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Focused stretching increases flexion in hemophiliac patients following TKA
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Focused quadriceps stretching can be used to increase flexion in hemophiliac patients who have undergone total knee arthroplasty, according to this study from researchers in Philadelphia.
Noting extrinsic tightness from quadriceps and flexion contractures exists in the hemophiliac population, the authors examined a total of 24 knees of patients undergoing intensive hemophiliac-specific physical therapy following total knee arthroplasty. According to the study abstract, patients were an average of 46 years of age and follow-up was an average of 50 months.
Results for patients demonstrating a preoperative knee flexion of less than 90° were compared to patients with preoperative knee flexion greater than 90°. The authors wrote that the patients’ average preoperative flexion contracture of -10.5° improved to -5.1° at final follow-up. Patients with preoperative flexion of greater than 90° were found to have experienced improved flexion and arc range of motion (ROM), as well as decreased flexion contracture.
Significant gains in flexion between the 12-month mark and final follow-up were found in those patients who had specific 12-month and final follow-up data.
“Hemophiliacs with the poorest flexion benefited most from focused quadriceps stretching to a more functional length, with gains not usually seen in the osteoarthritic population,” the authors wrote. “This data may challenge traditional views that ROM gains are not expected beyond 12 to 18 months.”
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Kamath AF. Clin Orthop Surg. 2012. doi:10.4055/cios.2012.4.2.121
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