Here is a brief article about arthrofibrosis, it is written for knees, but much of it will apply to shoulders.
Arthrofibrosis Article
Arthrofibrosis is excessive scarring that limits a joints normal movement. It occurs during the healing process after an injury or surgery. For reasons not yet understood some individuals bodies respond with an excessive amount of scar tissue. There are two types of Arthrofibrosis, Type 1 effects individuals due to an underlying predisposition to form excessive scar tissue in response to any injury or surgery. Type 2 follows an injury or surgery in a localized area, and is not a part of a healing disorder. The primary focus of this article is Type 2 Arthrofibrosis.
The frequency of Arthrofibrosis after knee replacement is approximately 1% to 10%, following autologous chondrocyte implantation (ACI) 1% to 20%, and less than 10% following ACL reconstruction.
Early identification of Arthrofibrosis is important to achieve a satisfactory outcome and return patients to an active lifestyle.
Symptoms that may develop are a flexed knee gait, worsening pain, weak or wasted quadricep muscle, a warm joint, and continued swelling past the expected recovery time, and loss of previously gained ROM.
Arthrofibosis may form within the joint or outside the joint, resulting in a loss of flexion (how much you can bend your knee) or extension ( how much you can straighten your knee) or a combination of both. Your surgeon will need to do a thorough examination to determine where Arthrfibrosis in located in order to develop an effective treatment program for return to an active lifestyle.
Diagnosis of Arthrofibrosis includes the patient history, physical examination, and ruling out other diagnosis.
The following diagnostic tests may help with determining the location and extent of Arthrofibrosis.
X-rays - will show if the patella is in the too high or too low, and heterotrophic ossification.
UltraSound - Can show joint capsule thickening and increased blood vessel formation
CT scan - is helpful for identifying heterotrophic ossification.
MRI - for locating scar tissue and new bone formation.
Diagnostic Arthroplasty - arthroscopic exploration of the knee.
Biopsy - To determine if the histology of the cells are consistent with Arthrofibrosis.
Treatment will depend on the extent, location, and time since surgery.
The first line of treatment in early stages usually is a gentle manipulation under anesthesia (MUA).
Surgical options are arthroscopic lysis of adhesions and removal of scar tissue, or an open surgical procedure for removal of adhesions and removal of scar tissue.
Surgical and non surgical procedures are usually followed by a well planned individualized physical therapy program with a therapist skilled in Arthrofibrosis treatment. Medications may also be prescribed, such as prednisone and anti-inflammatories.
References:
Noyes F, Barber-Westin S. Knee Arthrofibrosis: Everything You Need to Know to Recognize, Treat, and Prevent Loss of Knee Motion after Injury or Surgery, 2013