Scar tissue in the knee can form after traumatic injuries or surgery, causing knee stiffness and limited motion. Excessive scar tissue may require further surgery or manipulation under anesthesia to break it up and restore motion. Conservative treatments such as CPM machines, physical therapy, and deep tissue massage are recommended to prevent scar tissue formation.
Scar tissue in the knee develops as a result of traumatic knee injuries or as a complication of knee surgery. It could form after procedures such as anterior cruciate ligament (ACL) surgery or total knee replacement. Like other types of scar tissue, scar tissue in the knee is a grouping of collagen fibers that develops during wound repair. Scar tissue formation is often problematic due to its association with knee stiffness. During the healing process, some individuals develop a condition known as arthrofibrosis, in which excessive internal scar tissue forms, causing the ligaments surrounding the joint socket to tighten and limit or prevent full knee flexion.
The formation of excess scar tissue in the knee depends on the severity of the injury and genetic factors. In arthrofibrosis, the open spaces within the joint are filled with stiff fibrous tissue and the patient feels a lack of movement or a “frozen” joint. Lack of knee motion further aggravates the problem and causes scar tissue to form stiffer than would otherwise be present, further limiting motion.
In cases where excessive joint stiffness is observed due to scar tissue in the knee, further surgery may be required to return the knee to an acceptable range of motion. Six weeks after a total knee replacement, the patient should be able to bend the knee beyond at least 90 degrees. If not, and if physical therapy hasn’t produced the desired results, the patient may be taken back to the hospital to undergo a process in which the knee is forcibly bent to break up the scar tissue and restore motion. This procedure is typically conducted under general anesthesia and is known as manipulation under anesthesia (MUA). After the scar tissue is broken through MUA, the patient must undergo more physical therapy.
While this surgery is sometimes necessary, orthopedic surgeons and sports medicine professionals usually recommend following a course of conservative treatment whenever possible. The use of a continuous passive motion (CPM) machine is prescribed after knee surgery to prevent stiffness and scar tissue from forming in the knee. CPM works by gently bending the knee in a series of repetitions, extending the knee’s range of motion without the need for physical exertion that could damage the knee. Physical therapy and deep tissue massage are also popular treatment methods used to improve flexibility and break down scar tissue in the knee.
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