I had a severe twisting injury (01.08.2021), got arthrofibrosis within the first 4 days after, and after 3 months with a stiff knee (ROM 5-45 degree), I had surgery: arthroscopy + brisement. In 8 weeks after brisement I went to the hospital's specialized physiotherapy 3 times a week, Used CPM several times a day and night (for 3 weeks), cycling 15 min every day with low effort and was on morphine in 6 weeks.
2 weeks after brisement my ROM started to be restricted and then it happened that (because I have a bad back) I got a hold in my back - couldn't move and had to stay in bed in a week. I was very worried about the status of my ROM after a week of rest - but surprisingly it turned out that the week's rest had done me good: my ROM was much better so now it was finally going the right way. And then I later read an article about the importance of supporteing the parasympatic system when having trouble with any fibrosis-production.
I have now achieved good ROM (-5 to about 130 degrees), but this is probably because I have NOT trained hard. When I was of from hosptial I was told that my diagnosis had a name: "arthrofibrosis"! I had never heard about it - and even then psysiotherapist at hospital didnt mention! So I researched everything I could (not much) about arthrofibrosis and in the process after I had achieved sufficient ROM was very careful to avoid exercises that triggered the inflammation. None of all the physiotherapists, surgeons and rheumatologists I have met have had any knowledge of arthrofibrosis and often the guidance has been downright harmful. Every time a physiotherapist has pushed mwe to but weight on my knee joint, it has gone back a lot. Could feel the artofibros was active as long as the inflammation was active and that was while my bone bruise healed - it took 1 1/2 years. During that time, my bad knee was constantly 1-2 degrees warmer than the other. Now two years after the injury, I do not have an active inflammation, but I am still very careful about provoking pain, as I suspect that I can "wake up" the "sleeping" arthrofibrosis. Also still have a feeling of stiffness that varies. It is worst if I stand still or sit still. Think it has to do with lack of oxygen supply..? Suffers from quad astrophy and finds it very difficult to train as the knee reacts negatively to stress in flexion.
Besides in addition to suffering from arthrofibroses, I have a master's degree in Danish and philosophy, so I have no medical background, but I try to understand the overall lines and have promised myself to improve the Danish healthcare system's way of handling arthrofibrosis, so I have created a Facebook group and has made contact with the chairman of the Danish Association of Sports Medicine - my goal am to create procedures for best practice...evn its not an easy target it can ONLY improve from now...