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. 2023 Dec 11;11(12):e23.00140.
doi: 10.2106/JBJS.RVW.23.00140. eCollection 2023 Dec 1.

Arthrofibrosis After Total Knee Arthroplasty: A Critical Analysis Review

Michael S Ramos  1 , Ignacio Pasqualini, Peter A Surace, Robert M Molloy, Matthew E Deren, Nicolas S Piuzzi
Affiliations

Arthrofibrosis After Total Knee Arthroplasty: A Critical Analysis Review

Michael S Ramos et al. JBJS Rev. .

Abstract

» Arthrofibrosis after total knee arthroplasty (TKA) is the new formation of excessive scar tissue that results in limited ROM, pain, and functional deficits.» The diagnosis of arthrofibrosis is based on the patient's history, clinical examination, absence of alternative diagnoses from diagnostic testing, and operative findings. Imaging is helpful in ruling out specific causes of stiffness after TKA. A biopsy is not indicated, and no biomarkers of arthrofibrosis exist.» Arthrofibrosis pathophysiology is multifactorial and related to aberrant activation and proliferation of myofibroblasts that primarily deposit type I collagen in response to a proinflammatory environment. Transforming growth factor-beta signaling is the best established pathway involved in arthrofibrosis after TKA.» Management includes both nonoperative and operative modalities. Physical therapy is most used while revision arthroplasty is typically reserved as a last resort. Additional investigation into specific pathophysiologic mechanisms can better inform targeted therapeutics.

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Conflict of interest statement

Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSREV/B45).

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