook


Kindle eBook - Authors: Frank Noyes & Sue Barber-Westin

Knee Arthrofibrosis: Everything You Need to Know to Recognize, Treat, and Prevent Loss of Knee Motion After Injury or Surgery

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