83 year old female with a history of R TKR revision ...

Bay Physical Therapy: Case Study 2 11-24-04 - 9:12 AM

Patient is a 83 year old female with a history of R TKR revision secondary to infection on 4/21/04. Patient had the original TKR 5/03 and L TKR prior to 03. Patient's main complain was inability to flex knee.
Limiting factors included prior history of LTKR, pain and limited ROM R knee. Patient had been manipulated under anesthesia subsequent to the revision.

The ATM2 was added to the program on 9/9/04. Her initial office visit was 6/1/04.

Knee ROM at most in the side lying 2 joint stretch position was 70 flexion to -10 extension. Hip extension was 0. Knee pain at most was 6/10. She had an antalgic gait with a straight cane. Distance of 1-2 blocks was tolerated. ROM had plateued with quad strength of 3+/5, hip extensor strength of 3/5.

The ATM2 was initiated at the end of August for hip extension without the resistive band. The positioning on the ATM2 enhanced the active assistive stretches of the quad and psoas muscles (Sara Meeks advanced approached) being performed by the therapist.

By 9/20/04 the patient had reduced her pain medication. She could ambulate up to1 hour or up to 6 blocks without a device with intermittent CG of a second person. Her stride was improved as hip extension had increased 15 degrees even thought knee ROM remained unchanged. When last seen on 11/8/04 she was able to ambulated on the treadmill for ½ hour daily, and ambulate outdoors without any device, or power walk with exerstriders. She was off her pain medication. Strength was 4-/5. Gait and functional level improved despite the fact that knee ROM had plateaued.