The use of electrical stimulation to increase quadriceps femoris muscle force in an elderly patient following a total knee arthroplasty

Background and Purpose. Persistent residual quadriceps femoris muscle force deficits after total knee arthroplasty (TKA) are commonly reported and can prevent patients from returning quickly and fully to functional activities . Neuromuscular electrical stimulation offers a potentially more effective means of increasing muscle force than current rehabilitation protocols. Cas e Description. The patient was a 66-year-old man. Neuromuscular electrical stimulation for increasing quadriceps femoris muscle force was initiated 3 weeks after TKA for 11 sessions to supplement stretching exercises and a hi gh-intensity volitional strengthening program. Outcome. The patient's isome tric quadriceps femoris muscle force increased from 50% (involved/uninvolve d) at 3 weeks after surgery to 86% at 8 weeks after surgery. A concurrent i ncrease in his uninvolved quadriceps femoris muscle force concealed the pat ient's true increase in his involved quadriceps femoris muscle force in a s ide-to-side comparison. The patient's final involved quadriceps femoris mus cle force (10 weeks after surgery) was 93% of the initial uninvolved quadri ceps femoris muscle force. Discussion. Our patient was able to return to in dependent activities of daily living and recreational activities, with forc e gains that surpassed those reported in the literature.