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Functional Problems and Arthrofibrosis Following Total Knee Arthroplasty by Thorsten M. Seyler, David R. Marker, Anil Bhave, Johannes F. Plate, German.

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Presentation on theme: "Functional Problems and Arthrofibrosis Following Total Knee Arthroplasty by Thorsten M. Seyler, David R. Marker, Anil Bhave, Johannes F. Plate, German."— Presentation transcript:

1 Functional Problems and Arthrofibrosis Following Total Knee Arthroplasty by Thorsten M. Seyler, David R. Marker, Anil Bhave, Johannes F. Plate, German A. Marulanda, Peter M. Bonutti, Ronald E. Delanois, and Michael A. Mont J Bone Joint Surg Am Volume 89(suppl 3):59-69 October 1, 2007 ©2007 by The Journal of Bone and Joint Surgery, Inc.

2 A standardized algorithm was used to diagnose and treat functional problems following total knee arthroplasty. Thorsten M. Seyler et al. J Bone Joint Surg Am 2007;89:59- 69 ©2007 by The Journal of Bone and Joint Surgery, Inc.

3 Taping was utilized to medialize the patella in patients with atrophy of the vastus medialis obliquus, increased activity of the vastus lateralis muscle, and tightness of the iliotibial band during isokinetic strengthening. Thorsten M. Seyler et al. J Bone Joint Surg Am 2007;89:59- 69 ©2007 by The Journal of Bone and Joint Surgery, Inc.

4 The custom knee device was used to improve knee flexion in patients who had limited flexion (<90°). Thorsten M. Seyler et al. J Bone Joint Surg Am 2007;89:59- 69 ©2007 by The Journal of Bone and Joint Surgery, Inc.

5 Knee flexion stretch with hip extension was used to treat tightness of the rectus femoris. Thorsten M. Seyler et al. J Bone Joint Surg Am 2007;89:59- 69 ©2007 by The Journal of Bone and Joint Surgery, Inc.

6 Use of a custom knee device to treat a knee flexion contracture. Thorsten M. Seyler et al. J Bone Joint Surg Am 2007;89:59- 69 ©2007 by The Journal of Bone and Joint Surgery, Inc.

7 The Joint Active Systems (JAS) knee device was used by patients at home to augment the efforts of their physical therapists in the clinical setting. Thorsten M. Seyler et al. J Bone Joint Surg Am 2007;89:59- 69 ©2007 by The Journal of Bone and Joint Surgery, Inc.

8 Botulinum toxin type A was injected into four sites of a contracted medial hamstring muscle, three sites of a contracted lateral hamstring muscle, and two sites in each head of a contracted gastrocnemius muscle. Thorsten M. Seyler et al. J Bone Joint Surg Am 2007;89:59- 69 ©2007 by The Journal of Bone and Joint Surgery, Inc.

9 Neuromuscular electrical stimulation (7 to 10-sec on-time, 15 to 20-sec off-time, frequency of 70 to 90 pulses/sec, 400-μsec-pulse duration, 90 Hz, and intensity set at the maximum tolerated to produce a superimposed muscle voluntary contraction) augmented... Thorsten M. Seyler et al. J Bone Joint Surg Am 2007;89:59- 69 ©2007 by The Journal of Bone and Joint Surgery, Inc.

10 Manipulation under anesthesia performed within twelve weeks following total knee arthroplasty can result in substantial improvement in knee flexion. Thorsten M. Seyler et al. J Bone Joint Surg Am 2007;89:59- 69 ©2007 by The Journal of Bone and Joint Surgery, Inc.

11 A five-step surgical technique was utilized for peroneal nerve release to decrease peroneal nerve symptoms. Thorsten M. Seyler et al. J Bone Joint Surg Am 2007;89:59- 69 ©2007 by The Journal of Bone and Joint Surgery, Inc.


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