kinesio tape Total Knee Arthroplasty

[flaviodal]

A patient who's got a total knee arthroplasty one and a half month ago, now is suffering of a knee stiffness with a limited flexion ( about 80 degrees) and extension( only 3 degrees).
Should be kinesio taping techniques useful for this pathology?
I'm thinking about using this one
photo_4_large.jpg

What do you think about this?
Thanks

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[Judith Mollet]

A patient who's got a total knee arthroplasty one and a half month ago, now is suffering of a knee stiffness with a limited flexion ( about 80 degrees) and extension( only 3 degrees).
Should be kinesio taping techniques useful for this pathology?
I'm thinking about using this one
photo_4_large.jpg

What do you think about this?
Thanks

What sort of Pathology are you referring to? I assume it's the stiffness of movement post op. This kinesio tape technique looks like one used for Lymph problems and I've not seen it before like that on a knee. Is the range of movement you describe
0°-3°-80°? which means 3 degrees of extension are missing and flexion finishes at 80° before a "right angle" is reached?
Firstly: 6 weeks for many knee arthroplasties is still very early. I see quite a number and some, for some reason have excellent movement reaching 90° quickly and some take longer. Some have difficult wound healing problems, some have soft tissue adhesions to be dealt with, some have oedema problems. Most have had muscular difficulties due to pain/lack of use beforehand. Some stay restricted in motion longer and in a couple of cases the surgeon has basically told me: "no idea why". Sometimes there is a problem with the protheses parts. So, back to your question: you must decide which of the possible problems are a problem and deal with them accordingly. Check with the patient when the next appointment is by the surgeon and write a short physio report to the surgeon or speak directly if it's possible. Patients can of course also ask but they aren't heath professionals. As to kinesiotaping you have to assess the suitability of the patient skin and scarring, allergies, circulation problems (clotting) and why you want to use the tape. is it for stereognosis, increasing or decreasing muscle tone of specific muscles, correction of patella movement, lymph, etc etc. I 've just thrown in a few ideas here to let your mind go over. Maybe it's helped a bit!

[Wilfie]

How is that going to help?????

[flaviodal]

The knee is swallen and stiff, I'm asking if this kind of tape could help it. What do you think?

[Wilfie]

The knee is swallen and stiff, I'm asking if this kind of tape could help it. What do you think?

How will tape help it to become less stiff?.... There is a lot of hype about this tape but not a lot of evidence to back up a lot of what it says it can do.

[flaviodal]

I see, I mean, couse the knee it is still swallen, this kind of tape, as I red on david blows' book, help to deflete the knee. So less pressure and the knee could be less stiff. Well, I mean that it isn't the only therapy I give to the patient, I use k tape and mobilization , exerxise and ice couse I know that only kinesio tape doesn't makes any big diference.
What do you think about that?

[physiobob]

It might make more sense to try some form of taping to reduce quadriceps activity. You should be able to feel what is blocking the flexion e.g. the joint or the quads restricting the movement. You may need to drain the knee if there is still a significant effusion. Think also about gently mobilizing the knee in the flexed position, with or without prior pain reduction which could be with something as simple as ice / cold wraps

[flaviodal]

What sort of Pathology are you referring to? I assume it's the stiffness of movement post op. This kinesio tape technique looks like one used for Lymph problems and I've not seen it before like that on a knee. Is the range of movement you describe
0°-3°-80°? which means 3 degrees of extension are missing and flexion finishes at 80° before a "right angle" is reached?
Firstly: 6 weeks for many knee arthroplasties is still very early. I see quite a number and some, for some reason have excellent movement reaching 90° quickly and some take longer. Some have difficult wound healing problems, some have soft tissue adhesions to be dealt with, some have oedema problems. Most have had muscular difficulties due to pain/lack of use beforehand. Some stay restricted in motion longer and in a couple of cases the surgeon has basically told me: "no idea why". Sometimes there is a problem with the protheses parts. So, back to your question: you must decide which of the possible problems are a problem and deal with them accordingly. Check with the patient when the next appointment is by the surgeon and write a short physio report to the surgeon or speak directly if it's possible. Patients can of course also ask but they aren't heath professionals. As to kinesiotaping you have to assess the suitability of the patient skin and scarring, allergies, circulation problems (clotting) and why you want to use the tape. is it for stereognosis, increasing or decreasing muscle tone of specific muscles, correction of patella movement, lymph, etc etc. I 've just thrown in a few ideas here to let your mind go over. Maybe it's helped a bit!

ok, I will check the patent. Thank you!!

