Hello
I had an ACL reconstruction 17 years ago and never regained full range of motion. I had further surgery after a few months - supposedly to release what was causing problems - and that may have helped a bit but I've been left with a knee that cant fully bend or straighten (other than under pressure), and gets inflamed and sore more often than one would like. Haven't done anything high impact since the surgery, I kept up distance walking for quite a while but it gets harder and more painful to recover so generally avoiding too much walking now. Reformer pilates and aqua aerobics are my go-to activities - eventually couldn't manage standing poses in yoga. Over time I've strengthened all the supporting muscles and with passive stretching and regular but not daily NSAIDS I'm not incapacitated. I just limp at times.
I'm really fed up with never finding anyone who could tell me why my knee wasn't right - MRI looked OK according to the sports physician. So maybe this arthrofibrosis and if it is, does that mean there could be a diagnosis based on blood chemicals? And possibly a quite different form of treatment. Who can I talk to in Sydney? If I self-fund a cytokine panel, I'll want someone to interpret it.
Any advice would be much appreciated.
Thanks
Debbie K
Hi Debbie,
A diagnosis of arthrofibrosis is usually made when there is a lack of range of movement (and often pain with activity), after other mechanical causes like a misplaced ACL graft and infection have been ruled out. Assuming that these things have been looked into (if not, perhaps seek another opinion), then it's likely that you have arthrofibrosis. MRIs are not good at detecting scar tissue unless there is severe distortion of the tissues, and many radiologists are not expert in detecting arthrofibrosis. They might mention patellar baja or similar, which is arthrofibrosis.
At this stage there aren't any blood biomarkers that are recognised for diagnosing arthrofibrosis and it's difficult to find a clinician who will prescribe medications based on cytokine panel results, but a rheumatologist might. It would be a good idea to see a rheumatologist and have some testing done to see if there are medications that can help. I have heard that the surgeon Dr David Young in Melbourne treats arthrofibrosis and ligament injuries, but we don't know anyone in Sydney. Please let us know how you go, and if you find a good clinician.
All the best,
Kayley