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Continuous passive motion following cartilage surgery: does a common protocol exist?

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Continuous passive motion (CPM) may improve cartilage repair, but clinical evidence is limited. Studies lacked standardized protocols for CPM use after knee cartilage surgery, hindering consistent application and research.

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Area of Science:

  • Orthopedics
  • Regenerative Medicine
  • Biomedical Engineering

Background:

  • Continuous passive motion (CPM) devices show potential for enhancing chondrogenesis in cartilage repair.
  • Clinical evidence supporting the widespread use of CPM after cartilage restoration procedures is currently insufficient.

Purpose of the Study:

  • To review and analyze the existing clinical evidence on the use of CPM following knee cartilage repair and restoration surgeries.
  • To identify and evaluate the described CPM protocols in published studies.

Main Methods:

  • A systematic literature search was conducted across PubMed, CINAHL, SPORTDiscus, and Cochrane databases.
  • Inclusion criteria focused on English-language human studies (Evidence Levels I-IV) reporting CPM use post-knee cartilage surgery.
  • Data extraction included procedure type, patient demographics, defect characteristics, and CPM protocol details.

Main Results:

  • 107 studies met the inclusion criteria, involving 5723 patients and 6612 defects.
  • CPM was most frequently reported after autologous chondrocyte implantation (63 studies) and microfracture (28 studies).
  • The majority of studies provided inadequate details on CPM implementation, including duration, initiation, and range of motion.

Conclusions:

  • While CPM holds theoretical benefits for cartilage repair, the current clinical evidence base is limited by inconsistent and poorly described protocols.
  • Standardized reporting of CPM parameters in future research is crucial for establishing its efficacy and optimizing clinical application in knee articular surgery.