Continuous passive motion after total knee arthroplasty: a prospective study.
OBJECTIVE
Continuous passive motion (CPM) has been shown to increase significantly the amount of knee flexion for patients with total knee arthroplasty in the acute care hospital. Whether there is any additional benefit to using CPM for these patients who are transferred to a rehabilitation hospital is not known. There have been no prospective, randomized, controlled studies in this area.


METHODS
Fifty-one such patients on an inpatient rehabilitation service were randomly assigned to two groups. Group 1 (n = 23) received CPM for 5 consecutive hours per day plus physical therapy, whereas group 2 (n = 28) received only physical therapy. Knee flexion was measured by a blinded physical therapist on admission, on the third and seventh days of hospitalization, and at the time of discharge.


RESULTS
The results indicated no significant difference in passive range of motion between group 1 and group 2. Patients in group 1 achieved an average increase in passive range of motion of 16 degrees, whereas those in group 2 achieved an average of 19 degrees (P = 0.33).


CONCLUSIONS
Although power analysis indicated the need for differences in results for 32 patients per group to achieve significance, the difference between the two groups suggested neither statistical nor clinical significance. We concluded that the use of CPM in the rehabilitation hospital is likely of no added benefit to patients admitted after single total-knee replacement.
Chen
B
B
Department of Physical Medicine and Rehabilitation, UMDNJ-New Jersey Medical School, University Hospital, Newark 07103, USA.
Zimmerman
J R
JR
Soulen
L
L
DeLisa
J A
JA
D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D015915:Motion Therapy, Continuous Passive / Q000379:methods*; D026741:Physical Therapy Modalities / Q000379:methods; D011182:Postoperative Care / Q000379:methods*; D011446:Prospective Studies; D016059:Range of Motion, Articular; D016037:Single-Blind Method; D013997:Time Factors; D016896:Treatment Outcome