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  1. 31-01-2016 01:23 PM #1
    sargan
    sargan is offline
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    Human Body
    Brief Medical History Overview

    Age: 58, Male, Presenting Problem Since: 1 month, Symptom Behaviour: reduced now lowerbut constant issue, Symptoms Worse (24hr Behaviour): often hip pain at night or tingling in lower leg, Aggravating Factors:: walk down starirs, getting up form sitting - pronoiuced limp after sitting at desk, Easing Factors:: walking, Investigations: deatiled in description, No Diabetes, No history of High Blood Pressure, No Medications, No Osteoporosis, No Hx of Cancer, Unexplained Weight Loss: Pin cells detected - precancer prostrate cells, No Bowel/Bladder issues, Other Info: no

    Major problem / Symptomatic Areas

    Knee - Anterior - Left

    Looking for advice on exercise that can be done

    Physical Agents In Rehabilitation
    After 4 arthroscopy ops over a number of years .. no cartilage remains on the lateral side .... developed into severe grade 4 OA
    8 years ago as part of trial was fitted with Conformis iForma Interpositional device :
    http://www.atmedicals.com/PDFs/publicaciones/2006%20iForma%20ORS%20-%20Dr.%20Koeck.pdf

    8 years on - Knee occasionally locking up due to crepitus on patella and a new medial meniscal tear .. resulted in follow up arthrocopy in Apr 2015
    Tear removed and rear of patella debrided.

    All OK until Nov when without trauma woke up one day with intense pain in knee, very painful Quadriceps and difficulty walking down stairs, getting up from seated position and inability to kneel. The knee feel like it has a steel wire going diagonally across it under the patellar restricting movement. Frequently locking up.

    Further visits to surgeon .. have advised grade 3 changes over trochlea and patellar, and very rough patello femoral articulation.
    Consideration now is further surgical procedure - a patello fermoral replacement (patello femoral arthroplasty)

    It is recommended to build up quadriceps specifically and also the hamstrings before such an operation to aid recovery time.

    What exercise would you suggest can be performed to build quadriceps with as little impact on patella as possible.
    It is also 'possible' that such exercise 'may' settle knee back down, avoiding need for surgery.

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  2. 31-03-2016 12:32 PM #2
    jakeireland
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    Re: Looking for advice on exercise that can be done

    Aircast Airselect Short Boot
    https://www.youtube.com/watch?v=pBboyf6FhiU

    Not sure what she has round her upper thigh in this video but these open chain exercises (non weight bearing) might be suitable due to the reduced movement of the patella and that they are not loading the patella with weight.

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