Adding compression to mobilization in a rehabilitation program after knee surgery. A preliminary clinical observational study

Abstract

The cyclical loading of cartilage, which occurs during normal use of an articulation, stimulates biosynthetic activity of the chondrocytes. Therefore functional stimulation may contribute to joint repair. In this study the researchers added mobilization with compression to a standardized rehabilitation program in patients recovering from intra-articular reconstructive surgery of the anterior cruciate ligament. Thirty patients were treated with a standardized physical therapy program following surgery. For half of the patients, mobilization under compression was added to this rehabilitation program. The knee flexion range of motion (FROM) was measured using a goniometer. Patients who received mobilizations with compression reached a pre-set goal of 130° FROM after a mean of six treatment sessions, compared to 11 sessions in the control group. This rapid progression was characterized by a significantly greater increase of FROM during the first two treatment sessions. The explanation for this observed effect may lie in fast response processes which could include rheological changes in synovial fluid, enhanced exchange between synovial fluid and cartilage matrix or increased synovial turnover rather than complex metabolic phenomena. The faster recovery of the pre-set goal (130° of FROM) in the group receiving mobilizations with compression, would appear to justify future clinical trials investigating the potential benefits of adding these techniques to current rehabilitation programs.