{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T14:32:01Z","timestamp":1758205921970,"version":"3.44.0"},"reference-count":11,"publisher":"Springer Science and Business Media LLC","issue":"17-18","license":[{"start":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T00:00:00Z","timestamp":1738540800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T00:00:00Z","timestamp":1738540800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100005788","name":"Medical University of Vienna","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005788","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Wien Klin Wochenschr"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Summary<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Arthrofibrosis (AF) is a\u00a0relatively frequent complication after knee surgery, leading to painful limitation of joint mobility. Currently, intense stretching is performed in many patients, without improvements in mobility. A\u00a0novel concept, established on a\u00a0cellular, cytokine-based model, advocates to consider the warning function of pain and to terminate forced joint mobilization to disrupt the cycle of arthrofibrosis. Based on these findings, our clinic developed a\u00a0comprehensive antifibrotic treatment protocol. The aim of this analysis was to evaluate the patients treated so far.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Patients treated at the Clinic Donaustadt, an academic teaching hospital of the Medical University of Vienna, Austria, according to the clinic\u2019s AF protocol, were evaluated by reviewing their records. Patellar mobility, range of motion, tightness, overheat, pain, general mobility, assistive devices, working status and the necessity of additional surgery were assessed at baseline, after 2\u00a0months and after 12\u00a0months (follow-up).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Four patients were treated according to the AF protocol. After two months, patellar mobility and range of motion clearly increased in three out of four patients. At the follow-up examination, patella mobility further increased, extension was complete, flexion at least 120\u00b0, and symptoms such as tightness, overheating, nocturnal pain and pain after activity had disappeared in three out of four patients. None of the patients had analgesics or walking aids and three out of four patients had returned to work. Out of the four patients, three expressed high satisfaction with the AF protocol and reported no limitations in daily life, including recreational activities.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Based on this pilot evaluation, the comprehensive conservative AF program seems to have high potential. Therefore, larger future studies should be conducted to validate this concept.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00508-024-02497-0","type":"journal-article","created":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T14:35:04Z","timestamp":1738593304000},"page":"551-556","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Conservative treatment of knee arthrofibrosis according to a\u00a0cellular cytokine-based model"],"prefix":"10.1007","volume":"137","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5855-395X","authenticated-orcid":false,"given":"Robert","family":"Wakolbinger-Habel","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jakob","family":"Gaudernak","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brigitte Elisabeth","family":"Scheffold","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rainer","family":"Fiala","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Breuer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Bittner-Frank","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clemens","family":"Lang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helena","family":"Zehetner-Nics","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana","family":"Oljaca","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mehdi","family":"Mousavi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tatjana","family":"Paternostro-Sluga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,2,3]]},"reference":[{"key":"2497_CR1","doi-asserted-by":"publisher","first-page":"1479","DOI":"10.1302\/0301-620X.98B10.37957","volume":"98-B","author":"NS Kalson","year":"2016","unstructured":"Kalson\u00a0NS, Borthwick\u00a0LA, Mann\u00a0DA, Deehan\u00a0DJ, Lewis\u00a0P, Mann\u00a0C, et\u00a0al. International consensus on the definition and classification of fibrosis of the knee joint. Bone Joint\u00a0J. 2016;98-B:1479\u201388.","journal-title":"Bone Joint J"},{"key":"2497_CR2","doi-asserted-by":"publisher","DOI":"10.1097\/JSA.0000000000000324","author":"DR Lee","year":"2022","unstructured":"Lee\u00a0DR, Therrien\u00a0E, Song\u00a0BM, Camp\u00a0CL, Krych\u00a0AJ, Stuart\u00a0MJ, et\u00a0al. Arthrofibrosis nightmares: prevention and management strategies. Sports Med Arthrosc Rev. 2022; https:\/\/doi.org\/10.1097\/JSA.0000000000000324.","journal-title":"Sports Med Arthrosc Rev"},{"key":"2497_CR3","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.RVW.23.00140","author":"I Pasqualini","year":"2023","unstructured":"Pasqualini\u00a0I, Surace\u00a0PA, Molloy\u00a0RM, Deren\u00a0ME, Piuzzi\u00a0NS. Arthrofibrosis after total knee arthroplasty: a\u00a0critical analysis review. JBJS Rev. 2023; https:\/\/doi.org\/10.2106\/JBJS.RVW.23.00140.","journal-title":"JBJS Rev"},{"key":"2497_CR4","doi-asserted-by":"publisher","first-page":"S350","DOI":"10.1016\/j.arth.2023.03.076","volume":"38","author":"HI Salmons","year":"2023","unstructured":"Salmons\u00a0HI, Payne\u00a0AN, Taunton\u00a0MJ, Owen\u00a0AR, Fruth\u00a0KM, Berry\u00a0DJ, et\u00a0al. Nonsteroidal anti-inflammatory drugs and oral corticosteroids mitigated the risk of arthrofibrosis after total knee arthroplasty. J\u00a0Arthroplast. 