Joint Contracture
Joints with recoverable motion loss due to scar tissue formation after surgery or injury.
Shoulder M24.51
Elbow M24.52
Wrist M24.53
Hip M24.55
Knee M24.56
Ankle M24.57
Great Toe M24.57
Joint ankylosis
Permanent motion loss due to change in the joint shape from arthritis or injury. For example, the joint changes from round to square preventing any rotation in the joint.
Shoulder M24.61
Elbow M24.62
Wrist M24.63
Hip M24.65
Knee M24.66
Ankle M24.67
Great Toe M24.67
Joint Stiffness
These joints do NOT have motion loss. They are just difficult to move but retain full motion.
Shoulder M25.61
Elbow M25.62
Wrist M25.63
Hip M25.65
Knee M25.66
Ankle M25.67
Great Toe M25.67
Joint Contractures cannot be prevented!
There is no passive substitute for postoperative stretching.
In the 1990s the majority of Providers adopted Continuous Passive Motion (CPM) in their postoperative protocols, it has not proven to reduce postoperative joint contractures.
Joint Contractures occur as a result of bleeding during the normal course of surgery. Scar tissue is then formed and its quality is determined by genetics.
Treatment Options
Start stretch assist devices early to avoid surgery!
Nonoperative Stretch Assist Options are wearable splints and standalone machines. Pick one and commit to daily use to avoid the last option, Motion Restoring Surgery.
Dynamic Low load Progressive Splint
This splint applies a continuous gentle load for a long duration.
static Progressive stretch splint
This splint applies load through a twisted knob for 30 minutes.
high intensity stretch machine
This stepin-stepout machine applies high loads for 5-10 minutes.
motion restoring surgery
This option involves anesthesia and a surgeon to perform.
Avoid Motion Restoring
Surgery!
Surgery causes bleeding, which creates the scar tissue that causes a joint contracture.
Don’t start over!
Motion Restoring Surgery include:
Manipulation Under Anesthesia (MUA), Arthroscopic Lysis of Adhesions, Arthroscopic Debridement, Arthroscopic Synovectomy, Open Scar Tissue Resection, Open Debridement, Open Synovectomy…
Nonoperative Options to help with Stretching
Ermi Shoulder Flexionater
Step-in and Step-out patient driven hydraulically enhanced system applying a therapist level stretch. the torso is controlled for a safe shoulder stretch.
SOS Medical CPM Machine
the low load progressive stretch splint requires the patient to lay in this position for hours to produce results.
JAS SPS Shoulder Splint
This static progressive splint applies both abduction and external rotation once it is properly applied. there is no control over the torso.
Ermi Knee Flexionater
easy, stand alone device that is used 10 minutes-6 times. per day to treat your joint contracture!
Bar none, the best product that i used to achieve “ESPY comeback athlete of the year” – Adrian peterson
Knee Dynasplint
This dynamic splint applies a low load over hours to encourage the knee into either extension or flexion. it is not designed to both in the same sitting,
JAS Knee SPS Splint
The JAs Static progressive stretch splint uses a worm gear system to straighten or bend the knee by turning a knob. it requires good hand strength.
Ermi Ankle Flexionater+
Stepin stepout system that completely stretches the ankle while capturing the knee for a more effective stretch.
Ankle Dynasplint
This splint is used to dorsiflex the ankle. it has difficulty sliding down the calf when pressure is applied to the foot.
JAS SPS Ankle Splint
The JAS static progressive stretch splint uses a geared system to dorsiflex the ankle. It also experiences calf slide when pressure is applied.
Ermi Elbow Flexionater+
patient compliance is easy with this seated system that can flip between extension and flexion with the flip of a switch and apply a therapist level stretch.
Elbow Dynapslint
this low load progressive stretch splint is effective in increasing elbow range of motion. Extension and flexion splints are separate.
JAS SPS Elbow Splint
The jas sps elbow splint is an effective tool for regaining range of motion after injury or surgery. it applies both bending and straightening forces.
Ermi Forearm Flexionater+
This machine allows for stretch assisted pronation/supination, ulnar/radial deviation and wrist flexion/extension in the same sitting at the level of a therapist at home.
Forearm and Wrist Dynasplint
these llps splints require three separate splints to stretch the wrist and forearm. The wrist requires separate splints for extension and flexion.
