Arthroscopic Lysis of Adhesions With Adjuvant Radiation for Recalcitrant Knee Arthrofibrosis After Ligament Reconstruction: A Report of Three Cases

We report three patients-a 35-year-old female, a 19-year-old female, and a 36-year-old male-who presented with recalcitrant knee arthrofibrosis following anterior cruciate ligament reconstruction (ACLR) and prior lysis of adhesions (LOA). Each patient underwent a multistep treatment approach including revision arthroscopic LOA followed by low-dose irradiation, performed at 26, 8, and 6 months, respectively, after the index procedure. All patients experienced improved range of motion and better outcomes compared to prior interventions. In patients with recalcitrant arthrofibrosis after ACLR who have not responded to standard management, a revision LOA and low-dose irradiation can be safely performed, offering a moderate success rate for the most challenging cases.