Manual Physical Therapy for a Patient Following Total Knee Arthroplasty (TKA)
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A 66-year-old woman was referred to outpatient physical therapy 3 weeks following primary unilateral TKA for severe osteoarthritis. Upon initial examination, the patient had significant post-operative pain, impaired gait, and decreased range of motion (ROM),strength, and functional mobility. Additionally, the patient presented with adherent scar tissue along the length of her surgical incision and diffuse soft tissue restrictions in the quadriceps and tensor fascia latae. Treatment consisted of all the components of conventional physical therapy in addition to manual physical therapy. Components of traditional physical therapy included strengthening exercises, aerobic exercises, stretching, and training in performance of everyday activities, such as navigating stairs. Manual therapy techniques included joint mobilization, scar tissue massage, soft tissue mobilization, and therapist-assisted manual stretching. Active knee flexion ROM, the Timed Up and Go (TUG), the 6 Minute Walk Test (6MW), and the 36-Item Short Form Health Questionnaire (SF-36) were completed at initial examination and again 5 weeks later at discharge.