2023;38:S350\u2013S4.","journal-title":"J Arthroplast"},{"key":"2497_CR5","doi-asserted-by":"publisher","first-page":"103486","DOI":"10.1016\/j.ebiom.2021.103486","volume":"70","author":"X Chen","year":"2021","unstructured":"Chen\u00a0X, Wang\u00a0Z, Huang\u00a0Y, Deng\u00a0W, Zhou\u00a0Y, Chu\u00a0M. Identification of novel biomarkers for arthrofibrosis after total knee arthroplasty in animal models and clinical patients. eBioMedicine. 2021;70:103486.","journal-title":"eBioMedicine"},{"key":"2497_CR6","doi-asserted-by":"publisher","first-page":"1075","DOI":"10.1016\/j.arth.2023.10.021","volume":"39","author":"AM Schneider","year":"2024","unstructured":"Schneider\u00a0AM, Rice\u00a0SJ, Lancaster\u00a0N, McGraw\u00a0M, Farid\u00a0Y, Finn\u00a0HA. Low-dose irradiation and rotating-hinge revision for the treatment of severe idiopathic arthrofibrosis following total knee arthroplasty: a\u00a0review of 60\u00a0patients with a\u00a0mean 6\u2011year follow-up. J\u00a0Arthroplast. 2024;39:1075\u201382.","journal-title":"J Arthroplast"},{"key":"2497_CR7","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1007\/s00132-005-0915-5","volume":"35","author":"H Gollwitzer","year":"2006","unstructured":"Gollwitzer\u00a0H, Burgkart\u00a0R, Diehl\u00a0P, Gradinger\u00a0R, B\u00fchren\u00a0V. Therapie der Arthrofibrose nach Kniegelenkendoprothetik. Orthopade. 2006;35:143\u201352. https:\/\/doi.org\/10.1007\/s00132-005-0915-5.","journal-title":"Orthopade"},{"key":"2497_CR8","doi-asserted-by":"publisher","DOI":"10.1038\/s41413-019-0047-x","author":"KM Usher","year":"2019","unstructured":"Usher\u00a0KM, Zhu\u00a0S, Mavropalias\u00a0G, Carrino\u00a0JA, Zhao\u00a0J, Xu\u00a0J. Pathological mechanisms and therapeutic outlooks for arthrofibrosis. Bone Res. 2019; https:\/\/doi.org\/10.1038\/s41413-019-0047-x.","journal-title":"Bone Res"},{"key":"2497_CR9","doi-asserted-by":"publisher","first-page":"839","DOI":"10.1007\/s00113-022-01237-1","volume":"125","author":"P Traut","year":"2022","unstructured":"Traut\u00a0P. Klinische Diagnostik, Differenzialdiagnostik, Pathogenese- und Stadienmodell der Arthrofibrose. Unfallchirurgie. 2022;125:839\u201348. https:\/\/doi.org\/10.1007\/s00113-022-01237-1.","journal-title":"Unfallchirurgie"},{"key":"2497_CR10","doi-asserted-by":"publisher","first-page":"849","DOI":"10.1007\/s00113-022-01247-z","volume":"125","author":"K Kieslich","year":"2022","unstructured":"Kieslich\u00a0K, R\u00fcckert\u00a0U. Prevention, physiotherapeutic preoperative and postoperative treatment and rehabilitation of arthrofibrosis. Unfallchirurgie. 2022;125:849\u201355. https:\/\/doi.org\/10.1007\/s00113-022-01247-z.","journal-title":"Unfallchirurgie"},{"issue":"2","key":"2497_CR11","first-page":"118","volume":"2","author":"M Wilk","year":"2002","unstructured":"Wilk\u00a0M, et\u00a0al. The application of high-tone power therapy in the rehabilitation of patients with soft-tissue damage to the knee joint. Fizjoterapia Polska. 2002;2(2):118.","journal-title":"Fizjoterapia Polska"}],"container-title":["Wiener klinische Wochenschrift"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00508-024-02497-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00508-024-02497-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00508-024-02497-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T07:44:04Z","timestamp":1758181444000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00508-024-02497-0"}},"subtitle":["A\u00a0retrospective pilot evaluation"],"short-title":[],"issued":{"date-parts":[[2025,2,3]]},"references-count":11,"journal-issue":{"issue":"17-18","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["2497"],"URL":"https:\/\/doi.org\/10.1007\/s00508-024-02497-0","relation":{},"ISSN":["0043-5325","1613-7671"],"issn-type":[{"type":"print","value":"0043-5325"},{"type":"electronic","value":"1613-7671"}],"subject":[],"published":{"date-parts":[[2025,2,3]]},"assertion":[{"value":"7 November 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 December 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 February 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"R.\u00a0Wakolbinger-Habel, J.\u00a0Gaudernak, B.E.\u00a0Scheffold, R.\u00a0Fiala, R.\u00a0Breuer, M.\u00a0Bittner-Frank, C.\u00a0Lang, H.\u00a0Zehetner-Nics, A.\u00a0Oljaca, M.\u00a0Mousavi and T.\u00a0Paternostro-Sluga declare that they have no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}