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The knee at times may not recover its normal range of motion (0–135 degrees usually) after total knee replacement. Much of this is dependent on pre-operative function. Most patients can achieve 0–110 degrees, but stiffness of the joint can occur.
[4] [5] Arthrofibrosis can follow knee injury and knee surgeries like arthroscopic knee surgery or knee replacement. Scar tissue can cause structures of the knee to become contracted, restricting normal motion. Depending on the site of scarring, knee cap mobility and/or joint range of motion (i.e. flexion, extension, or both) may be affected. [6]
Continuous passive motion (CPM) devices are used during the first phase of rehabilitation following a soft tissue surgical procedure or trauma. The goals of phase 1 rehabilitation are: control post-operative pain, reduce inflammation, provide passive motion in a specific plane of movement, and protect the healing repair or tissue.
Both the active and passive range of motion should be assessed. The normal knee extension is between 0 and 10 degrees. The normal knee flexion is between 130 and 150 degrees. Any pain, abnormal movement, or crepitus of the patella should be noted.
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The partial replacement does not disrupt the knee cap, which makes for a shorter rehabilitation period. A partial replacement also causes minimal blood loss during the procedure, and results in considerably less post-operative pain. The hospitalization time compared with a total knee replacement is also greatly reduced. [1] [3] [5]
Range of motion (or ROM) is the linear or angular distance that a moving object may normally travel while properly attached to another. In biomechanics and strength training , ROM refers to the angular distance and direction a joint can move between the flexed position and the extended position. [ 1 ]
The ideal passive range of motion is 0 to 90° of flexion on postoperative day one after surgery and should be followed for 2 weeks, as tolerated, with a goal of 130° of flexion at the end of the 6th week. To protect the newly reconstructed ligaments, a hinged knee brace should be used. [4]