A discussion of the frustrations of patients who have experienced knee stiffness from arthrofibrosis after knee injury or surgery.

 

 

Transcription of this video

In most patients who are struggling to regain the range of motion of their knee, the whole thing started with a minor surgical procedure, and the patient is bewildered and groping to understand what’s going on.

Since patients generally have little anatomical or medical knowledge when first confronted with their problem, it is even harder for them to know where to look for answers.

 

Inappropriate early stiffness

A common story that we hear all the time - I would feel safe enough estimating that this happens 95% of the time - is that, after a minor initial procedure, the physical therapy didn’t progress as expected, due to joint stiffness plus a loss in the range of motion of the knee. Often the initial surgeon basically didn’t know what to do, as well as the physical therapist.

Sometimes these patients undergo further procedures with their initial surgeon, but the situation doesn’t improve or even gets worse. They insist day after day to all the members of the medical staff that they feel their situation to be extremely worrisome, but without a precise diagnosis of their problem they end up being turned away after a lot of ineffective physical therapy. So it’s sort of classic that these patients are very frustrated by the whole situation. The impairment is highly handicapping, the functional pain can be unbearable and they often weren’t even able to get a precise diagnosis.

They likely were told initially to expect to resume their daily activities - such as working or going out for a movie - and their sports activities in a determined amount of time. Obviously this may vary patient by patient, but with the continued postponement of their expected recovery time severe frustration becomes inevitable.

The patient may feel a surreal disconnect with their clinicians. Despite hearing repeatedly that “It’s just a matter of time and eventually you will recover, it can’t last forever”, they remain convinced about how serious their condition is, and the fact that the physical therapists and doctor - unskilled as they are in this case in dealing with adhesions and arthrofibrosis - are not as worried as they are aggravates their frustration.

If the patient has reached the eight-week mark and feels anxious and frustrated, then we would advise consulting with a surgeon who has acknowledged expertise in this subject.

I understand that a lot of people question their being able to afford this step, but it is my opinion that no matter how far a patient has to travel to see an expert it could represent the best money they ever spent. In developing this course, we are trying to help people get to grips with the issues at an early enough stage that such travel does not become necessary. If it does, then we want to draw to your attention that the KNEEguru website maintains a list of knee surgeons who we believe to have the right kind of expertise, based on reports from the patients who regularly participate in the bulletin board discussions there. You will find a link to this list in the Resources for this lecture.


eBook Chapter by Dr Noyes - Arthrofibrosis - everything you need to know....


Surgeons with expertise in arthrofibrosis

Who's Who in Arthrofibrosis Surgery

 


 

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