Ms. Jones is a 65 year old white patient whose medical history is unremarkable and current medical diagnosis is Joint Pain –L/Leg LOC PRIM Osteoart-L/Leg. The patient felt pain in his left knee about a year ago, he received an injection in his left knee but it did not resolve the pain, the pain got worse. Ms. Jones had her first surgery on 09/17/2013. Ms. Jones was in hospital for four days and took part in home physical therapy for two weeks but experienced no improvement. The initial physical therapy diagnosis is TKR. Ms. Jones visited select physical therapy on October 17, 2013, head complains of pain current severity 5/10, worst case severity 8/10 pt feels limited in activities such as walking, sitting, squatting and is unable of taking care of her son daughter, location of anterior knee pain, intermittent duration, stiff and aching nature of pain. The PT performed a functional balance test on Ms. Jones which was poor, left knee gait/locomotion performance, WB status was full weight, assistive device swing walker, cadence was moderately decreased, and the swing phase was also decreased. MMT lower limb muscle test. Hip flexion left 2/5 right +4/5, knee extension left 2/5, right 5/5, knee flexion left 3/5 right 5/5. Left AROM Extension Range of Motion +15, Left PROM none, Left AROM Flexion 62, Left PROM 66, AROM Extension 0, AROM Flexion 124. Pt present with moderate weakness and stiffness in left knee after TKR, Mrs. Jones would benefit from therapy 3 times a week to help you improve your functional activities and help you become independent with ADLs, skilled intervention required to reduce pain, improve function, increase range of motion and increase strength, treatment emphasis for focus on pain... ... middle of paper ......15° from TKR, however, some hyperflexible patients will lose motion. Looking at the preoperative range of motion ROM bell curve, the postoperative curve will shift toward a larger average ROM, but will also have a smaller standard deviation. The patient would benefit from an ERMI flexion machine to improve knee flexion ROM. Patient exhibits 92 degrees of AROM with elevated pain. the flexor mode would benefit the patient to achieve better knee flexion ROM and may be tolerable for the patient. the patient is demonstrating good progress due to elevated pain and decreased tolerance during manual therapy and also benefits from the experienced patient continuing to use the ERMI flexion modality used at home to return to his goals and reduce pain. Works cited Su E, Su S, Valle A. Stiffness after TKR: how to avoid repeat surgery. ORTHOPEDICS. 1; 33: [link]