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Int J Ther Massage Bodywork. 2010 Jun 23;3(2):14-21.

Treatment of knee arthrofibrosis and quadriceps insufficiency after patellar tendon repair: a case report including use of the graston technique.

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  • Duke Physical Therapy and Occupational Therapy, Durham, NC, USA.


Arthrofibrosis of the knee is a surgical complication that can limit range of motion, inhibit muscle activity, and decrease patient function. Optimal conservative treatment has not been well established in the literature, leaving a clinician with limited evidence for treatment planning. Described here is part of the rehabilitative course of care for a patient with arthrofibrotic limitations after a mid-substance patellar tendon repair with augmentation. Marked limitations in knee flexion range of motion and quadriceps activity were addressed using the Graston Technique to deal with soft-tissue adhesions; traditional physical therapy care was also provided. Clear improvement in range of motion and quadriceps activity and function was noted over the course of 5 treatments during 1 month. Treatment process and clinical reasoning are offered to promote understanding and to facilitate future inquiry.


Rehabilitation of contracture; manual therapies; musculoskeletal manipulations; patellar tendon; rehabilitation of postoperative complications; therapy of joint diseases; tissue adhesions

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