Treatment
Our motto for treating arthrofibrosis is “first, do no harm”.
We believe that specialised approaches are necessary to reduce the risk of further activating fibrosis, particularly for surgical and physiotherapy treatments where aggressive methods can cause worsening of the disease [1]. The fibrosis triggers to be avoided, as far as possible, include hypoxia, bleeding, and fat pad injury. In knees the infrapatellar fat pad (IFP or Hoffa’s fat pad) must be treated with great care. The fat pads present in other joints, such as the subacromial fat pad in shoulders [2], are also likely to generate pain and fibrosis due to chronic inflammation.
Arthrofibrosis is a complex disease that, like other serious diseases, requires treatment by a team of professionals. Members of the team can include the areas of rheumatology, physiotherapy, surgery and psychology. Treatments may include medications, exercise, passive stretching [1] and psychological support, with surgery the “last resort” option. Non-prescription approaches include good sleep hygiene, massage, supplements, dietary approaches, meditation and stress reduction.
References
Usher, K. M. et al. Pathological mechanisms and therapeutic outlooks for arthrofibrosis. Bone Research 7, doi:10.1038/s41413-019-0047-x (2019).
Kirsch, J. R. et al. Minimally invasive, sustained-release relaxin-2 microparticles reverse arthrofibrosis. Science Translational Medicine 14, eabo3357, doi:10.1126/scitranslmed.abo3357.
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