Table 1 The stages of pathogenesis of sterile arthrofibrosis of the knee with corresponding clinical features, risk factors and current managements
From: Pathological mechanisms and therapeutic outlooks for arthrofibrosis
Pathogenesis | Clinical features | Risk factors | Current management |
|---|---|---|---|
Inflammatory response, upregulated TGF-β | Pain, redness and swelling | Surgery or injury | •Elevation and icing •Corticosteroids •Aspirin |
Proliferation of myofibroblasts and ECM production | Stiffness and restricted range of motion | Surgery or injury | |
Dysregulation of inflammation and TGF-β signalling, excessive ECM in and around joint, adhesions and contractions. Epigenetic alterations | Persistent pain and restricted ROM, with typically mild swelling. Further ECM production and contractions of soft tissues, abnormal gait | •Previous surgeries •Mutations causing excessive TGF-β or inflammation •Female gender? •Early onset OA •Inflammatory and autoimmune diseases | •Daily CPM •Exercise rehabilitation •Control of inflammation •MUA •Surgery to lyse adhesions and debride ECM |
