ABSTRACT
Knee rotationplasty is a surgery wherein the rotated ankle serves as the new knee joint after resecting the original knee joint and lesion. However, details of postoperative rehabilitation treatment in a convalescent rehabilitation ward are not well-known. Therefore, we reported the rehabilitation progress of a 36-year-old man who underwent knee rotationplasty in the convalescent rehabilitation ward. In the early postoperative period, the surgery required no weight bearing on the operated lower limb until bone healing. Even during this period, we conducted physical therapies such as joint range of motion training and muscle strength training as outpatient rehabilitation therapy. After being admitted to the convalescent rehabilitation ward, physical therapy was intensified and the patient's rotationplasty prosthesis was then fabricated and fitted by a prosthetist and orthotist. The patient was discharged 80 days after his hospitalization and could eventually walk stably with his prosthesis and returned to work. In Japan, the length of stay in a convalescent rehabilitation ward is limited. If patients are provided with enough physical therapy during the postoperative course and rotationplasty prosthesis by a skilled prosthetist and orthotist, rehabilitation treatment after knee rotationplasty can achieve good results in a convalescent rehabilitation ward.
ABSTRACT
<p>For lower limb amputees, good prosthetic fittings are important for wearing prostheses while ensuring gait stability, without skin breakdown. Poor prosthetic fittings tend to occur in the early stage after amputation because of significant changes in residual limb volume. We measured the extent of change in residual limb volume in three below-the-knee amputees by using computed tomography. The measurements were performed before and after inpatient rehabilitation for the first prosthesis. The measurement showed a remarkable change in residual limb volume in a highly active amputee without complications. In contrast, the change in residual limb volume was small in two less active below-the-knee amputees with serious complications, such as heart and renal failures. Generally, to maintain good prosthetic fittings, the first prostheses should be made during inpatient rehabilitation to facilitate maturation of the residual limbs. For the less active below-knee amputees, the prostheses could be made in the outpatient settings because the volume fluctuations of their residual limbs are small and the functional requirements for their daily living are modest.</p>