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

Dr Peter Millett chats about arthrofibrosis, and why patients with established arthrofibrosis need to seek out a surgeon who is expert in this potentially devastating complication.

An 'interpretation' of a medical publication from 2005 where the authors offer surgeons a list of practical advice about arthrofibrosis of the knee.

An 'interpretation' of a 2004 medical publication evaluating the usefulness of sonography in identifying arthrofibrosis as a cause of knee stiffness after knee replacement.

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

An 'interpretation' of a 2004 medical publication discussing the possibility of genetic screening to identify those patients likely to develop aggressive arthrofibrosis after cruciate ligament reconstruction.

An 'interpretation' of an article from 2003 detailing the rehabilitation protocol practised in Vail at that time in managing the stiff arthrofibrotic knee.

An 'interpretation' of a publication from 1999 describing how these surgeons managed knees that were severely locked up with arthrofibrotic scarring.




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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