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Author Topic: Video - What is arthrofibrosis?  (Read 7535 times)

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Offline The KNEEguru

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Offline missmyknee

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Re: Video - What is arthrofibrosis?
« Reply #1 on: September 04, 2014, 08:05:58 AM »
What a great addition to this site!

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Re: Video - What is arthrofibrosis?
« Reply #2 on: September 09, 2014, 04:38:03 PM »
Hi Sheila,

Thank you for a very useful video link that will be beneficial to many AF sufferers that is on the increase, I wish modern day science can find a cure for arthrofibrosis!

[email protected]
RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline msqureshi

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Re: Video - What is arthrofibrosis?
« Reply #3 on: September 06, 2018, 10:07:52 AM »
Did it get resolved ? I am 6 weeks out and have scare tissue . Pls tell me has anything helped ? My patella also catches while I try to walk fast and straighten my leg while applying pressure on it . I donít know what to do .. my doc said that itís fine .. itís just swelling and will go by time but the lump is same size and not reducing

Offline DogfacedGirl

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Re: Video - What is arthrofibrosis?
« Reply #4 on: September 10, 2018, 09:59:10 AM »
Hi msqureshi,
It is early days so your knee is still healing, however, it is good to find out what things help reduce inflammation. I suggest that you don't walk fast for a while, and avoid putting pressure on your patella. Avoid anything that hurts or causes more inflammation. I'll copy below some things I have posted in the past in case some of it helps you.

Unfortunately, there is very little research into how to stop scar tissue forming after an operation or injury. The following comes from reading other posts on this forum, my own experience, and from research papers on fibrosis.

If your range of motion (ROM) isnít good, I believe that you should use a continuous passive motion machine (CPM). Try to hire one and use it as much as possible, at least daily, but only use a computer controlled CPM and have your finger on the stop button. Always start at a safe amount of bend and only increase by 1o at a time, following at least 3 bends at the same level. It should never be painful, no more than tight stretching discomfit. If there is pain the amount of bend is too much, and you could damage tendons and ligaments.

Inflammation is the driver of arthrofibrosis so try to keep inflammation as low as possible, using all means available such as icing, elevation, and medications including corticosteroids. However, avoid NSAIDS such as Nurofen and ibuprofen, using these for longer than 2 days encourages long term inflammation, see more info on that below. If youíre not already on corticosteroids try to get onto them asap, but there is a time limit to being on these as well.
It is very important that you do not push exercise too hard and upset your knee. Anything that hurts, back off, especially if there is more inflammation afterwards (pain and swelling). Exercise rehab is important and you need to keep the knee moving, but everybody progresses at a different pace. That goes for walking around too, be careful not to over-do it. That can be hard for people that are used to being active and independent, but absolutely necessary until the knee settles. I would avoid quad squats at this point, and anything that hurts, more pain afterwards is a sign you shouldn't do that again. Be prepared to stand your ground on that, some PTs don't understand how important it is.
It has recently been discovered that inflammation has an "on" switch (injury or infection) as well as an "off" switch. The "off" switch is a group of molecules that are made in the body in response to inflammation, there are a number of them with slightly different actions, but the best known are called resolvins. These are necessary to bring a stop inflammation, and they also clear out pathogens and promote healing. Resolvins are made from omega 3 fatty acids, which is why you need to have those in your diet.
The enzyme that makes resolvins is called COX 2. This is the same enzyme that makes inflammatory cytokines, and it is the one that NSAIDS target. So, NSAIDS will "turn off" the production of COX 2, which will stop the production of inflammatory cytokines, so far so good. But after about 2 days the gene that makes COX 2 switches to make resolvins. If the genes are still being turned off by NSAIDS, they can't do this, and resolvins fail to be made. This results in long-term inflammation.

So you probably shouldn't take NSAIDS (other than aspirin, that works differently) for more than two days. Don't expect your GP or surgeon to know about this, it is relatively new research. It is also thought to be the reason why long term use of NSAIDS significantly increases the risk of heart attack and stroke, while aspirin reduces it. But get a doctorís advice before starting low dose aspirin in case it interacts with other medications or medical problems.

A diet that is low in sugar will also help because sugar increases inflammation. If you want to get serious, look into a calorie restricted diet such as the 5/2 fast, there is a large body of research that shows that this approach has a wide range of medical benefits including reducing inflammation and encouraging healing, but it is difficult for some people to follow it.

Fibre is a very important thing to eat daily and long term, and it will help to reduce inflammation, especially resistant fibre. Our western diets don't contain nearly enough of it normally, so itís necessary to make an effort to find food with it in. The research in this area has really taken off in the last few years, with a number of science based books released explaining the importance of healthy gut bugs on everything from the immune system, inflammation, and even mental health. And of course colon cancer.

Metformin reduces inflammation and may be able to help with arthrofibrosis, however there is not much research into this particular area. There is research that shows that it most likely reduces TGF-β, the main player in arthrofibrosis, and it has a very well established safety profile.

Let me know if you would like more info on any of this.
All the best for your recovery.
1999 Osteoarthritis both knees, chondroplasty
2004 MACI graft L knee
2005 MACI graft both knees
2007 MACI graft R knee
2007 Patella baja
2011 TKR both knees
2011 arthrofibrosis