Laser Therapy for Postoperative Knee Dysfunction in Ankylosing Spondylitis: A Case Report

Abstract:
This case report describes a 23-year-old female patient with patellar dislocation and post-surgical patellofemoral dysfunction, accompanied by undifferentiated arthritis, ankylosing spondylitis, and congenital hip dysplasia. Four weeks after surgery, she presented with significant knee pain, limited active flexion/extension, and functional impairment. A multimodal rehabilitation approach, including high-energy laser therapy, manual therapy, and exercise, resulted in reduced pain and improved knee mobility after one week.

Case Presentation:
A 23-year-old female presented with persistent knee dysfunction four weeks after patellofemoral surgery. She had a history of ankylosing spondylitis (diagnosed at age two) and congenital hip dysplasia, contributing to chronic joint pain, hip stiffness, and generalized weakness. Postoperatively, she exhibited:

• Severe functional limitations: Inability to stand, use crutches, or perform active knee flexion/extension.
• Pain and swelling: Visual Analog Scale (VAS) score of 4 during passive movement, with peri-knee swelling and delayed wound healing.
• Systemic arthritis: Ongoing joint pain (fingers, arms) managed with weekly biologic injections.

Diagnosis:

• Postoperative patellofemoral dysfunction.
• Undifferentiated arthritis with ankylosing spondylitis.
• Congenital hip and patellar dysplasia.

Intervention:
A 1-week intensive rehabilitation program was implemented:

1. High-energy laser therapy (3×/week, 10 min/session): Targeted periarticular soft tissue inflammation.
2. Manual therapy: Muscle relaxation and patellar mobilization.
3. Exercise therapy: Gradual mobility restoration.

Outcomes:
After one week, the patient reported:

• Reduced knee pain (VAS improvement).
• Enhanced patellar mobility and knee range of motion.
• Increased tolerance to assisted movement.

Discussion:
This case highlights the efficacy of combined physiotherapy modalities in addressing complex postoperative arthritis and biomechanical dysfunction. Early intervention with laser and manual therapy may accelerate recovery in patients with concurrent inflammatory joint diseases.

Conclusion:
Multidisciplinary rehabilitation is crucial for optimizing outcomes in surgically managed patellofemoral disorders complicated by systemic arthritis. Further studies should explore long-term effects of such protocols.

Keywords:
Patellofemoral dysfunction, ankylosing spondylitis, laser therapy, postoperative rehabilitation, undifferentiated arthritis.