The patient appeared to be a healthy 64-year-old white male. The patient's past surgical history included a right ankle fracture with fixation 23 years ago. The patient reported hypertension well controlled with medications as his only medical condition. System Review Integumentary System After examining the integumentary system, swelling was found in the bilateral knees. Bilateral swelling was measured by taking the upper and lower patellar circumferences on both knees. Left knee swelling was measured at 44.5 cm and 41.0 cm at the superior and inferior patella, respectively. Right knee swelling was measured at 43.5 cm and 39.0 cm, respectively. The incisions on both knees were closed and well healed. The patient did not report any numbness or tingling bilaterally in the lower extremities, so sensitivity was not tested. All other systems were unremarkable. Gait The patient stated preoperatively that he was not using an assistive device. He reported that he only needed to use a cane when walking long distances to increase balance and stability. He said his legs would become tired after long periods of walking. During the gait examination, the patient walked without a cane. He had a mild antalgic gait, leaning to the right with reduced loading on the left lower extremity. In addition to having a mild antalgic gait, the patient had normal and coordinated movement patterns. When gait speed was measured, the patient walked safely at 263 ft/min. The patient's balance was tested by having him stand in tandem. The patient was able to remain in the tandem position for more than 30 seconds with the left and right foot in front, indicating that the patient had good balance. Pain The patient's pain was assessed ... center of sheet ... and resistance, manual therapy to reduce pain and increase range of motion, augmented soft tissue mobilization (ASTYM) to break up scar tissue and help regenerating new healthy tissue, neuromuscular re-education to increase balance and proprioception, and a home exercise program. The patient was to be seen in the outpatient clinic twice a week for four weeks. At four weeks the patient was re-evaluated and the surgeon approved the patient to continue therapy twice a week for another three weeks. Interventions During the six weeks of treatment of the patient by the physiotherapy student, general bilateral strengthening and stretching exercises of the lower limbs were introduced in the clinic together with manual therapy on both lower limbs. Each treatment session lasted 60 minutes. A home exercise program was also established for the patient.