Arthrolysis

Arthrolysis is a surgical procedure to release contracted or adherent tissue within a joint in order to restore motion. The goal is to remove scar tissue, loosen the joint capsule, and thereby improve range of motion and function. The operation can be performed openly or arthroscopically.

Open arthrolysis uses a larger incision to access the joint and directly release scar tissue, perform capsulectomy, and address any structural blocks. Arthroscopic arthrolysis employs small portals and specialized instruments to visualize and lyse adhesions with less tissue disruption. In many cases, the procedure is combined with other steps such as synovectomy, removal of osteophytes, ligament balancing, or tendon lengthening.

Postoperative rehabilitation is essential to success and typically involves structured physical therapy to maintain gains in motion and prevent reformation of adhesions. Manipulation under anesthesia may be used in some cases to improve early range of motion.

Indications include significant loss of motion due to intra-articular adhesions or contractures after trauma, surgery, fracture, inflammatory arthritis, or degenerative joint disease. Joints most commonly treated are the knee, shoulder, elbow, and hip. Contraindications include active infection within the joint, severe joint destruction with limited functional potential, and deformities that cannot be adequately corrected or stabilized with rehabilitation.

Outcomes vary with factors such as duration of stiffness, underlying joint health, and adherence to therapy. Many patients experience meaningful improvements in range of motion and function, though stiffness can recur and complications such as nerve or vascular injury, infection, or heterotopic ossification may occur.