[Arthrofibrosis after total knee arthroplasty-Diagnosis and management]

Arthrofibrosis is a common complication following total knee arthroplasty (approximately 5%), characterized by painful limitation of range of motion and increased soft tissue fibrosis. Women are affected more frequently than men. A distinction is made between primary (early postoperative, global) and secondary forms (mechanical/infectious causes). Diagnosis is established clinically and confirmed histopathologically. Early non-surgical, antifibrotic treatment with physiotherapy, relaxation techniques, and, if needed, prednisolone and propranolol is recommended. If there is no improvement, mobilization under anesthesia (MUA), ideally within the first 90 days postoperatively, or arthroscopic arthrolysis should be performed. Arthrolysis, while requiring surgical intervention, shows the best improvements in range of motion, particularly at later stages. Late revision surgeries are less effective. In the future, pharmacological therapies may play a role.