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Child Orthopedics
Spine - Cervical
Spine - Lumbar
Spine - Thoracic

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I had a total knee replacement about three months ago. I never did get my full motion back. The doctor mentioned manipulating the joint and sending me back to PT for an intense rehab program. How soon should I do this?

Your surgeon may have a time frame in mind so be sure to ask for his or her best recommendation. For some patients manipulation is enough. The patient is anesthetized and the surgeon moves the joint through its full range of motion while the body is completely relaxed. Tiny adhesions and fibrotic tissue tear during this process.

Manipulation is best done in the first 90 days after the joint replacement. If the surgeon waits too long, the risk of fracture goes up.

Some patients need a more aggressive treatment. An operation called arthrotomy is done to clean the joint of any scar tissue. Many surgeons debate the timing of this treatment. Some experts suggest this type of surgery only after four to six months of intense physical therapy first.

With either type of procedure, intense rehab for weeks to months is needed afterwards. Exercise may be aided by stretching, bracing, and electrical therapy. The patient should show steady improvement in range of motion over the first two to three weeks in PT. Communication between the patient, therapist, and surgeon is also extremely important for the best outcome possible.


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