Continuous Passive Motion After Total Knee Arthroplasty

Chen, Boqing; Zimmerman, Jerald R.; Soulen, Leslie; DeLisa, Joel A.

doi:10.1097/00002060-200009000-00003

Cited by 44 publications

(17 citation statements)

References 11 publications

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“…The findings of this study have indicated that CPM use for 1 hour twice a day following TKA has no influence on flexion, extension or pain which is in agreement with Beaupre et al [10], Chen et al [13], Montgomery and Eliasson [11] and Ritter et al [14]. Interestingly mean range of flexion outcome at final follow-up was greater than the preoperative range in both groups (Fig.…”

Section: Discussionsupporting

confidence: 90%

“…This is unsurprising, and is not comparable with current practice as patients are usually permitted to mobilise or commence flexion immediately postop. Under these circumstances no difference in range of flexion are found [8][9][10][11][12][13][14] with any quicker attainment of flexion [15][16][17] insignificant at longer term follow-up [7,15,16].…”

Section: Introductionmentioning

confidence: 99%

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Continuous passive motion following total knee replacement: a prospective randomized trial with follow-up to 1 year

Leach

Reid

Murphy

2006

Knee Surg Sports Traumatol Arthrosc

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We have carried out a prospective randomised, single blind clinical trial to investigate the effect of continuous passive motion on range of knee flexion, lack of extension, pain levels and analgesic use after total knee replacement surgery. 85 subjects were randomly allocated to control or study group. All subjects followed the existing rehabilitation protocol, which permits immediate active range of motion exercises and mobilisation with the study group using continuous passive motion for 1 h, twice a day. Outcome measures employed were range of motion, pain assessed on a visual analogue scale and analgesic use according to the WHO ladder. Blinded evaluation was carried out preoperatively, at time of discharge from hospital, 6 weeks, 6 and 12 months postoperation. No significant difference was observed between groups at all time intervals for each outcome variable using Wilcoxon Rank sum tests. The results substantiate previous findings that short duration continuous passive motion following total knee arthroplasty does not influence outcome of range of motion or reported pain.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Continuous passive motion following total knee replacement: a prospective randomized trial with follow-up to 1 year

Leach

Reid

Murphy

2006

Knee Surg Sports Traumatol Arthrosc

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“…Nine studies 1,3,4,6,10,[12][13][14]16 were identified that compared standardised PT plus CPM with a control group that received only the standardised rehabilitation programme. Two studies 13,16 did not report a short-term measurement, so these were not included in the metaanalysis of short-term effects.…”

Section: Cpm + Pt Versus Ptmentioning

confidence: 99%

“…Some trials have shown positive effects on early postoperative knee ROM, [1][2][3][4][5][6]8 whereas other studies have found no difference in ROM. [9][10][11][12][13][14][15][16] Nearly all authors concluded that the use of CPM did not result in better ROM 3-6 months after the operation. This review focuses on flexion ROM because gain of flexion ROM is the prime reason for adding CPM in a rehabilitation programme following TKA.…”

mentioning

confidence: 99%

Continuous Passive Motion Following Primary Total Knee Arthroplasty:short- and Long-term Effects on Range of Motion

Lenssen¹,

Köke²,

Bie³

et al. 2003

Physical Therapy Reviews

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BACKGROUNDTotal knee arthroplasty (TKA) is a common form of orthopaedic surgery, mostly in osteoarthritis patients.Since patients undergoing joint arthroplasty are discharged from the hospital within 1-2 weeks after the operation, the main targets of rehabilitation are rapid mobilisation of the patient and early regaining of the ABSTRACT Study design: a systematic review of randomised controlled trials. Background: Knee arthroplasties are a common surgical procedure for patients suffering from knee osteoarthritis. Continuous passive motion (CPM) is frequently used to increase range of motion (ROM) in the knee and promote rapid postoperative recovery of patients undergoing total knee arthroplasty (TKA). Many clinical trials have tried to assess its efficacy, but results have been contradictory. Objectives: To review the efficacy in terms of ROM of CPM in the postoperative management of patients undergoing TKA. Methods: Medline, Embase, Cinahl and Cochrane databases and bibliographic indexes and relevant citations were searched. All relevant studies were assessed for methodological quality using a validated scoring instrument. Data collection and analysis: Two reviewers independently extracted data and assessed trial quality. Results of a meta-analysis of ROM data were divided into short-term effects (i.e. 7-14 days after surgery) and long-term effects (i.e. 6-12 months after surgery). Where possible, data from individual trials were combined in a meta-analysis. Data were analysed using weighted mean differences (WMD with 95% confidence intervals [CI]) between treatment and control groups in the short and long term, weight being the inverse of variance. Main results: Fifteen studies investigating the effect of continuous passive motion in the management of TKA patients were included in the review. Study quality ranged from poor (2 points on a 10-point scale) to good (8 points). The evidence on the efficacy of CPM after TKA is conflicting. Positive short-term effects of adding CPM to standardised physical therapy (PT) have been reported on flexion ROM. Five studies were included in a pooled analysis, for a total of 317 patients (pooled effect size WMD 8.27; 95% CI -1.60, 18.15) Conclusions: There is evidence of a moderate positive, short-term effect of adding CPM to standardised PT after total knee arthroplasty. There is no relevant long-term effect of CPM use.

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“…One study reported that the pain experienced during rehabilitation after TKA was one of the main issues of concern for patients before TKA [26]. While PROME using a CPM device has been the subject of many studies [7,9,17,20,22,23,27,30,33,35,36], to the best of our knowledge, there have been no reports on the clinical value of PROME by a physical therapist after TKA. This study examined whether or not the incorporation of regular PROME by a physical therapist would offer additional clinical benefits to the knees with TKA in terms of the pain experienced during physiotherapy, the ROM and the scores of the American Knee Society (AKS) and Western Ontario McMaster University Osteoarthritis Index scales (WOMAC).…”

Section: Introductionmentioning

confidence: 99%

Clinical value of regular passive ROM exercise by a physical therapist after total knee arthroplasty

Kim

Park

Yoon

et al. 2009

Knee Surg Sports Traumatol Arthrosc

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Regular passive ROM exercise (PROME) by a physical therapist is often incorporated in rehabilitation protocols after total knee arthroplasty (TKA). This randomized, controlled trial examined whether or not the incorporation of PROME to a postoperative rehabilitation protocol would offer a better clinical outcome after TKA. Fifty consecutive patients who underwent bilateral TKAs staged 2 weeks apart received PROME for one knee and not for the other. The pain level (7D and 14D), patient's preference (before discharge, 6M), maximum flexion (7D, 14D, 3M, 6M) and American Knee Society and WOMAC scores (6M) were determined in the knees with and without PROME and compared. There were no significant differences in the maximum flexion, pain level, patient's preference, AKS scores and WOMAC scores. This study demonstrates that the incorporation of PROME does not offer additional clinical benefits to the patients after TKA. Our findings may suggest that encouraging patients to perform active ROM exercise would be a better option and that a physiotherapy session by a physical therapist can focus on more functional rehabilitation, such as preparing to return to daily activities.

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Continuous Passive Motion After Total Knee Arthroplasty

Cited by 44 publications

References 11 publications

Continuous passive motion following total knee replacement: a prospective randomized trial with follow-up to 1 year

Continuous passive motion following total knee replacement: a prospective randomized trial with follow-up to 1 year

Continuous Passive Motion Following Primary Total Knee Arthroplasty:short- and Long-term Effects on Range of Motion

Clinical value of regular passive ROM exercise by a physical therapist after total knee arthroplasty

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