Total Knee Arthroplasty #2

Case Study: Total Knee Arthroplasty #2

Kristin Tyse Shadduck, PT

Introduction

The patient is a 60 year old male with long history of R knee pain. He has had prior arthroscopy on the R knee some years ago. He is active, enjoys playing golf and has his own construction business.

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Goals

  • Develop a normal gait pattern
  • Improve knee ROM for extension and flexion
  • Improve strength of R LE
  • Return to previous activity level including being able to walk a golf course

History / Progression

  • Progressive R knee pain for years, which is now causing limitation in activity tolerance
  • Increased knee pain and swelling at the end of work day
  • Inability to walk a golf course – uses cart and has increasing knee pain during rounds, which limits his ability to play
  • Patient elected a traditional knee replacement secondary to progressing knee symptoms
  • Two weeks post-op patient began physical therapy

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Treatment

  • Soft tissue work to quad, ITB, calf, hamstring
  • Patellar mobilization
  • Stretching R LE
  • Passive extension and flexion ROM
  • Strengthening for R LE
  • AlterG for gait training and exercise
  • Ice with interferential stimulation

Results

The patient was seen for a total of 11 physical therapy sessions for the above described treatment, 1-on-1 with the physical therapist. In addition, he attended 7 sessions for exercise and AlterG walking. He achieved post-operative knee ROM of 0/125.

He had a good gait pattern and good strength of his R LE after physical therapy exercise. He was able to climb stairs with proper gait mechanics. He was able to work without increased in pain or swelling. Pain level at initial evaluation was 4/10 and decreased to 0/10 upon discharge. He felt ready to begin his return to the golf course at 8 weeks post-op. The rehabilitation program incorporating the AlterG enabled this patient to return to golf and pain-free function faster than similar patients on a traditional rehabilitation program.

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