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Question:
HI DOCTOR
I AM 35 YRS OLD AND HAVE JUST HAD A TOTAL KNEE REPLACEMENT.
MY PROBLEM NOW IS THE MY GUADS ARE TOO SHOET TO ALLOW MY KNEE TO BEND
MORE THAN 50 DEGREES.
I HAD A FUSED KNEE FOR ABOUT 15 YEARS BEFORE THE KNEE REPLACEMENT WAS DONE
CAN MY MUSCELS BE MADE LONGER AND HOW CAN THIS BE DONE.
Question submitted by:
ALAN GINO POLLASTRINI - ABPOLLASTRINI@NETSCAPE.COM
| Dr. Golden |
Dr. Golden is an orthopedic surgeon and the author of the "Knee Pain" chapter in the upcoming "Manual of Pain Management". He has presented numerous scientific studies at orthopedic conferences. In addition, Dr. Golden is a member of the American Academy of Orthopaedic Surgeons (AAOS),the American Medical Association (AMA), and the Arthroscopy Association of North America (AANA).
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Answer:
The total knee replacement, or arthroplasty (TKA) you had is complex when compared to a total knee placed in someone with arthritis rather than a previous fusion. One of the difficulties with your TKA is the risk of the soft tissues, such as the quadricep muscles, not being able to function normally. Although those muscles work even with the knee fused, they do not move as they would with a normal knee. For that reason, there are additional procedures that sometimes need to be performed after the TKA is done.
The exact procedure(s) may vary. Physiotherapy must be maximized first and only then should surgery be considered. Thers is no one specific surgery to perform but the muscles can be lengthened is preventing the knee from flexing appropriately. Be sure to ask you surgeon about the options and continue with the exercises you were prescribed to continue to try to get the appropriate knee flexion.