Her knee had been bothering her for years – “bone on bone” as the phrase goes – so she finally decided to pursue knee replacement. She underwent a complete medial meniscectomy (removal of the meniscus) when she was 17 years old, and arthroscopic surgery years afterward to “clean up” arthritic damage. “I was told 25 years ago I’d need this surgery.” Just 6 days after her replacement, she arrived in our office to start her rehabilitation.
Examination
She had been doing well with her continuous passive motion (CPM) machine at home, and had advanced it according to her surgeon’s instructions, giving her a great start in therapy. She was obviously in a lot of pain and reported that she was being kept awake at night by pain behind her knee, as well as cramping in her knee and thigh. She did not have any signs of a blood clot, though. She was able to nearly straighten her knee completely, and bend it to 100 degrees, although those were very painful. She came in on a walker, but said that she had been trying to use a cane a bit at home.
Treatment
Our first task was to make sure that she could extend her knee fully without pain – going to complete hyperextension. Because she followed our recommendations to the letter, she had that task handled quickly. Over those first few visits, we also worked on fine motor control and very light agility, and restored her ability to walk normally.
Once those tasks are handled (getting the knee to go straight, bend past 90 degrees, and getting the knee to hold itself straight) therapy will normally fly along at a breakneck pace. Hers certainly did! Before we knew it, she was into heavier strength training tasks, stepping up, stepping down, balancing on the leg, and performing partial squats.
Outcome
After 8 visits over 16 days, (22 days after her knee replacement) she was able to do everything that she wanted to do, and even bend her knee to 130 degrees – an amount which is normal for most people. As so often is the case, her other knee is also arthritic, and further progress was limited by her pain in that knee….which she will have replaced later this summer.
AND SHE SURPRISED US WITH CUPCAKES!
