Amy J. Litterini
© 2017 Nicholas Cebula
Background and Purpose: Total knee arthroplasty (TKA) ranks among the most frequently performed orthopedic procedures in the United States. Approximately 581,000 people undergo TKA annually, and the number of procedures is expected to increase significantly by 2030. The purpose of this case report was to document the potential benefits of prescribed physical therapy (PT) interventions for a patient following TKA revision. Case Description: The patient was a 69-year-old female post her eighth right (R) knee surgery, a TKA revision, due to an aseptic loosening of components from a previously placed artificial joint. The original TKA was eleven years prior. She received inpatient PT at a skilled nursing facility six times a week for just over two weeks. Her plan of care included manual stretching, strengthening, patient education, functional mobility training, and cryotherapy. Outcomes: Improvements were noted in all measured outcomes at discharge. Pain intensity decreased on the Numeric Pain Rating Scale (8/10 to 5/10 at rest), active R knee range of motion improved (7-42 to 3-105 degrees), and R knee swelling decreased circumferentially (16.5 to 15 inches around the mid patella). A Timed Up and Go Test (TUG) was performed at three intervals during her stay to assess gait speed and quality, with improvements noted each time in speed (TUG attempts: 23, 19, and 14 seconds). Discussion: This patient appears to have benefited from rehabilitation following TKA revision. Many studies support receiving skilled PT services following TKA opposed to routine care. Research suggests implementing quadriceps strengthening, manual stretching, and gait training as skilled PT interventions post TKA. Further research is needed to determine the potential long-term benefits of skilled PT services.
Cebula, Nicholas, "The Use Of Therapeutic Exercises And Manual Stretching For A Patient Following A Total Knee Arthroplasty (TKA) Revision: A Case Report" (2017). Case Report Papers. 68.