Despite experiencing a painful rehab, the majority of patients who have had Total Knee Replacements (TKR) usually report being happy with their surgery.
Recently, I treated a patient who was not responding favorably to this surgery. She was experiencing pain and swelling around her medial knee with both walking and stairs.
As with any other patient, I observed her walking and going down a step. Like most people she hopped off the step at end range. When I observed her pelvis, I noticed that when she flexed her trunk forward her knee would go into valgum .
Using the principles of Diagnostic Motion Evaluation (observation of quality of motion), I observed that her femur would move in adduction causing a valgus of the knee when she flexed her trunk forward at the level of L4.
When I asked her if she had a history of an appendectomy, she confirmed that she had and wondered why I asked. I explained that she may have scar tissue from the appendectomy that resulted in a connective tissue restriction causing her femur to move into adduction and place a valgus pressure on her knee.
When I mobilized that area, sure enough her femur remained in neutral as she bent forward and her valgus disappeared.
