抄録
We performed physical therapy for a patient who had great difficulty with walking due to pain-defense contraction of the right knee joint after total knee arthroplasty (TKA). This patient had much trouble restoring knee range of motion (ROM), even after TKA, because of a long period of suffering from pain in the right hip joint which limited the ROM. When walking, he could hardly move his knee joint and always showed knee flexion; his right hip joint was bent and his trunk leaned forward. He could not perform internal rotation of the right hip in the right stance phase. Instead, he elevated the left scapula and the left side hip joint and executed external rotation of the right side hip joint. We thought these problems resulted from limitation of ROM of the right knee joint, and we prescribed some exercises for ROM. Subsequently, ROM of the right knee joint and the joint position sense improved a little, but the patient still bent his right knee joint and showed no improvement of walking. After rethinking these problems, we concluded that we should provide therapy considering his habits before TKA. We set the bed in front of his trunk after he leaned against the bed because of relief of muscle hypertonia and position sense of knee joint. We asked the patient to lean against the bed to try and lengthen his hamstring. Subsequently, he showed less, compensatory motion of the trunk and pelvis, and internal rotation of the right hip joint gradually became possible, easing his walking difficulty. We have received the patient’s consent to publication of this report.
