Depending on the site of scarring, knee cap mobility and/or joint range of motion (i.e. flexion, extension, or both) may be affected.
[6] Symptoms experienced as a result of arthrofibrosis of the knee include stiffness, pain, limping, heat, swelling, crepitus, and/or weakness.
[5] Clinical diagnosis may also include the use of magnetic resonance imaging (or MRI) to visualize the knee compartments affected.
Advice to AF patients now typically consists of "listen to your knee" and stop, or reduce, activities that increase pain during and after exercise.
Although MUA and surgery can be successful, the resulting increase in inflammation may cause scar tissue to rapidly return and symptoms can worsen.
Biologics that reduce the signalling of the major inflammatory cytokines TNF-α (Simponi, Humira) and IL-1β (anakinra) are promising treatments.
MUAs can lead to adverse outcomes, including fractures, rupture of tendons, damage to the prosthesis, heterotrophic ossification, muscle tears and bleeding and the return of scar tissue.
If the fibrosis is chronic (more than 12 weeks) there is a decreased likelihood of success with MUA, and open lysis of adhesions is sometime performed.