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and now were going to the other end of the spectrum from too loose to uh to too stiff uh so first of all I think stiffness after total knee is one of the most common issues that we Face Mayo Clinic data uh mua is considered re-operation it was up to five percent so the most common reason for reoperation is is stiffness leading to mua uh the prevalence in literature depends on the criteria you use so the stricter the criteria uh the higher the percentage of patients are going to have stiffness so it ranges between one percent and 13 depending on how you set those criteria I think its important to think about how range of motion impacts uh functional activity so you need 65 degrees for level walking 85 for stair climbing 105 are descending stairs and for extension if you have more than a five degree contracture you start to see some pretty docHub gate changes definitely after 10 degrees with some adaptive muscle shortening so stiffness really is a cause of a patient dissatisfacti