The Bee's Knees

Bucket Handle Meniscus Tear (Solving the Recovery). Learn how Patrick solved the MUA, Manipulation Under Anesthesia, and these injuries using The X10 Knee Recovery System.

We are pleased to share this interview from The Bee's Knees Podcast and KNEE RADIO 1. Podcast host PJ Ewing interviews Larry Sallings from Texas. PJ and Larry explore getting back to life a year after TKA.

The longer the swelling is in the knee, the tougher it can be, the more "fibrotic."

This week we share a new episode of The Bee's Knees Podcast featuring an interview with Marisa Rodgers. Marisa describes first a knee replacement surgery and eventual failure, and then a new and novel solution using a female knee implant.

Lack of Full Knee Flexion

Part Four of our investigative series: Threats to a Proper Knee Replacement Recovery

by PJ Ewing

Flexion is...

We define ‘good flexion’ as a minimum of 110o bend. A lack of full knee flexion is a problem that can linger forever after a knee surgery if not solved somewhat quickly after surgery. Watch this short video to get a handle on what we’re talking about with range of motion, and why flexion/bending is a crucial part of knee surgery recovery:

Lack of Full Knee Flexion

We care about flexion because it greatly impacts our overall mobility and activity levels. Mobility is crucial to our overall well being. John McKay (RN) writes in great detail about how important mobility is in his article: Want to Live Longer, You May Want to Start from the Ground Up.

You need good flexion to do basic things like walk up stairs, enter/exit a vehicle, play sports, garden, kneel down to play with your grandkids. Here are some benchmarks:

• Stand up from a seated position: 90o
• Sit comfortably at a dining room chair/desk: 95o
• Walk up stairs 105o

• Get in and out of a car 110o
• Ride a bike with seat in proper position: 115o
• Bend down, kneel to garden: 117o
• Dig out a tough low shot in tennis 120o

If you do not get “good flexion” what are the implications?

• Your overall mobility will be compromised
• You will move less as moving can be painful
• You will not build your strength back after surgery
• Your heart and lungs get “lazy” and less productive as there is less demand on your cardiovascular and pulmonary systems
• You will age more¹ than otherwise

There is a decline in muscle strength and other factors as we age. Being mobile helps put off the impact of those conditions.

Knee Surgery Coming Up?

For those facing surgery, your pre-surgery flexion is predictive of your post-surgery flexion as demonstrated in this research by Natarajan, Narayan, and Vijayaraghavan.

In the study it is shown that “pre-operative flexion significantly influenced the post-operative flexion”. Pre-operative flexion “is a good parameter for predicting the post-operative outcome.” ²

One Critical Finding

“There was a positive correlation between pre-operative and postoperative flexion; the better the pre-operative flexion, the better the post-operative flexion. However, good flexors tend to lose flexion while the poor flexors tend to gain some. TKR can produce a predictable result, not totally dictated by poor pre-operative flexion. Interestingly, restoration or even improvement in ROM for those with good pre-operative flexion may be limited by implant design and soft tissue tension.”

Just think about that for a second. “Good flexors tend to lose some and poor flexors tend to gain some,” meaning that even if you have good bending before surgery you might lose ground. And if you have poor flexion before surgery there is an opportunity for gains. With a knee replacement surgery, it is not simply the new mechanical joint that can be the determining factor. Rather, it is the ligaments, tendons and muscles that you have had all your life that may impact how well you can flex your knee.

And just for the record this is news for all of us as the study points out: “Other factors such as age, sex, etiology, type and kind of prosthesis did not show much evidence in influencing the outcome on postoperative ROM at the end of one year follow up interval.”

What can you do if surgery is ahead of you and you have poor flexion? The Answer is Pre-hab

That said, the question becomes which pre-hab program should you go through? For a definitive comparison between a rigorous eight week “boot camp” pre-hab program, and a short prehab program using the X10, listen to this interview with Dr. Carl Freeman. Or just know that you can get more done in 10 days on the X10 than eight weeks of hard core pre-hab using conventional methods.

Pre-hab before Knee Replacement Surgery

To read research about pre-hab before knee surgery click here: The Value of Pre-hab Before Knee Sugery

To hear patient accounts about their pre-hab see below:

• Reba’s Pre...