Manual Therapy and Post-Surgical Chronic Knee Pain
Background:Arthroscopic Meniscectomy is the most common orthopedic procedure that shows no superior benefit on symptomatic pain levels or functionality, when compared to conservative therapies or sham treatment. This lack of effectiveness may be due to ineffectiveness of joint alignment. Altered kinematics in the lower extremities and joint malalignment has proven to be source for knee pain.
Purpose:To utilize manual therapy performed by a student massage therapist to stabilize the ankle, knee, and hip in optimal position in order to alleviate pain and restore normal function to the knee joint after surgical intervention has taken place.
Case presentation:Patient is a 20 year old female former jujitsu and MMA fighter. She was admitted to the study 4 months post operatively, unable to perform the activities of daily life without severe pain. Patient displayed pelvic anteversion, severe internal rotation of the femur, external rotation of the tibia, and an everted foot posture in the right leg and hip.
Results:Manual therapy decreased pain levels and improved mechanical function on the KOOS, IKDC, SF-36, BQMSK, and NPIS scales.
Discussion:Positive results for this case highlight the potential importance of restoring joint alignment using massage techniques in recovering from trauma including meniscectomy.
Key words: Arthroscopy, Electromyography, Biomechanical Phenomena, Proprioception