Joint stiffness is a common condition experienced by patients after injury, surgery, or inflammation of the joints. This condition is characterized by limited movement that can interfere with daily activities, from walking and lifting to performing light tasks. However, sometimes the body overreacts during the healing process. This reaction produces internal scar tissue that can lock your joints, a condition often referred to as arthrofibrosis.
Here is a complete guide to understanding this condition and the surgical solution called Arthrolysis.
Why Can Scar Tissue Cause Stiffness?
After surgery or major trauma, the body begins its natural repair process by producing collagen to close the wound. However, if this collagen production is excessive within the joint capsule, it forms thick, hard scar tissue that forms in excess and adheres to the joint structures (adhesions).
The formation of scar tissue in the joints restricts their range of motion, restricting their freedom of movement. Imagine your joints like door hinges. This scar tissue acts like glue spilling into the hinge. Instead of moving smoothly, the hinge becomes stuck, limiting range of motion (ROM), and often causing pain when forced to move, further impairing function and comfort.
When Should You Be Concerned About This Condition?
Joint stiffness requires medical attention if it persists for a long time and does not improve despite physiotherapy. Over time, this condition can lead to increasingly limited joint movement. Not all stiffness requires surgery. However, you should consult an orthopedic specialist if you experience the following signs:
- Physical Therapy Progress Stalled: You have undergone intensive physical therapy for 3-6 months but your joint range of motion has not shown significant improvement.
- "Hard End-Feel": When trying to straighten or bend a joint, you feel a hard physical resistance, rather than just the usual muscle stiffness.
- Chronic Pain: Sharp or throbbing pain that persists even at rest, triggered by scar tissue pulling on surrounding nerves.
- Decreased Quality of Life: Stiffness begins to interfere with daily activities, such as walking, climbing stairs, or getting dressed.
Treatment of Scar Tissue with Arthrolysis
Arthrolysis is a medical procedure performed to release scar tissue or adhesions within a joint that cause stiffness. This procedure aims to restore previously limited joint range of motion, reduce pain during movement, and allow patients to return to their activities more comfortably and optimally.
Arthrolysis can be performed by two methods:
- Open arthrolysis – through a surgical incision
- Arthroscopic arthrolysis – uses a small camera (minimally invasive) with faster recovery
Post-arthrolysis Recovery Process
After arthrolysis, patients generally undergo a rehabilitation program consisting of intensive physiotherapy and gradual range-of-motion exercises. The key to successful arthrolysis lies in early mobilization. The primary goal is to prevent new scar tissue from forming in the same location. Compliance with this therapy is crucial for optimal results and preventing recurrence of stiffness.
Consult your condition with an Orthopedic and Traumatology specialist at EMC Cikarang Hospital to get appropriate treatment early.
Article written by dr. AAG Putra Prameswara, Sp. OT, FICS, AIFO-K (Orthopaedic & Traumatology Specialist at EMC Cikarang Hospital).