Functional Problems and Treatment Solutions After Total Hip and Knee Joint Arthroplasty

by Anil Bhave, Michael Mont, Scott Tennis, Michele Nickey, Roland Starr, and Gracia Etienne

J Bone Joint Surg AmVolume 87(suppl 2):9-21

December 1, 2005

©2005 by The Journal of Bone and Joint Surgery, Inc.

The percentages of the total number of functional problems (n = 76) after total hip arthroplasty(THA).

Anil Bhave et al. J Bone Joint Surg Am 2005;87:9-21

©2005 by The Journal of Bone and Joint Surgery, Inc.

Anteroposterior standing radiograph showing an apparent limb-length difference caused by an abduction contracture.

Anil Bhave et al. J Bone Joint Surg Am 2005;87:9-21

©2005 by The Journal of Bone and Joint Surgery, Inc.

The percentages of the total number of functional problems (n = 68) after total knee arthroplasty (TKA).

Anil Bhave et al. J Bone Joint Surg Am 2005;87:9-21

©2005 by The Journal of Bone and Joint Surgery, Inc.

A 25° knee flexion contracture seen five weeks following a primary total knee arthroplasty in a sixty-nine-year-old woman.

Anil Bhave et al. J Bone Joint Surg Am 2005;87:9-21

©2005 by The Journal of Bone and Joint Surgery, Inc.

Iliopsoas stretching with the patient stabilizing the lumbar spine and pelvis by maintaining a “back-flat” posture.

Anil Bhave et al. J Bone Joint Surg Am 2005;87:9-21

©2005 by The Journal of Bone and Joint Surgery, Inc.

Image-intensifier-guided injection into the iliopsoas tendon just above the lesser trochanter.

Anil Bhave et al. J Bone Joint Surg Am 2005;87:9-21

©2005 by The Journal of Bone and Joint Surgery, Inc.

Stretching of the tensor fasciae latae with the contralateral hip positioned in 90° of flexion.

Anil Bhave et al. J Bone Joint Surg Am 2005;87:9-21

©2005 by The Journal of Bone and Joint Surgery, Inc.

Neuromuscular electrical stimulation to strengthen the gluteus medius.

Anil Bhave et al. J Bone Joint Surg Am 2005;87:9-21

©2005 by The Journal of Bone and Joint Surgery, Inc.

The customized knee device was used to increase the range of knee extension and to eliminate a knee flexion contracture.

Anil Bhave et al. J Bone Joint Surg Am 2005;87:9-21

©2005 by The Journal of Bone and Joint Surgery, Inc.

Closed-chain exercise for improving concentric and eccentric quadriceps strength.

Anil Bhave et al. J Bone Joint Surg Am 2005;87:9-21

©2005 by The Journal of Bone and Joint Surgery, Inc.

The custom knee device that is used to improve knee flexion.

Anil Bhave et al. J Bone Joint Surg Am 2005;87:9-21

©2005 by The Journal of Bone and Joint Surgery, Inc.

The joint mobilization technique to improve knee flexion.

Anil Bhave et al. J Bone Joint Surg Am 2005;87:9-21

©2005 by The Journal of Bone and Joint Surgery, Inc.

Rectus femoris stretch with inferior patellar mobilization.

Anil Bhave et al. J Bone Joint Surg Am 2005;87:9-21

©2005 by The Journal of Bone and Joint Surgery, Inc.

Peroneal nerve release to decrease peroneal nerve symptoms so that the patient can gain functional knee extension.

Anil Bhave et al. J Bone Joint Surg Am 2005;87:9-21

©2005 by The Journal of Bone and Joint Surgery, Inc.