Physiotherapists in Derby treat many different conditions including the issues profiled below.

Continuous Passive Motion after Knee Replacement

Total knee replacement is an increasingly common treatment for knee osteoarthritis and large numbers of elderly people undergo this operation every year. Physiotherapy management and treatment of these patients post-operatively is therefore becoming increasingly important if the best functional outcome is to be achieved. Early rehabilitation focuses on improving strength in the quadriceps muscle, restoring range of motion of knee flexion and facilitating gait and activities of daily living. The restoration of knee ranges of movement is one of the key elements on which success is judged and much physiotherapy time is dedicated to this part of the treatment.

A continuous passive motion machine is commonly used to improve knee flexion range of movement, as regular passive movement of a joint has been shown to result in better healing as compared to resting. Research work has shown a minor short term effect of using this treatment technique and it is often reserved for difficult cases such as after manipulation under anaesthetic for a stiff joint. Patients can remain on the machine for long periods but it is important not to forget active practice of the ranges of motion to improve muscle function. Overall continuous passive motion has not been shown to play a significant role in standard knee replacements.

Physiotherapy for Femoral Shaft Fractures

Fractures of the femoral shaft in adults are overwhelmingly the result of considerable force such as a road accident or a fall from a height. Due to the force involved and the power of the surrounding muscles the bone ends often overlap, cutting into the soft tissues around them, and there is often a considerable amount of bleeding and pain. Initial treatment consists of pain control, maintaining the patient.s blood volume and applying some traction to the leg to bring the bones out towards their normal positioning. Treatment used to be skeletal traction for up to 12 weeks but this has been superseded by internal fixation with a nail down the femur to stabilise the fracture.

Initial physiotherapy concentrates on restoring the muscle activity to the quadriceps, often inhibited by the pain and direct injury, and regaining range of motion in the knee. Mobilisation with a physiotherapist is performed as soon as comfort allows and the patient is often permitted to partial weight bear with crutches as the fracture is typically stable with the fixation. Further physio treatment includes massage to the fractured area to disperse scar tissue forming in the area which could bind down the muscle and other soft tissues, limiting movement and strength.