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Continuous passive motion versus physical therapy in total knee arthroplasty.
M A Ritter1, V S Gandolf, K S Holston
1Center for Hip and Knee Surgery, Mooresville, Indiana 46158.
Clinical Orthopaedics and Related Research
|July 1, 1989
Summary
Continuous passive motion (CPM) machines did not improve range of motion after total knee arthroplasty compared to physical therapy alone. CPM did reduce swelling but increased costs and muscle weakness, making it not cost-effective.
Area of Science:
- Orthopedic surgery
- Rehabilitation medicine
- Biomedical engineering
Background:
- Total knee arthroplasty (TKA) is a common procedure for end-stage knee arthritis.
- Postoperative management aims to restore range of motion (ROM) and function.
- Continuous passive motion (CPM) machines are frequently used in TKA rehabilitation.
Purpose of the Study:
- To evaluate the efficacy and cost-effectiveness of continuous passive motion (CPM) machines in the treatment of postoperative total knee arthroplasties (TKAs).
Main Methods:
- A comparative study involving 50 patients undergoing simultaneous bilateral TKAs.
- One knee per patient was randomly assigned to CPM treatment, while the contralateral knee received standard physical therapy (PT) only.
- Patients served as their own controls, with assessments at discharge and follow-ups at 2 weeks, 2 months, 6 months, and 1 year.
Main Results:
- No significant difference in ROM was observed between CPM and PT groups during hospitalization or at any follow-up point.
- CPM treatment led to a significant reduction in knee swelling.
- CPM-treated knees exhibited increased extensor lag and flexor tightness at hospital discharge, indicating potential muscle weakness.
Conclusions:
- CPM machines do not offer significant advantages over standard physical therapy for improving ROM after TKA.
- While CPM reduces swelling, it is associated with increased costs and potential muscle weakness, rendering it neither cost-effective nor beneficial for routine postoperative TKA care.