Pathological mechanisms and therapeutic outlooks for arthrofibrosis

Abstract

“Stiff knee” or “frozen shoulder” syndrome, also known as arthrofibrosis, may come in two forms, active and residual,  which could benefit from different therapeutic interventions. A team led by Kayley Usher and Jiake Xu from the University of Western Australia in Crawley review the immune cells, signalling molecules and risk factors underpinning arthrofibrosis, a complication of surgery or trauma, in which scar tissue accumulates leading to painful restriction of motion in the shoulders, knees or other joints. The researchers propose the existence of two disease subtypes—one involving active scar formation, and one in which inflammatory processes have resolved—and they suggest each should be treated differently. Although surgery remains the most common intervention it may not be successful, and new research is highlighting the potential of pharmacological remedies, including those that block transforming growth factor-β signalling or target epigenetic modifications.

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Funding

Arthritis Foundation of Australia(H J &G J Mckenzie grant)

Australian Health and Medical Research Council (NHMRC No.: APP1107828, APP1127396, APP1127156, APP1163933), and the Western Australia Medical & Health Research Infrastructure Fund.

National Natural Science Foundation of China (National Science Foundation of China)(81802235)

Zhejiang Experimental Animal Science and Technology Project of China (2018C37112), Project of Basic Scientific Research Program in Wenzhou (Y20180033).