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Athletic Knee Replacement

Happy Donut Day,

I have a 62 year old female client who had an Athletic Knee replacement at the Rosenburg-Cooley Clinic in Park City, Utah. She is about four and one-half months post op and has only about 80-90 degree knee flexion. The end feel is hard and there is pain with flex, walking downstairs, and still some swelling. This is a new type of surgery that uses pins instead of cement, preserves the PCL, and attaches an appliance to the patella. This women is very active and is frustrated with the lack of progress. She had completed PT in Park City and may have had more range earlier this year. She is very tired of the slow progress. Her surgeon said that this type of appliance is more suited to active persons, however, the rehab is slow.

So, I'm struggling to find some info and advice on how to help her. There is very little on the web, besides the surgeon's website. Does anyone have any suggestions and have you treated someone with this appliance?

Thanks, have a good donut.

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Permalink Reply by Lucianna Johnston on June 29, 2011 at 11:36am

One of my long time clients had a knee replacement two years ago. She is the same age, and also very active. I have been with her through her recover since week 5. We have used a combination of massage and various range of motion techniques.

Specifically, twice a week I massaged her leg for 20 minutes. During the massage time I would use passive, active w/resistance and passive stretching. We would also meet for a 45 minute yoga session once a week. We focused on strengthening her core, maintaining flexibility and strength in her legs and relaxation. She still does not have the flexion she hoped for in the beginning but as she walked into my office smiling on Saturday she said, "I danced til midnight last night". She hikes, she still does yoga with me once a week, she works out at the gym on the elliptical and she goes for bike rides and walks. We still do the massage twice a week for maintenance and also still seeing tiny improvements in her flexion as time goes on.

I would say listen to that end feel...don't push. Have your client relax, breathe and surrender to the process.

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Permalink Reply by Lucianna Johnston on June 29, 2011 at 11:37am

FYI...she had what she described as "tenderness/pulling" on her full flexion...and she still to this day has swelling. She became pretty used to icing her knee regularly and has continued to make great progress. The pain and tenderness she was feeling on flexion is almost completely gone. This entire time I worked with her ortho-surgeon giving the go ahead on the techniques we were using and following up with him on all progress.