Diagnostics

An accurate and sensitive imaging method for diagnosing arthrofibrosis and identifying the affected tissues is urgently needed. Due to the current lack of diagnostic biomarkers the diagnosis of arthrofibrosis has been based on non-specific symptoms, particularly a loss of range of motion (ROM) in the joint, and pain. However, a significant amount of scar tissue can be present in a joint and have minimal impact on ROM. After infection is ruled out (or treated), tests for inflammation can be useful, together with imaging. 
An ultrasound-guided injection of anaesthetic into the infrapatellar fat pad (IFP) is a useful method to determine the extent of IFP involvement as a pain generator. In our experience when a knee is painful and fibrotic IFP is typically inflamed due to repeated scissoring in the joint.