Treatment of a Knee Contracture Using a Knee Orthosis Incorporating Stress-Relaxation Techniques

Abstract

The subject of this case report was a 67-year-old Caucasian woman who had undergone total knee arthroplasty of the right knee. Postoperative physical therapy and a new orthosis that utilizes principles of stress relaxation (constant displacement) and static progressive stretching were used to reestablish range of motion. The total treatment time (cumulative orthosis wear time) was 32.5 hours over a period of 29 days, and the patient obtained a 17-degree increase in active range of motion. Six months later there was no measurable loss in range of motion. The results of the treatment may be beneficial for some patients. Researchers and clinicians need to conduct studies to further evaluate this approach to knee contracture management.

Static progressive splinting to improve wrist stiffness after distal radius fracture: A prospective, case series study

“…The dynamic splint should be worn for 6-12 hours a day (Dynasplint, 2008). SPS is a treatment technique shown to be effective in lengthening soft tissue around joints by applying controlled stress through splints (Bonutti, Windau, Ables, and Miller, 1994;Doornberg, Ring, and Jupiter, 2006;Gelinas, Faber, Patterson, and King, 2000;Jansen, Windau, Bonutti, and Brillhart, 1996). On the basis of the previous literature the authors expect to see improvements in range of motion in this sample with consistent use of the SPS splint.…”

Evaluation of Static Progressive Stretch for the Treatment of Wrist Stiffness

“…1,2,4,18 Static progressive stretch, which increases joint flexion or extension at regular intervals, is believed to cause separation and rebinding of links between collagen bundles, which may result in long-term remodeling of the soft tissues, as demonstrated in rabbit and rat models. 8,9,19 Splints that use the principles of SPS have been successful for treating other joints, [12][13][14][15] but no data have been published regarding the use of SPS for treating wrist stiffness. For these reasons, the current study was conducted to evaluate the usefulness of an orthosis that incorporated SPS for treatment of posttraumatic and postsurgical wrist stiffness.…”

“…11 An adjunct to stress relaxation is the technique of static progressive stretch (SPS), which consists of incrementally maintaining the joint near the end range of motion while increasing the displacement at regular intervals in an attempt to attain long-term remodeling. 9,12,13 Orthoses that apply the principles of SPS have been used to treat stiffness of the elbow, 12,13 knee, 14 and ankle, 15 although this technique has not been examined for the wrist. Previous studies of SPS were limited by small study groups and lack of control groups, but they did find improvements in range of motion and function.…”

Case Series Utilizing Drop-out Casting for the Treatment of Knee Joint Extension Motion Loss Following Anterior Cruciate Ligament Reconstruction

“…This is similar to results in other studies involving patients with arthrofibrotic joints. 15,19 Jansen et al 15 used a JAS (Joint Active Systems, Effinghams, lL) brace to increase knee extension by 68% in a patient following total knee arthroplasty. The total end range time for treatment of this patient was 32.5 hours.…”