arthrofibrosis and dynasplint

[kdhfrank]

hi, its kim from atlanta...the patellar tendon rupture with massive arthrofibrosis.

my question is: my wonderful physical therapist (i truely mean that) has ordered me a dynasplint. for those of you who dont know what it is...it is a torture device to increase flexion rom by creating  constant tension. worn while in bed on my side, awake or asleep, it applies continual tension and stretches the muscles with each little bit of relaxation it senses. it helps stretch the quads and increase the degree of flexion a knee can bend.

i have not seen it mentioned on this forum....everthing seems to be about the cpm. i love my cpm but my pt wants me to use the dynasplint also. what are your thoughts?

one week till trip to cincinnati!!

kim

[SarahSmile]

Hi Kim  

I've had a dynasplint for years- but it's an extension one. I think they are excellent for improving ROM - however, you first need to get the scar tissue cut out and your knee fixed before you can get any improvements from the brace. I wore it for 3 years and saw no improvement, because I needed a surgery to fix my problem- however, I am using it now and seeing improvements. My point is you first need to get your arthrofibrosis diagnosed and cut out via arthroscopy. Once the dr takes care of it, then I think the dynasplint is an excellent tool to help you gain your ROM back. But, just don't rely on it solely without seeing your OS!
Hope this helps!!!

Take care!!!
Sarah

[soccermom]

Kim,

The dynasplint did not work too well for me. It was very hard to sleep in. I ended up taking it off every night because it was too painful. It did not help my flexion in any way. The straightening one helped me a little I gained maybe 5-10 degrees back with that one. You may be different though. You never know.

Good Luck with your trip

Christina

[SarahSmile]

Kim, I would have to agree with Christina... I think everyone is different and it is DEFINATELY worth a try, but GOSH is it painful!!!! Not to scare you into not trying it, but it takes awhile to get used to ( i never got used to it!!!)  I still have never been able to wear it longer than three hours. I fall asleep with it, then wake up three hours later in AGONY, bad pain so I have to take it off just to sleep.   I also take Ambien to sleep and I still wake up with bad pain. I would definately recommend that you take a sleeping pill or pain pill before you go to bed to get through the pain initially... However, I have *heard* from the dynasplint Rep that it should only cause 'stretching' but not bad pain... so there you go! Hope that helps! I would definately try it out.
Ask your OS though- you need to get an experts opinion!!!!!

Sarah

[Jennifer_G]

I used a splint similar to the Dynasplint and had little progress from it as well.  I mainly used it for my flexion and am getting ready to use it for my extension.  Good luck!  Hope it works!

By the way...............why are you headed to Cincy?  Just curious...........I live in Cincy and my Dr. is here.  Just wondered if you were seeing the same doc.  

Jennifer_G

[Jan_L.]

Hi Kim,

There seems to be two different types of braces used to increase range of motion.  The dynasplint and the JAS brace.  I am currently using the JAS (joint active system) brace and I am very please with it although I have only had it for one week.  But I have already gained  additional range of motion in flexion and extension.  The JAS brace is easy to use and does not cause an increase in pain!  .  

My physical therapist suggested the JAS brace over the dynasplint because:
it wouldn't interfere with sleep,
one brace works on both flexion and extension,
worn 1/2 hour three times a day,and
patient sets the tension.

Jan

[Lanie44]

Hi, I have the same problem with arthrofibrosis from arthroscopic and total knee replacement on 3/10.  Going in for a manipulation on 5/17/06 in an effort to break up the scar tissue and then will be using a Dynasplint.  Like you I am so discouraged with my flexion.  How did it work for you?  Is it terribly unfomfortable?  Any experience you can share with me will be greatly appreciated!!!       Lanie

[kdhfrank]

