An 84-year-old woman with severe aortic stenosis (AS) and coronary artery disease (CAD) was admitted repeatedly with syncope and heart failure. Due to her comorbidities, concomitant transapical transcatheter aortic valve replacement (TAVR) and off-pump coronary artery bypass grafting (OPCAB) were performed. She did well postoperatively. CAD is often found concurrently in patients presenting with severe symptomatic AS. Concomitant TAVR and OPCAB is considered as a less invasive and more feasible treatment option in high-risk patients.

We performed physical therapy on a patient who had undergone simultaneous reconstruction of anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) for compound knee ligament injury. The physical therapy program was designed based on Tooyama's concept published in 1996 and our own regimens for postoperative therapy for separate ACL and PCL reconstructions.The results of our physical therapy were as follows: In four months after the surgery, the range of knee motion had been fully recovered. In 16 months postoperatively, the knee ligament had become stable. Knee extention strength had been restored 87% and its flexion strength 103%. The functional ability test found that knee performance was good.Worthy of note were the following three main features of this physical therapy: (1) To minimize stress on ligament until the minimum recovery level of recovery is expected after reconstruction, muscular workout to make quadriceps and hamstrings contracted simultaneiusly was performed so as not to induce contractions of only hamstrings; (2) We kept the chief physician posted on the recovery status of the knee motion range since mobilized arthroscopy might have been required because of knee contracture; (3) Knee coodination training was performed to enhance knee functional ability.
Knee ; Physical Therapy (Specialty) ; Ligaments ; Injury inflicted to the body by an external force ; Adenohypophyseal Diseases