Insights from looking at joint stiffness and adhesions

  What is the patient’s goal in choosing to have the surgery? The hope to recover their health and return to life as soon as possible. But the success of the surgery is not enough, certainly the cornerstone, but also needs timely and effective post-operative rehabilitation treatment. At present, post-operative rehabilitation in China is not perfect, especially in orthopedic post-operative rehabilitation, more often than not, the surgeon instructs the patient to go home and move more, lacking specific professional guidance training. As a result, many post-operative orthopedic patients have limited joint movement and cannot do flexion and extension normally, which seriously affects their life and work.  What is the problem of joint stiffness and adhesions?  Joint stiffness and adhesions refer to joint contracture, like a spring stuck by glue, which loses its original elasticity and extensibility and becomes stiff and short, and cannot move freely. There are many reasons for this, including intra-articular, such as fractures and meniscal injuries, and extra-articular, such as prolonged immobilization and soft tissue injuries.  Can joint stiffness and adhesions be avoided?  The answer is yes, they can! A more complete rehabilitation plan should actually start before surgery. Pre-operative health education, so that the patient is fully aware of what has happened and what is going to happen and the corresponding strategies, to get the understanding and support of the patient and the family, to lay the foundation for post-operative rehabilitation, and timely and on-time post-operative visits to the rehabilitation department, where the rehabilitation doctor will evaluate and develop a rehabilitation plan for each stage.  Can joint stiffness and adhesions be cured by hard breaking?  There are two types of treatment concepts for stiff joints and adhesions: “no pain, no effect” and “pain-free rehabilitation”. Most of the patients who come to our clinic have already received more aggressive manipulation treatment in outside hospitals. According to the patients’ descriptions, during the whole treatment process, the doctors try very hard to break the joint, and the patients are very hideous, usually biting the towel, which is a kind of heart-breaking pain. Most of the patients who chose to come to us were skeptical at first, “Most of them are breaking outside, and you say it can be done painlessly, really?” Of course the results of the treatment later gave them confidence. Painless rehabilitation not only has clinical efficacy, but also saves doctors’ heart and effort, and gives patients the dignity of being human, so why not.