Patients may experience the effects of arthrofibrosis after a trauma to a major joint. Observation alone is rarely performed, but may be recommended in some patients. Therefore, the purpose of this study was to compare TKA patients who received physical therapy (PT) and adjuvant NMES therapy versus physical therapy alone in terms of: 1) rates of manipulation under anesthesia (MUA) to treat arthrofibrosis; and 2) post-therapy range of motion (ROM). Treatment varies on the cause and duration of the fibrosis. 2006 Feb;35(2):143-52. Neuromuscular electrical stimulation after total joint arthroplasty: a critical review of recent controlled studies. USA.gov. Gradual pressure/force can create the phenomenon of “creep” or elongation of scar tissue. Treatment Modalities Post-TKA After Physical Therapy Arthrofibrosis is a challenging complication after primary TKA because deficits in range of motion can persist, mitigating the therapeutic effects of rehabilitation [41] . Added Dr. Hsu, “This therapy might be useful for that small set of patients who have post-surgical arthrofibrosis. Data regarding the requirement of MUA postoperatively for treatment of arthrofibrosis were collected for every patient. Discussion: Arthroscopic debridement of knee joint arthrofibrosis after ACLR in conjunction with a postoperative physical therapy algorithmic approach to maximizing knee joint extension ROM can be beneficial in gaining [Article in German] Gollwitzer H(1), Burgkart R, Diehl P, Gradinger R, Bühren V. Author information: (1)Abteilung für Unfall- und Wiederherstellungschirurgie, Berufsgenossenschaftliche Unfallklinik, Murnau. This includes aggressive range of motion work through physical therapy, home program and occasionally with the use of orthopedic movement devices. The process begins when the traumatic stimulus … Your physical therapy should never be rough and forceful. Your surgeon may prescribe a CPM machine while you’re lying in bed and recovering from surgery. [Therapy of arthrofibrosis after total knee arthroplasty]. Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. In my experience, extreme diligence and restraint over an extended period (many months) is paramount. Prospective, randomized controlled, and larger-scale studies are needed to validate these results. The use of neuromuscular electrical stimulation (NMES) has demonstrated the ability to facilitate quadriceps muscle recovery and reduce pain. Background: Arthrofibrosis is a debilitating postoperative complication of total knee arthroplasty (TKA). Arthrofibrosis is one of the most debilitating joint conditions and can cause pain and discomfort whether moving or sitting still. General stretching is a must, but in most cases not sufficient to overcome the detrimental condition of arthrofibrosis. Arthrofibrosis: Arthro: joint, fibr: fiberous, osis:abnormality/inflammation. 2017 Aug;32(8):2604-2611. doi: 10.1016/j.arth.2017.02.005. This type of joint uses fluid (synovial fluid) to provide lubrication, nourishment and protection to the articular surfaces of bones. Physical Therapy for Arthrofibrosis of The Knee The non-operative treatment of arthrofibrosis focuses on rehabilitation to regain range of motion. Arthrofibrosis is a serious condition that can afflict knee joints that have either been recently injured, operated upon, or both. 2019 May 1;42(3):163-167. doi: 10.3928/01477447-20190424-08. For more severe cases, orthopedic knee surgery may be needed. This was a retrospective review of TKA patients from multiple institutions who underwent physical therapy versus physical therapy and adjuvant NMES therapy following primary TKA. This type of specialized stretching and mobilization can provide a force that is great enough to elongate the scarred, shortened tissue but not cause extensive damage and enable the inflammatory process to get out of control. The focus of the rehabilitation program is strictly maintain the motion that was gained during surgery and keep the inflammation under control. A manipulation is a non-surgical p… This site needs JavaScript to work properly. by ACE Physical Therapy and Sports Medicine Institute. Physical Therapists are trained to mobilize a joint. A 6-8 weeks post op physical therapy rehabilitation program is vital. J Arthroplasty. COVID-19 is an emerging, rapidly evolving situation. 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