Physical Therapy and Sports Medicine for Birmingham, AL
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Arthrofibrosis (AF) is abnormal internal scarring inside the knee joint and surrounding structures. It may begin with sticky adhesions that can gum up the surfaces that are close to one another, such as the suprapatellar pouch above the patella, the anterior interval behind the patellar tendon, the area around the cruciate ligaments and the capsular ‘gutters’ at the side of the joint.
The abnormal ‘gumminess’ of these normally mobile tissues leads to painful knee stiffness. Attempts to bend the knee result in sickening pain above the knee in the region of the suprapatellar pouch. Aggressive physiotherapy tends to make the knee hot, swollen, red and painful, and instead of mobility improving it tends to worsen. Lack of understanding about the arthrofibrotic process may lead to doctor and physiotherapist berating the patient for not trying hard enough, and the patient may feel demoralized and angry.
