Use of inpatient continuous passive motion versus no CPM in computer-assisted total knee arthroplasty.
BACKGROUND
Continuous passive motion (CPM) has shown positive effects on tissue healing, edema, hemarthrosis, and joint function (L. Brosseau et al., 2004). CPM has also been shown to increase short-term early flexion and decrease length of stay (LOS) ( L. Brosseau et al., 2004; C. M. Chiarello, C. M. S. Gundersen, & T. O'Halloran, 2004). The benefits of CPM for the population of patients undergoing computer-assisted total knee arthroplasty (TKA) have not been examined.


OBJECTIVE
The primary objective of this study was to determine whether the use of CPM following computer-assisted TKA resulted in differences in range of motion, edema/drainage, functional ability, and pain.


METHODS
This was an experimental, prospective, randomized study of patients undergoing unilateral, computer-assisted TKA. The experimental group received CPM thrice daily and physical therapy (PT) twice daily during their hospitalization. The control group received PT twice daily and no CPM during the hospital stay. Both groups received PT after discharge. Measurement included Knee Society scores, Western Ontario McMaster Osteoarthritis Index values, range of motion, knee circumference, and HemoVac drainage. Data were collected at various intervals from preoperatively through 3 months.


RESULTS
Although the control group was found to be higher functioning preoperatively, there was no statistically significant difference in flexion, edema or drainage, function, or pain between groups through the 3-month study period.
Alkire
Martha R
MR
Cincinnati Orthopedic Research Institute, Cincinnati, OH, USA.
Swank
Michael L
ML
D000203:Activities of Daily Living; D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000379:methods / Q000534:rehabilitation*; D004487:Edema / Q000209:etiology; D005260:Female; D006400:Hematocrit; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D015915:Motion Therapy, Continuous Passive / Q000379:methods* / Q000451:nursing; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000209:etiology; D026741:Physical Therapy Modalities; D011182:Postoperative Care / Q000379:methods; D011446:Prospective Studies; D016059:Range of Motion, Articular; D025321:Surgery, Computer-Assisted / Q000009:adverse effects / Q000379:methods / Q000534:rehabilitation*; D016896:Treatment Outcome