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Hey guys, it's me, Tony. I'm a licensed physical therapist. I want you to record my thoughts right now while they're fresh in my mind
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So I'm here in the clinic. It's Friday night. I just saw a great, great patient who had a second manipulation under anesthesia
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What I find that so interesting. Now, this was a really young patient. He had a total knee replacement June 20th
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Today is September 16th. And so, you know, it hasn't been that long, really
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He had his first manipulation under anesthesia because he wasn't gaining the range of motion that he had anticipated
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He started on some anti-inflammatory medication, which significantly improved his range of motion
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but still not to the point that he could return to work and function the way he wanted
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So he had a second manipulation under anesthesia. He came into the clinic this evening
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Now, a couple thoughts on this for those of you who are thinking, should I have this done
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Should I not have this done? Nobody can tell you what to do or what not to do except you and your surgeon
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You guys are the ones that have to make the decision. But what's interesting about this is multiple times, and I've shared other videos on this
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channel where a patient will be under anesthesia, get to 120, 125 degrees of flexion, come into
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the clinic 20 minutes or an hour later, and you're barely getting to 90 degrees
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Now today we are at 94 degrees, which is awesome. But how does a person go from 120 under anesthesia to 94 an hour later
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Obviously that's not because of scar tissue. So this is something that I think is important to discuss
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There was lots of things that could be limiting range of motion. If he was experiencing improved range of motion when he reduced the inflammation in the knee
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I tend to believe that it more of a chemical problem than a mechanical problem I would equate scar tissue limiting motion to a mechanical problem And when you go in and the surgeon does the manipulation
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you hear these sounds that sound like scar tissue ripping, and I'm not saying that it's not
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but I want to say that there's more complexity to somebody who doesn't have full range of motion or
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isn't improving the range of motion as quickly as we would expect. There's more complexity to that
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than just blaming it on scar tissue. So if you're struggling with your range of motion
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if you don't have the extension, if you don't have the flexion, if you feel like it's just too painful or it's blocked
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or there's something that's going on, I would encourage you to connect with a local therapist
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or a local surgeon that really will take the time to kind of hash out what are some other things
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that could be limiting that range of motion. Maybe it's not just scar tissue
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Maybe scar tissue is a component of a bigger problem. Maybe there's some chemical changes, some immune issues that are going on
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I'm the first one to say I've seen lots of patients after a knee replacement
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I've seen patients do incredibly well. I've seen patients struggle. I still don't know the answer
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So I'm not telling you that I have the solution because I certainly don't. But what I am telling you is that you want to find the person to work with who has the
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time, who has the resources. In this case, for example, I'm going to come in on Saturday and Sunday, even though we don't normally operate on those days, because I want him to get multiple episodes of range of motion
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So if you find somebody that has their own practice, that has the freedom to do that, obviously there's a better chance that you as a team are going to achieve a better outcome
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So guys, I just want you to find the best clinicians that you can find
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If you have questions about that, post them in the comments below. Otherwise, I wish you the best and I'll catch you on the next video
