Arthrofibrosis is a generic term to describe postoperative stiffness (either extension or flexion) due to multiple causes including infection, pain, and inflammatory reaction. It can also be iatrogenic e.g. Cyclops lesions that occur in the absence of prior anterior ligament reconstruction. Background: Arthrofibrosis is a debilitating postoperative complication of total knee arthroplasty (TKA). anterior cruciate ligament (ACL) reconstruction, hockey stick sign (Creutzfeldt-Jakob disease), stepladder sign (intracapsular breast implant rupture), stepladder sign (small bowel obstruction), eccentric target sign (cerebral toxoplasmosis), trident sign (persistent primitive trigeminal artery), ginkgo leaf sign (subcutaneous emphysema), butterfly shape of the grey matter of the spinal cord, snake-eye appearance (cervical spinal cord), caput medusae sign (developmental venous anomaly), ice cream cone sign (middle ear ossicles), ice cream cone sign (vestibular schwannoma), in total anomalous pulmonary venous return, anterior cruciate ligament avulsion fracture, posterior cruciate ligament avulsion fracture, Ahlback classification system in assessing osteoarthritis of the knee joint, Kellgren and Lawrence system for classification of osteoarthritis, pattern of bone contusion in knee injuries, anterior cruciate ligament mucoid degeneration, MRI grading system for meniscal signal intensity. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. Arthrofibrosis is a complication of injury or trauma to a joint. It is classed as in inflammatory response and can affect all major joints. Arthrofibrosis is characterized by an abnormal proliferation of fibrous tissue that may be focal or diffuse and intra-articular or extra-articular. 27 (6): e26. post knee surgeries. Arthrofibrosis is a condition that leads to scar tissue formation around a joint. The cyclops lesion is a specific manifestation of localized arthrofibrosis and consists of a focal rounded mass of fibrous/scar tissue which occurs anterior to a reconstructed ACL ligament. 4. Arthrofibrosis is defined as joint pain and stiffness that does not allow functional range of motion and is due to adhesions or contracture of the joint. Radiology. MRI can confirm and define the extent of a suspected fibrotic lesion and assist in detecting and differentiating other postoperative complications with a similar clinical presentat… (1)Department of Diagnostic Radiology, Cleveland Clinic Foundation, OH 44195, USA. Arthrofibrosis can be diffuse or localized. Arthrofibrosis of the knee following ligament surgery. The differential diagnosis for a cyclops lesion includes focal pigmented villonodular synovitis, synovial chondromatosis and intra-articular loose bodies. Imaging of intraarticular masses. Impingement of the graft in knee extension is also postulated 4. At MR imaging, generalized arthrofibrosis is seen encasing the graft and extending into the infrapatellar fat pad and the posterior joint capsule . flexion, extension, or both) may be affected. Arthrofibrosis is quite a serious pathological condition that affects mostly the knee and the shoulder joints post an injury or a surgical procedure or both. Familiarity with the diagnosis and arthroscopic management of these disorders may lead to improved outcomes in this … Suspect periprosthetic soft-tissue abnormality unrelated to infection, including quadriceps or patellar tendinopathy (quadriceps or patellar tendon tears, postoperative arthrofibrosis, patellar clunk syndrome, or impingement of nerves or other soft tissues). All of the patients had an underlying diagnosis of osteoarthritis and were treated with a prolonged course of physical therapy after the primary total knee arthroplasty. MRI is effective as a tool to evaluate unexplained pain, limited range of motion, and functional limitation in the postoperative patient in whom arthrofibrosis is suspected. This condition often follows a traumatic injury or surgical procedure. Unable to process the form. 32 (8): 2604-2611. Depending on the site of scarring, knee cap mobility and/or joint range of motion (i.e. The condition sometimes occurs in a knee joint that has recently been injured. Arthrofibrosis can follow knee injury and knee surgeries like arthroscopic knee surgery or knee replacement. Intermediate-weighted fast SE pulse sequences with high spatial resolution are most versatile for imaging around knee arthroplasty implants because of the high signal-to-noise ratio, sensitivity to fluid, and favorable contrast-to-noise ratios, which allow sensitive detection and accurate characterization of periprosthetic bone and soft tissues. In the knee, arthrofibrosis is a complication of knee trauma, surgery, or prolonged effects of osteoarthritis. Minidoka Memorial Hospital’s Medical Imaging Department is committed to providing the highest quality diagnostic imaging with a personal atmosphere. It consists of excessive scar tissue formation within the joint capsule, resulting in pain, stiffness, and swelling, which are greater than expected in the given clinical scenario. A control group of 38 patients with a well-functioning total knee arthroplasty was matched. If you have been diagnosed with this condition, rehabilitation for it - whether this be post-operative or non-surgical - should be approached cautiously and appropriately. It is one of the leading causes of hospital readmission and a predominant reason for TKA failure. MR imaging evaluation of the postoperative knee. ; Worsening pain - Pain is a normal feature of injury and surgery, but usually settles in a predictable manner. 1. It can also be iatrogenic e.g. In “b” adhesions have pulled the walls of the pouch together with extracellular matrix (ECM) contracting the space and preventing normal movement.Green arrows = posterior capsule. 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