Maria's arthrofibrosis story

In August 2025, I sustained a significant knee injury while playing Padel (like tennis) tearing my ACL and experiencing extensive trauma to my knee. My first surgeon recommended immediate surgery, and the ACL reconstruction was performed just four days after the injury. At the time, I believed I was facing a relatively straightforward operation followed by six to twelve months of rehabilitation. Unfortunately, that was not what happened. Around four to five weeks after surgery, I began developing the first symptoms of arthrofibrosis.

Approximately six weeks after the reconstruction, I underwent my first arthrolysis. It was unsuccessful. My knee remained blocked at approximately 70-80º of flexion, I was limping, and the pain was excruciating. I subsequently sought several other medical opinions and was informed that the ACL graft had been malpositioned during the original reconstruction. This was extremely difficult for me to process, particularly because it meant that the mechanical problem with the graft may have been contributing to the ongoing restriction.

Around six and a half months after my original surgery, I found another surgeon who recommended removal of the graft together with another arthrolysis. At that point, I was still in denial and struggling to accept that the reconstruction I had undergone might need to be reversed. I therefore opted for the arthrolysis alone, hoping that this would be enough. Unfortunately, it resulted in only another 5-10º of improvement in my range of motion.

Three months later, I finally realised that my knee was becoming stuck again and that avoiding graft removal was no longer getting me where I needed to be. In July 2026, I underwent another surgery, this time involving removal of the ACL graft and arthrolysis. I am now approximately two and a half months post-operative. My knee still feels stiff and can be painful, and my activities of daily living continue to be affected. I still cannot run or cycle. At present, swimming is the only part of triathlon that I can do.

Together with my physiotherapist, we have managed to achieve approximately 110 degrees of passive flexion, terminal extension is lacking 6-7º. However, after one or two hours of rest, my knee tends to return to its default range of around 85º to 90º. With warming up and rehabilitation exercises, I can usually regain approximately 100º. What has been particularly difficult to accept is that I went into the original surgery believing I was beginning a six-to-twelve-month journey back to sport. Instead, more than a year later, after multiple operations, I am still fighting to regain basic function and trying to understand what my long-term outcome may be. I do not know what the rest of this journey will look like, but my goal remains the same: I want to return to triathlon and to an active, functional life.

I would therefore be incredibly grateful to hear from anyone who has experienced a similar pattern, particularly the repeated loss of range of motion after initially gaining it through rehabilitation. Any experiences, insights or guidance would mean a great deal to me.

I will also be attending the symposium in Milan, hoping to gain a deeper understanding of arthrofibrosis, both to help myself and, as a physiotherapist, to eventually use that knowledge to help others struggling with this condition. I am realistic that I may never regain my full range of motion or flexibility. But for me, being functional, active, and able to return to triathlon would be more than enough. I am prepared to do the work it takes to get there. My hope is that one day I will be able to put this chapter behind me and regain the active life that means so much to me.

Thank you for taking the time to read my story. I would sincerely appreciate any shared experiences.