A 69 year old male who had a history of bilateral knee pain underwent knee joint replacement surgery on March 14 and 16, 2006. After approximately two months of follow-up physical therapy the patient returned to our office. His knees were still “hot to touch” and had less then 90 degrees of knee flexion in both knees.  Manual muscle testing indicated bilateral weakness in Gluteus Medius, Hamstring and Tensor Fascia Lata; and hypertonicity in Rectus Femoris.  IRT was performed to both knee joints and the patellofemoral tendons on his first visit. We corrected his pelvic category and his iliolumbar ligament by IRT. By the end of the session, we increased his range of motion in his knees: Flexion to 105 degrees in his right knee, and 115 degrees in his left knee. The patient also reported that his balance improved as he was walking out of the office.