Extract
Although most patients who undergo total hip or knee joint
arthroplasty have an excellent clinical result with routine postoperative
interventions, substantial dysfunction develops in 15% to 20% of patients for
various reasons1.
These patients do not respond to standard physical therapy modalities and need
a very aggressive regimen of management that may include both invasive and
noninvasive therapeutic options. The purpose of this study was to identify
these patients with functional limitations and to assess the results of
treatment with a customized regimen. We defined soft-tissue problems as those
not directly related to the implant. Implant-related problems due to
malalignment or loosening were ruled out radiographically or by specialized
testing by two of the authors (M.M. and G.E.). We identified several
functional problems following total hip arthroplasty and total knee
arthroplasty that were related to muscle weakness, muscle tightness,
limb-length differences, and nerve problems
(Table I).