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A huge thanks and welcome to our new Clinical Advisors!

The IAA gives a huge thanks and welcome to our two new Clinical Advisors, Associate Professor of Physiotherapy at the University of Nottingham, UK, Michelle Hall and Orthopaedic Surgeon and Head of Knee Surgery at EUKAF/EOC Switzerland, Dr Marco Valoroso.

Both Advisors shared their insights in informative presentations at our recent Knee Arthrofibrosis Symposium in Milan. Ass. Prof. Hall presented her research about patient experiences of knee arthrofibrosis and Dr Valoroso covered his arthrofibrosis-specific surgical methods and extensive experience in the surgical treatment of knee arthrofibrosis.

The IAA is delighted to have these passionate clinicians join our team.

Kayley

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Thank you for sharing your knowledge to further the understanding of Arthrofibrosis.

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Removing ACL

Hi,

I don’t know who asked the question about the removel off the ACl,i can’t see it.

But ,indeed,in 3 years and 5 months i haven’t been able to bend or strech my knee,i had 4 different surgeries to remove the ZF,in januari the surgeon made the notch wider and made cuts in the ACL and stiched it back in a special way,but didn’t help

So now ,they take it away,because it causes scartissue .I also developted a lot of cartelige damage behind the kneecap bevause of the AF,in a short ampunt of time🥲🥲

So it is a pre surgery for a TKR,but i still hope wikt this surgery,i will have less pain ,so the TKR can

Wait!


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Hi everyone,

Afther an ACL and

Meniscussurgery,i had 4 surgeries to remove scartissue.

I have had so much pain ,and a lot cole from the Hoffa FP.

Now the surgean want’s to remove (a part) of the Hoffa,because nothing helps

But i read a lot about the Hoffa,,better not to remove it?

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Question regarding knee injection post-surgery

​Hi,

​I am two months post-op from my second knee surgery for arthrofibrosis clearance. I still have a limited range of motion, severe pain during any knee activity, and I can barely walk.

​My surgeon recommended getting a corticosteroid and hyaluronic acid injection into the knee, hoping it will improve my condition.

​I would very much like to hear your opinion or from personal experience: are these injections helpful, and can they indeed improve the situation?

​If they do provide pain relief, is it long-lasting or only temporary?

​Are there any risks with these injections that could worsen the arthrofibrosis due to the substances introduced into the knee?


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A patient mentioned a HOPPA. what is that, a procedure?

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IAA's international Knee Arthrofibrosis Symposium

The IAA’s world-first international Knee Arthrofibrosis Symposium in Milan, on October 15th, was a great success for our Arthrofibrosis Awareness Day. A huge thanks to those who helped put this together, and to the 9 speakers who covered the topics of surgery, physiotherapy, pathology, psychology and pain control. Attendance was excellent, and there was lots of interest and great questions.

Stay tuned for the YouTube videos on the IAA’s YouTube channel (the first presentation by Kayley Usher is published) and the blog.


Kayley

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Arthrofibrosis Awareness Day

How is everyone - not at the conference - acknowledging AF Awareness Day? I am wearing my hoodie (grateful it is not yesterday's 80°F) and reminded all my friends to wear their AF Awareness pins today.


I know some don't want to talk about it. To have to keep explaining why they have their mobility issues and what it is. I feel like we need a lot more education and awareness, even with orthopedists.


My new orthopedist feels that my surgeon should have been aware that I was at significant risk for arthrofibrosis based on my medical history and worked on pre-op preventative measures and treatment post-op when my leg wouldn't bend at all. The joys of hindsight.


Anyway, happy advocacy.



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Hi Erica,

Thank you for promoting the Arthrofibrosis Awareness Day and raising awareness about arthrofibrosis! I love your hoodie 😀

Our Knee Arthrofibrosis Symposium in Milan was a great success. I'll write a blog with photos soon.

All the best,

Kayley

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ZuzanaZuzana
Zuzana

Rheumatological tests

Hello,

I have been dealing with arthrofibrosis for over 3 years, and this is the first time I managed to get an appointment with a rheumatologist. Beyond a Cytokine Panel Blood Test, is there a recommended list of tests/examinations I should ask for? I’ve already read general descriptions on IAA website, but I’m looking for more detailed information on specific tests or a pointer on where to find it.


Thank you in advance.

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I went finally meet Dr Noyes. He never took any blood. He just looked at my X- ray and said I know what you have. He explained what it was and honestly said he could do surgery with 80% success. That is better than what the doctors didn’t offer me for my three years. Just waiting for him to call me to come back for the procedure.

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Second surgery to clear arthrofibrosis

Hii

About two and a half years ago, I underwent ACL reconstruction surgery and developed arthrofibrosis.

About a year and a half ago, I underwent an arthroscopic surgery to clean out the diffuse arthrofibrosis that was present in the knee.

The arthrofibrosis has returned again, and I was recommended to undergo another surgery for cleanup, and this time to take a medication called Losartan for six weeks following the surgery.

I would be happy to know:

Does an additional cleanup surgery pose too high a risk for another recurrence of the arthrofibrosis?


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Hi,

Your question about surgery is a difficult one, and there is no easy answer. However, it's important to have scans to make sure that the ACL graft has been positioned correctly. It can be helpful to see a different surgeon who is not associated with the first, to get advice on the ACL graft positioning.

After the scans you might consider arthroscopic arthrofibrosis surgery. However, surgery stimulates the healing response again, and arthrofibrosis is a condition of over-healing. So, as you have experienced, the outcome might not be good, and might even be worse.

If the surgeon follows the methods that are outlined in the Surgical Checklist, especially not using a tourniquet and not using a mechanical shaver, that reduces the risk since there is less damage done, but we still can't predict the outcome. It seems that the Hoffa's fat pad is almost always inflamed and fibrotic, and cutting it is not advisable.

Losartan was shown to reduce arthrofibrosis for some people in some research, but other research has not found a positive response. An individual's reaction to it likely depends on the biological pathways that are dysregulated, which determines what will help.

If you can find a surgeon who is willing to consider the arthrofibrosis-aware surgical methods then you might decide the risk is worth it. We're happy to meet virtually with a surgeon if they want to discuss this, and we can also point you to a couple of experienced arthrofibrosis surgeons in Europe and the US.

Please feel free to ask more questions.

All the best,

Kayley

Edited

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A short break

Hello, and thanks for your interest in the IAA. This is a courtesy note to inform you that the Directors are taking a short break until July 11th, and likely won't be able to respond to questions during this time. We hope this doesn't inconvenience you.

Kayley

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