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Clinician Checklists

Help building an international database of clinicians who treat arthrofibrosis

This will be used to identify clinicians whose treatments are based on our understanding of fibrosis pathology. Your contribution will be much appreciated and individual responses will not be published. Clinicians are welcome to complete the checklist themselves. Please understand that this international database will take time to build.

Surgical Checklist

If you’re planning surgery you may find it helpful to ask your surgeon this list of questions. The surgical methods used appear to make a difference to risk of fibrosis returning, however, there can never be a guarantee of success. See this summary of recommendations by experienced arthrofibrosis surgeon Dr Singleton.


Please note: This checklist for surgical approaches is not applicable to revision total knee replacements. The IAA encourages surgeons to avoid revision TKRs unless there are clearly identifiable problems with the prosthesis.

Are you:
Joint
Avoids standard use of mechanical shaver
Uses a cauterising tool
Avoids standard use of a tourniquet
Minimises surgical procedure (severity, duration, number of cuts)
Takes time to ensure bleeding has stopped before closing wound
Performs arthroscopy for AF post TKR
Recommends daily, gentle CPM post-op
Recommends gentle physiotherapy approaches post-op
Recommends anti-fibrosis and/or anti-inflammatory medications post-op
Are you willing to be contacted if we have a question?
Respectful, listens and responds well
PoorFairGoodVery goodExcellent
Demonstrates good post op care & instructions
PoorFairGoodVery goodExcellent

Thanks for submitting!

Physical 
Therapist
Checklist

If you’re planning surgery you may find it helpful to ask your physical therapist this list of questions. The methods used appear to make a difference to risk of fibrosis returning, however, there can never be a guarantee of success. See this list of recommendations by experienced arthrofibrosis physical therapist Sebastiano Nutarelli.

Are you:
Joint
Has reducing inflammation and healthy healing of joint as a priority over building muscle in affected limb
Recognises arthrofibrosis symptoms and changes the plan in response to the joint’s reaction
Has an open dialogue with the patient about arthrofibrosis, their symptoms and the lengthy time needed for recovery
Patiently waits to strengthen the affected limb until inflammation is resolved and healthy healing is well under way
Never tries to manually force range of motion
Never blames the patient
Never recommends pushing through the pain
Recommends exercising non-affected parts of the body
Recommends pain-free Continuous Passive Motion daily (lower body joints) or passive stretches (upper body joints) in the initial post-op period, as tolerated
Recommends non weight-bearing for initial post-op period: crutches or wheelchair (lower body joints), with partial weight-bearing later, as tolerated
Refers to rheumatologist, pain specialist or other clinician for medications & tests as needed
Are you willing to be contacted if we have a question?
Respectful, listens and responds well
PoorFairGoodVery goodExcellent

Thanks for submitting!

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