Clinical Management of Arthrofibrosis: State of the Art and Therapeutic Outlook.

JBJS Rev · Jul 2020 · Review

Ibrahim IO, Nazarian A, Rodriguez EK

Harvard Medical School Orthopedic Trauma Initiative, Boston, Massachusetts

General Orthopaedics

SUMMARY — THE REDUCTIONThis review outlines arthrofibrosis pathogenesis (via TGF-beta) and current imperfect treatments—physiotherapy, manipulation, and debridement—while highlighting a need for future antifibrotic drug therapies.
Abstract, as published

* Arthrofibrosis is a pathologic condition that is characterized by excessive periarticular scar-tissue formation. Arthrofibrosis may occur secondary to injury, surgical trauma, hemarthrosis, or infection, or it may occur idiopathically.* The pathogenesis of arthrofibrosis is incompletely understood but involves the dysregulation of normal reparative pathways, with transforming growth factor-beta (TGF-[beta]) as a principal mediator.* Current treatment options for arthrofibrosis primarily involve physiotherapy, operative manipulation, and surgical debridement, all with imperfect results.* Currently, there are no pharmacologic treatment options for arthrofibrosis. This has prompted increased investigational interest in the development of antifibrotic intra-articular therapies.

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