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Knee Scar Tissue: What to Know

Medically Reviewed by Dan Brennan, MD on May 24, 2021

If you've ever experienced debilitating knee pain that prevented you from walking or moving, you understand the importance of healthy knees. The knee is a hinge joint, made up of complex structures like soft tissues and ligaments that are easily injured. 

Repeated injuries or knee surgery can cause scar tissue to develop in the joint. This condition is called arthrofibrosis and can make simple movements difficult and painful. 

What Is Knee Scar Tissue?

Arthrofibrosis, also called stiff knee syndrome, occurs when too much scar tissue develops around the knee.

This condition can occur in any joint. It makes daily movement, like walking or standing up, difficult and painful. People of all ages develop arthrofibrosis, though it's less common in children. 

What Causes Knee Scar Tissue?

Knee scar tissue is often attributed to knee surgeries like ACL reconstruction, but it can also be the result of repetitive injuries that cause scar tissue to build up over a long period of time. 

Signs and Symptoms

The amount of pain or disability you experience depends on the severity of your condition. The symptoms of arthrofibrosis in your knee are the most apparent when you try to stand up or walk. It's typically worse than the original knee injury.

A lack of movement contributes to arthrofibrosis. If you've recently had knee surgery, some stiffness is normal. Here are some other symptoms you might experience.

  • Increasing Pain. As you recover from an injury or knee surgery, the pain will decrease over time. If it gets worse, it may be a sign of excess scar tissue. 
  • Knee Bending. Walking with a bent knee, or the inability to contract your quadricep muscles to straighten your knee, could be a sign that you're developing arthrofibrosis. 
  • Swelling. This is often a sign of fluid buildup but can be an early warning sign of arthrofibrosis. If it doesn't get better, seek medical attention. 
  • A "Hot" Feeling. This is a common symptom right after knee surgery. Pay attention if it persists or gets worse. 

When to See Your Doctor

Knee pain or stiffness doesn't necessarily mean you have arthrofibrosis. But if these symptoms persist, it's important to see your healthcare provider. He or she can determine the source of the problem and provide treatment options to help you manage your condition. 

Knee Scar Tissue Treatments

Arthrofibrosis treatment options depend on how much scar tissue has developed in your knee. In some cases, a course of intense physical therapy can solve the problem. People with more severe cases may need additional surgery. Here's a look at the types of treatment you might receive.

Physical Therapy: A physical therapist will provide exercises to help strengthen the tissues and muscles around your knee joint. This includes manual mobilization techniques and some forms of passive stretching

Manipulation: A surgeon will move the joint in specific ways to loosen and break up scar tissue. This is commonly done with anesthesia. 

Arthroscopic Surgery: Sometimes, your surgeon will suggest arthrolysis, a minimally invasive surgery to remove scar tissue. This treatment is becoming more and more common. 

Open Knee Surgery: If your arthrofibrosis is severe, you may need additional surgery. Your provider will likely suggest another course of physical therapy. 

If you've had knee surgery or have a chronic injury, it's important to seek treatment early to maintain the range of motion in your knee. 

Preventing Arthrofibrosis

After surgery, you'll learn new ways to safely move your knee joint. This often includes: 

  • Gentle physical exercise like walking on a treadmill
  • Wearing a compression brace to keep the joint in place and provide extra support
  • Using a continuous passive motion machine (CPM) to move your knee through a specific range of motion 

Treatment options vary depending on the type of injury, but even after surgery, it's important to continue to move. Loss of motion can lead to more scar tissue in your knee and could prolong your pain. 

Show Sources

SOURCES:

American Academy of Orthopaedic Surgeons: "Arthrofibrosis of the Knee." 

American Academy of Orthopaedic Surgeons: "OrthoInfo: "Common Knee Injuries." 

Bone Research: "Pathological mechanisms and therapeutic outlooks for arthrofibrosis." 

Orthopaedic & Traumatology: Surgery & Research: "Post-traumatic knee stiffness: Surgical techniques." 

Physiotherapy Theory and Practice: "Presentation and management of arthrofibrosis of the knee: A case report."

St. Alphonsus Rehabilitation Services: "Breaking Up Stiff Knee Syndrome After Knee Surgery."

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