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Knee Arthrofibrosis Center

The Center for treating KNEE ARTHROFIBROSIS provides a comprehensive evaluation and treatment program of Orthopedics, Physical Therapists and Strength and Conditioning Experts.  In addition, working with expert consultants a patient undergoes infectious disease consultation, expert MRI analysis and advanced state-of-art treatments when necessary to remove knee scar tissue using minimally invasive surgical techniques. Our program employes all possible modalities to address knee stiffness and reduced  knee motion and lessen the risk of return of knee arthrofibrosis.

About the knee Arthrofibrosis Center

As a major division of the Noyes Knee Institute for over 3 decades, the Arthrofibrosis Center has developed innovative techniques both non-operative and operative and published these programs in Knee Textbooks nationally and internationally.  The Arthrofibrosis Center has taught hundreds of surgeons and physical therapists these advanced treatment techniques. 

Knee arthrofibrosis is a devasting condition and not every patient and arthrofibrosis knee will respond, even to these state-of-art programs.  Based on the experience of our team we provide the most realistic assessment and patient education of the different treatment modalities possible.  We recognize there remains controversy on arthrofibrosis treatment and based on our over 30 year experience having treated hundreds of patients we provide an individualized approach to each patient for compassionate care and recognition of the serious loss of knee function that occurs with knee arthrofibrosis.

FREE Dr. Noyes E-Book Series

There is a combination of non-operative and operative treatment approaches that are utilized based on the knee condition and severity of the knee arthrofibrosis. These treatment approaches are in a published Ebook that is provided by the authors for each patient, to read and understand the approaches that have been successful at the Noyes Knee Institute.

Everything You Need to Know to Recognize, Treat, and Prevent Loss of Knee Motion After Injury or Surgery



About Knee Arthrofibrosis

It is estimated that up to 10% of all total knee replacements will experience some form of arthrofibrosis meaning there is an excess of scar tissue that develops inside and around the knee joint that produces knee stiffness, pain and limitation of knee motion.  It is important that arthrofibrosis be recognized and treated as early as possible before the scar tissue matures and becomes more dense and more resistant to therapy and stretching programs. All types of knee injuries and knee surgery may develop the complication of KNEE ARTHROFIBROSIS.

It is highly important that gentle therapy and stretching techniques be used to regain motion that we have published, and involves OVER-PRESSURE stretching that is low in force and over time to gently restore knee motion.  It is imperative to avoid  high resistance and high forces on the knee joint that is deleterious and produces further inflammation and scar production

It is important to obtain multiple diagnostic and imaging tests to rule out infection that sometimes may be very subtle and difficult to detect.  This involves special bone scans, MRI and blood studies and knee aspiration and analysis.

What knee Arthrofibrosis looks like

Shown in the figure are all of the possible areas of scar production that comprises Knee Arthrofibrosis that must be addressed.  This involves different scar tissues and knee structures that limit knee flexion, or knee extension or patella (knee cap) mobility.  It is important that treatment be as soon as possible to prevent the patellar tendon from shortening (patella infera) or the quadriceps muscle from shortening. These structures will adapt and shorten when knee motion is limited that further compounds the problem of regaining knee motion and function.

Why Choose NKI for Knee Arthrofibrosis

Our treatment approach is very time intensive and patients have travelled to our Center from throughout the United States and internationally for treatment.  One of the most difficult treatment problems is that the patient needs to dedicate time to remain at our Center for the initial treatment to determine the response of treatment in restoring knee motion and attacking the knee arthrofibrosis.  It usually takes an initial 3-4 weeks to determine the response surgery and therapy working  with our expert physical therapy team and under the close supervision of the surgeon.  Patients then enter into a program in their own city or home and continue the program for an additional two to three months and return to our Center at appropriate times for evaluation and advances in the program.

In addition to nonoperative and operative approaches there is an important need for medications that are provided in a cautious manner to decrease the return of knee arthrofibrosis that includes oral steroids and interleukin directed medications when appropriately indicated. We continue our study and goal for expert knowledge of all the latest advances in treating Arthrofibrosis for our patients. Throughout the years we have adopted certain programs that are efficient and beneficial and deleted other programs in our experience with less value and benefit.

“Our treatment approach is very time intensive and patients have travelled to our Center from throughout the United States and internationally for treatment.”

“Based on over 30 years of experience in treating hundreds of patients, we provide an individualized approach to each patient for compassionate care and recognition of the serious loss of knee function that occurs with knee arthrofibrosis.”

"Dr. Noyes, I want to say thank you again for being so understanding and helpful in my situation. I have never experienced such a pleasurable doctor appointment before. I want to stay in touch with you and your staff. You are the only one doctor who I trust in America and definitely I want to have my surgeries done by you in the future."

What you need to know:

One important note for patients coming for CONSULTATION: ask for an appointment with Dr Noyes and Mr. Chad Smith (Head physical therapist Arthrofibrosis Center) as all patients receive a dual evaluation by the team. Our Center is integrated with BonSecours-MercyHealth that is a major national health care network.  We will provide contact information for those requesting insurance coverage information.  It is important that each patient understand the coverage for physical therapy visits and consultation as more than 30 physical therapy visits will be needed during the course of treatment and in particular when surgery is required to remove knee scar tissue.

We are offering our Arthrofibrosis eBook free to our arthrofibrosis patients.  Our goal with this book is to help you understand basic knee anatomy, what knee structures may be affected in the arthrofibrosis process, how arthrofibrosis happens and how it is diagnosed, prevention of the problem, and conservative and operative treatment options. Two other serious medical issues that may either cause arthrofibrosis (complex regional pain syndrome) or occur as a result of arthrofibrosis (patella infera) are also discussed in detail. 

Download Free eBook on Arthrofibrosis