Postarthroscopic Arthrofibrosis of the Shoulder

Background: Post-Arthroscopic Arthrofibrosis (PAA) of the shoulder is a debilitating condition characterized by excessive scar tissue formation and joint stiffness following arthroscopic shoulder surgery. This condition can significantly impair functional mobility and quality of life for patients, often resulting from surgical interventions such as rotator cuff repair, labral reconstruction, and shoulder arthroplasties. Various factors contribute to the development of PAA, including pre-existing conditions like diabetes, a history of keloid formation, and inadequate postoperative rehabilitation. Understanding the causes and risk factors associated with PAA is crucial for orthopedic surgeons to implement effective prevention and management strategies. Methods: In this study, the existing literature on PAA from ۲۰۰۸ to ۲۰۲۱ has been reviewed to identify its pathophysiology, risk factors, and treatment options. This review also examines the role of postoperative rehabilitation protocols, patient demographics, and surgical techniques in influencing the development of arthrofibrosis. By analyzing case studies and clinical outcomes, this study aims to provide an overview of PAA and highlight effective strategies for prevention and management. Results: The findings indicate that post-arthroscopic arthrofibrosis occurs in approximately ۵% to ۳۰% of patients undergoing shoulder surgery, with higher rates observed in specific populations such as those with diabetes or previous joint stiffness. Contributing factors include prolonged immobilization, inadequate physiotherapy, and surgical techniques that may predispose patients to excessive scar tissue formation. The pathophysiological process involves an exaggerated inflammatory response leading to abnormal collagen deposition in the joint capsule. Patients typically experience significant pain, reduced range of motion, and functional limitations that may persist for months or even years after surgery. Non-operative treatment options such as physiotherapy, corticosteroid injections, and anti-inflammatory medications are often utilized initially. However, surgical intervention may be necessary for severe cases where conservative measures fail. Techniques such as arthroscopic lysis of adhesions have shown promise in restoring mobility and alleviating symptoms. Conclusion: Post-arthroscopic arthrofibrosis presents a significant challenge in orthopedic surgery due to its impact on patient recovery and long-term function. Identifying risk factors such as diabetes and previous keloid formation can help classify patients at higher risk for developing this condition. Effective prevention strategies should focus on optimizing surgical techniques, minimizing periods of immobilization, and ensuring adherence to rehabilitation protocols. While non-operative treatments can be beneficial in many cases, timely surgical intervention may be required for patients who do not respond to conservative management. Continued research into the underlying mechanisms of PAA will enhance understanding and improve treatment outcomes for affected individuals. Keywords: Postarthroscopic arthrofibrosis, shoulder surgery, joint stiffness, rotator cuff repair, rehabilitation strategies.

کلیدواژه ها:

Postarthroscopic arthrofibrosis ، shoulder surgery ، joint stiffness ، rotator cuff repair ، rehabilitation strategies