Lack of TKE on left total knee revision.

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Lack of TKE on left total knee revision.

Postby Jbeas » Wed Jan 25, 2012 4:32 pm

Have a patient who is S/P L total knee replacement/ revision. The main issue is the complete lack of TKE. If the patient states they had that even before the sugery should we expect to achieve any more than what they have at present? Patient is just over 3 months S/P surgery and TKE remains 0. E-stim for muscle re-ed requires a MMT of 0/5 and FES requires a MMT of 2/5. The patient has no limitations at home and can even get up from kneeling position. Should the TKE be treated with E-stim or even worried about at this point.
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Re: Lack of TKE on left total knee revision.

Postby justCat » Wed Feb 01, 2012 4:02 pm

Does the lack of TKE cause any other symptoms? I think that it is possible to increase ext slightly. The age of the patient makes a difference too. If there is no pain , no function limitation, then i would not fix what is not broken sorta speak.
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Re: Lack of TKE on left total knee revision.

Postby Sillevis » Wed Feb 08, 2012 10:43 am

Going on on this thought..Does the limitation result in decreased ankle DF or hip extension? Will this result into an increaded lumbar lordosis and problems in the near future? What would be the interregional relationship that could be affected by a lack of TKE? This would direct your clinical decision making.
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Re: Lack of TKE on left total knee revision.

Postby justCat » Wed Feb 08, 2012 11:55 am

Yes I agree, if the other symptoms are a lack of hip ext or decrease DF then self mobilizations and stretching should be given as a maintenance. Im not sure how much of a increase of TKE is possible if the patient has never had it. I would think the surgery should have corrected that.
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Re: Lack of TKE on left total knee revision.

Postby Jbeas » Mon Feb 13, 2012 12:54 pm

The main c/o was pain and loss of KNEE function s/p knee revision. No c/o LBP . So if the function of the KNEE is plateaued and there is no pain in ADL's then the patient should be eligible for discharge with a maintenance HEP. Right?
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