Lanie

it has been a long time since I have been on the board. In regards to your question about the dynasplint...it did nothing for me...I would wake up in the middle of the night in excruciating pain...rip it off...and throw it across the room. The scar tissue in my knee was like concrete...and no amount of force from a dynasplint could help. I also had a manipulation of the knee which resulted in a ruptured patellar tendon and partial rupture of the quad tendon. The Ortho surgeon did not believe me when I told him I could not bend my knee...he found out the hard way when he tore my knee apart at twenty five degrees flexion. I ultimately went to Cincinnati in June 2004 and had my knee put back together by a wonderful surgeon named Dr. Lindenfeld. I am presently at about 140 degrees flexion at the max but I can live with that. My knee still bothers me and I wear a support at all times when I am at work or out and about. I also no longer play tennis but I can ride a bike with no problem. Hope this answered some of your questions. Please proceed with the manipulation with caution...do your research...and if possible have your MD determine how extensive the scar tissue in your knee is...just breaking it up wont solve the problem...it has to be removed too. Mine involved a pretty major surger to get back to some of my former life...all of this from a stupid scope because my knee was bothering me.  good luck. kim

[Jakem]

The Dynasplint was a huge help at me maintaining extension after my LOA surgery.  Without it I would not have maintained extension in the those critical first few weeks after surgery.  Yes it is painful and yes like Soccer Mom I don't think I made it all the way through a single night because of the pain.  However i persevered with it and gutted it out and it saved my extension.

The dynasplint won't help and extension deficit without first having surgery however.  You must have the scar tissue cut out first then wear the dynasplint to maintain extension along with prone hangs and push downs.

Other options for extension are the Elite Seat and the JAS.  People seem to really like the elite seat whereas the JAS seems to have mixed results like the Dynasplint.

[kdhfrank]

Jakem

I think Lanie is talking about flexion versus your problem of extension. I have heard that the dynasplint works much better when the problem is maintaining extension...but has had less success with helping to obtain flexion (bend). In this instance it is excrutiatingly uncomfortable as it slowly bends the joint during sleep...at one point you wake up and feel like a knife is being jammed into the joint and you have to take it off. It really hurts. When the scar tissue is in there like concrete no matter how much force the dynasplint applies it will not bend it. The scar tissue needs to come out. I personally would consider wearing it to maintain extension...but never again for flexion (bend). Just my two cents.

Kim

[SarahSmile]

Hey Jake!

What is the Elite seat? I'm very interested in this as I've tried everyting in the past five years for a huge extension deficit: dynasplint (which I've owned for the past four years, and it hasn't worked much), JAS brace, which I own as well, and it has worked better than the dynasplint and much more tolerable, and I love that I don't have to sleep in it like the dynasplint, but I'm still searching for something better. if you have anymore info. on the elite seat, please let me know or send it to me! I would greatly appreciate any info on this! Thanks!!! And, by the way Kim, I totally agree with you regarding the dynasplint poorly managing flexion deficits- I have both flexion and extension issues, and the dynasplint and JAS has only helped (although slightly) with extension and not at all with flexion. I would love anything that would help with flexion as well, but mine isn't *too bad* at 120, but my other leg is 150, so obviously, I want MORE MORE MORE flexion.. haha! 

Best of luck to you all

Take care,

Sarah

[Jakem]

Sarah,

Contact KnickNack as he is the expert on the Elite Seat.  Still, I doubt it will help you without first having surgery to remove the scar tissue, but Knick could add some light on that also.

[mee]

Hi Sarah,

You can find out more about the Elite Seat at www.kneebourne.com.

I used it for a month before my surgery and about three months after.  I have extension equal to my other leg and credit the elite seat for my success.  Well, that and having a surgeon who understands arthrofibrosis removing a big ol' cyclops lesion and fibrotic fat pad tissue from my knee.

Best of luck,

Mary

[Mike H]

I've been using the EliteSeat for 2 1/2 months 3 times a day. I started at 27 degrees extension and now I'm running around 5 degrees. It has worked great for me and I still see improvement. It's very easy to use and the tension applied to the leg is controled by the user.

I'm hoping to be back to normal extension in a few months so I can then start working on flexion. I think I'm going to be in trouble in that direction. I'm at 85 degrees now and the goal is 145.

Mike

[smg]

The problem with the CPM is that you will only spend about a few seconds at end range.  You can rent the dynasplint for a month (?) and see what you think??