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I see, but I tested the quadricepts and I found out that the stifness is from the swallen knee and it isn't from quadricepts.

- - - Updated - - -

It might make more sense to try some form of taping to reduce quadriceps activity. You should be able to feel what is blocking the flexion e.g. the joint or the quads restricting the movement. You may need to drain the knee if there is still a significant effusion. Think also about gently mobilizing the knee in the flexed position, with or without prior pain reduction which could be with something as simple as ice / cold wraps

I see, but I tested the quadricepts and I found out that the stifness is from the swallen knee and it isn't from quadricepts.

[Judith Mollet]

In addition: age of patient; state of general health and mobility; current level of weight bearing allowed by surgeon? ; ammount of pain present?; temperature of knie around the site of OP? Ability of patient to be compliant and actually carry out your instructions without supervision. If cooling helps I'd advise against aggressive too icey cooling. We use "quark" poultices here in Switzerland which translates as "formaggio tipo ricotta" and the patients do it at home themselves when needed. Just take it out the fridge (not freezer) plaster the quark on and let it cool the knee.
I had one lady who somehow thought 6 weeks was enough to get back to normal and she tried going up and down stairs again and again between my treatments to make things get stronger..a disaster and I don't know where she got the idea from. Another did hardly anything and was massively overweight and unfit but her knee was brilliant....so think a bit laterally as you continue. Good luck

[estherderu]

dear Flavio,
I would certainly suggest you try using this tape application. I have used it in a number of cases and swelling and pain diminished rapidly.
A number of case studies have been published on using tape application after surgery....... and some are even in Italian

Gazzella I (2008) Riabilitazione ginocchio post traumatic dopo indicente stradale TNM no8 genio 08 8-9
Lazzarini G (2012) Valutazione dell’efficacia del taping neuromusculore nella riabilitazione dopo l’intervento di protesi die ginocchio. TNM 2012 19-02-2012 pg 6-9
Hinman R.S. et al (2003) Immediate effects of adhesive tape on pain and disability in individuals with knee osteoarthritis. Rheumatology 2003;42:865-869
Mazzarini Maurizio a case study of 17 yr old girl with serious contusion knee KTI Italy
Aussum U & Breitenbach S (2011) Taping met grossen potenzial in der chirugie BDC|Online - Information und Service für Deutsche Chirurgen German Surgeon Association advocating use of tape after surgery.
Coutinho J (2013) VNM como tratmiento difioterapeytico eficaz tras cirugia plastic (abdominoplastia- liopsuccion) 1st Jornada AEVNM Madrid 06-04-2013
Markvoet J & Platvoet R (2010) Herstelbevordering na TKR met behulp van het medical taping concept. A pilot study Dutch thesis on effect taping after total knee surgery
Reino Xavier J (2011) Estudio de casos sobre los efectos del kinesiotaping en el tratamiento del linfedema de miembros inferiores. Thesis FT Uni de Alcala
Szcegielniak J et al (2008) The effectiveness of Kinesio Taping applications in physiotherapy of post-cholecystectomy patients: preliminary report. FP2008;8(3):ICID 879825
Szcegielniak J et al (2007) The possibilities of using Kinesio Taping in patients after cardiac surgery. FP 2007;7(4):ICID 681473
Szcegielniak J et al (2007) Kinesiotaping in physiotherapy after abdominal surgery FP2007;7(3): ICID 511019


You can use the fan shape as you have shown us in the photo but there are more ways.
I do not have any experience using David Blow's technique taping on the MEL's.
Will try to attach two pictures of tape applications I have used in total knee patients.
Am finding that I have no idea how to do this. Will try to figure this out.

You will have to be a little patient with me.

Esther

- - - Updated - - -

I am sharing two pages of my manual to be..... about tapes you can use to treat this problem and some pictures of the same application on two patients with total knee surgeryphysiobob knee.pdf.

[estherderu]

Hi Wilfie,
There is actually more and more evidence that it is doing something.....
There are a lot of theories as to why the tape has influence on lymph and blood flow.
There is no consensus but we are seeing great results in the clinic......that is enough for me for the time being.....
Of course, evidence always needs to catch up... but if you do not try anything first.... you will never know if a treatment is going to work.
Esther

[davisjone]

Yea you must go for kinesio Taping as it will give support and stability to your joints and muscles without affecting circulation and range of motion. It is a great technique as you can wear it continuously for 3-4 days before a new application is required.