© 2017 Michael Ikemura
Background and Purpose: Osteoarthritis (OA) of the knee is a common cause of severe pain, disability within the community, and dependence on others. If conservative treatments fail, orthopedic surgeons often perform a total knee arthroplasty (TKA), in which damaged articular parts of the knee are resurfaced with prosthetics. To maximize physical function, the underlying cause of gait speed limitation must be determined and treated. The purpose of this case report was to examine the impairments following a TKA with concurrent severe OA of the contralateral knee, develop an effective plan of care, describe physical therapy (PT) interventions, and report the outcomes. Case Description: The patient was a 64-year-old male status-post three weeks right TKA with severe contralateral knee OA. He received outpatient PT once a week for seven weeks to improve range of motion (ROM), strength, muscular endurance, balance, and functional mobility. Outcomes: At discharge, the patient demonstrated improved mobility, knee ROM, and strength. The 2 Minute Walk Test score improved from 178 feet to 251 feet, Lower Extremity Functional Scale improved from 23/80 to 29/80, and Numeric Pain Rating Scale improved from 7/10 to 6/10. At discharge, the patient improved right knee flexion to 117 degrees and extension to 0 degrees, and increased quadriceps and hip abductor strength. Discussion: This report suggests that a combination of manual therapy and therapeutic exercise directed towards hip and knee strengthening along with balance is beneficial for function and quality of life for patients following a TKA. Future research should be performed to further investigate ideal PT interventions to improve function for patients with a unilateral TKA and concurrent contralateral knee OA.
Ikemura, Michael, "Outpatient Physical Therapy Management Of A Total Knee Arthroplasty With Severe Contralateral Knee Osteoarthritis: A Case Report" (2017). Case Report Papers. 81.