RT Journal Article
ID 2e7c57e266df66e0
A1 Bhave, Anil
A1 Corcoran, James
A1 Cherian, Jeffery J.
A1 Mont, Michael A.
T1 Astym® Therapy for the Management of Recalcitrant Knee Joint Stiffness after Total Knee Arthroplasty
JF Journal of Long-Term Effects of Medical Implants
JO JLT
YR 2016
FD 2017-01-06
VO 26
IS 2
SP 151
OP 159
K1 Astym® mobilization
K1 bracing
K1 stiffness
AB Knee stiffness is a common complication after total knee arthroplasty (TKA). Despite studies published on the surgical management of reduced range of motion (ROM) after TKA, there is limited evidence on the nonoperative management of joint and soft tissue imbalances possibly contributing to reduced knee ROM. This report assesses changes in ROM, pain, function, and patellar tendon length after Astym® joint mobilization use. A 38-year-old male professional skier had a right TKA 3 months before presentation with 2 subsequent manipulations under anesthesia secondary to persistent knee stiffness. He had patellar baja on radiograph, a reduced arc of ROM, reduced patellar mobility and muscular extensibility, and pain to palpation along the patellar tendon. He had 12 visits of physical therapy with the use of Astym®, patellar mobilization, and tibio-femoral mobilizations with movement. The patient also used a customized knee device at home for prolonged knee extension stretching. The patient was treated for 12 visits, along with home use of customized bracing for knee extension. Significant improvements were seen in pain, function, and ROM. He returned to work full-time, ambulated prolonged distances, and negotiated stairs pain-free. He also demonstrated resolution of patellar baja radiographically. Conservative management of recalcitrant knee joint stiffness after primary TKA can be effective in restoring knee mobility and reducing pain and activity limitation. A multimodal approach using Astym® treatment, customized knee bracing, and targeted joint mobilization can be effective in resolving knee joint stiffness.
PB Begell House
LK https://www.dl.begellhouse.com/journals/1bef42082d7a0fdf,7b6ba9c258e2ab07,2e7c57e266df66e0.html