Arthrofibrosis Knee Treatment & Recovery

By Dr Sara Aspinall, PhD, MSc, BSc (Hons), MCSP
Founder & Physiotherapist, STAK Orthopaedics –
www.stakkneestretcher.com

Arthrofibrosis knee treatment is essential for managing this frustrating and often painful condition that can make even simple movements difficult. It commonly occurs after surgery particularly total knee replacement (TKR) or after injury, due to excessive scar tissue forming inside the joint. This limits your knee’s range of motion and interferes with everyday activities.

But there is hope. With the right combination of stretching, inflammation control, physiotherapy support, and in some cases medical procedures, many patients can regain significant movement.

In this blog, we’ll walk you through proven strategies for managing arthrofibrosis, when to seek extra help, and how a structured, high-intensity home programme can help you avoid or recover from more invasive procedures.

What Is Arthrofibrosis of the Knee?

Arthrofibrosis refers to an overgrowth of fibrous scar tissue in the knee following surgery or injury. This internal scarring causes the joint to become stiff and inflamed, limiting the ability to bend or straighten the knee fully. It’s as if the body’s natural healing response becomes overactive and creates too much “internal glue”.

Signs to watch for include:

• A knee that won’t fully bend or straighten
  
• Ongoing pain or swelling after the initial recovery period
  
• A sense that the knee is “blocked” or catching
  
• Little or no progress in physiotherapy despite regular sessions
  

Why Early Intervention Matters

Arthrofibrosis doesn’t improve on its own and the longer it’s left, the more dense and restrictive the scar tissue becomes. Once movement is lost, it can be difficult to regain without structured rehab or medical intervention.

The key is early recognition and consistent, high-quality treatment, which can include physiotherapy, home stretching tools, medication, and if required surgical procedures.

Manipulation Under Anaesthetic (MUA): A Common Next Step

If you’ve hit a plateau with your recovery after knee surgery and the knee remains stiff, manipulation under anaesthetic (MUA) may be recommended.

MUA is a non-invasive procedure where your surgeon gently forces the knee through a range of movement while you are under anaesthetic, breaking up scar tissue without cutting into the joint. It’s often a middle-ground solution before considering more invasive procedures like arthrolysis or revision surgery.

💡 Did you know? MUA is actually more common than arthrolysis and revision knee surgeries for arthrofibrosis, and often the first intervention offered when physiotherapy alone isn’t working.

What to expect after MUA:

• Immediate improvement in range on the operating table – Range sometimes lost once patient returns home and scar tissue begins to reform.
  
• Following-MUA swelling and bruising
  
• A strict, intense rehab programme to maintain the gains
  
• Potential use of home devices like the STAK to support aftercare and ensure progress made.
  

Top 5 Tips for Beating Arthrofibrosis

1. Control Swelling and Inflammation

Start with the basics: apply ice packs regularly, elevate the leg, and take prescribed anti-inflammatories if you’re able to. Inflammation is a key driver of scar tissue formation and pain, so controlling it helps create the right conditions for movement.

Tip: Apply ice after every physio session or stretch to calm the joint and reduce post-activity swelling.

2. High-Intensity Stretching- More Than Once a Day

To break down scar tissue, you must stretch the tissues beyond their current resting length and do so repeatedly. Once a day is rarely enough.

“For treatment to be effective, tissues must be stretched daily, several times a day, at high intensity, otherwise collagen reverts back to its shortened position.”

(Jacobs & Sciascia 2011)

Many physiotherapists recommend the use of assistive tools at home in between physiotherapy sessions to achieve consistent, high-quality stretches. One such device is the STAK Knee Stretcher, which allows controlled, gradual, repeated high intensity stretching throughout the day. It’s designed to help increase range safely especially useful to prevent MUA or after MUA or when NHS physio isn’t working or you just want to accelerate your recovery.

Patients who use tools like STAK often report feeling more in control of their recovery and really value feeling the immediate benefits and tracking their progress on the STAK scale.

3. Take Pain Relief Before You Stretch

Pain can become a barrier to effective rehab. If your doctor agrees, taking pain medication or anti-inflammatories before your stretching or physiotherapy session can help you push further, which is necessary to remodel dense scar tissue.

4. Stay Active, But Modify Load

Don’t fall into the trap of resting too much. Prolonged inactivity can worsen stiffness. However, not all activity is helpful. Reduce high-impact or heavy weight-bearing exercises that aggravate your symptoms. Instead, focus on:

• Stationary cycling (if possible)
  
• Gentle swimming
  
• Low-load movement and glute/core activation work
  

5. Recognise When Progress Has Stalled

If your knee has been stiff for weeks or months despite good effort, don’t delay in seeking further advice. Patients often wish they’d acted sooner when they realise how effective MUA or intensive rehab can be.

Your physiotherapist or surgeon can help decide whether you need:

• An escalation in physiotherapy
  
• A guided stretching tool
  
• MUA
  
• Or (in rarer cases) surgical arthrolysis
  

Supporting Your Knee at Home

Devices & Tools

There’s growing evidence and clinical experience showing that devices like STAK can offer a valuable supplement to clinic-based rehab. Used correctly, they:

• Provide controlled, repeatable stretching
  
• Are adjustable for pain levels and stiffness
  
• Help maintain and improve post-MUA gains
  
• Fit into daily routines (20 mins, 3–5x/day)
  

This can be especially helpful for patients with limited NHS physio access or long waits between appointments or patients in real need where physiotherapy isn’t working.

Real Stories, Real Progress

Many people are surprised at how quickly gains can be made when they find the right combination of consistency and support. Some avoid MUA entirely by ramping up their stretching intensity early, while others use tools like STAK post-MUA to lock in results and avoid recurrence.

“8 weeks post-op, I had barely 60 degrees of bend and was being booked for MUA. I hired the STAK tool and saw improvement within a fortnight. I’ve now avoided surgery altogether.”
– Jill, 2024

These stories aren’t magic they’re the result of early action and consistent input.

Preventing Recurrence of Arthrofibrosis

Even after recovering from arthrofibrosis, you’ll need to maintain your progress:

• Daily stretching: Even 5-10 mins keeps tissue mobile
  
• Regular reviews: Don’t skip check-ins with your physio or surgeon
  
• Strengthening: Long-term strength support reduces risk of re-stiffening
  
• Nutrition: Anti-inflammatory diets (omega-3s, antioxidants) support tissue healing
  

Final Thoughts: Hope for Recovery

Arthrofibrosis can feel like a setback, but it doesn’t have to define your recovery journey. With the right blend of high-intensity stretching, support tools, and expert guidance, many patients return to activities they thought they’d lost.

Whether you’re just noticing stiffness after surgery, or you’ve been dealing with it for months, don’t wait to seek help. MUA is a commonly used next step, and support tools like STAK can empower you to take an active role in your rehab.

Your movement isn’t gone for good. With the right support, it can be reclaimed.