The estimates for risk of manipulation and adverse events are very imprecise and the estimate for the risk of adverse events does not distinguish between a clinical ly important increase and decrease in risk .
There was insufficient evidence to determine the effect of CPM on participants ' global assessment of treatment effectiveness .
CPM does not have clinical ly important effects on active knee flexion ROM , pain , function or quality of life to justify its routine use .
BACKGROUND Arthritis of the knee is a common problem causing pain and disability .
If severe , knee arthritis can be surgically managed with a total knee arthroplasty .
Rehabilitation following knee arthroplasty often includes continuous passive motion ( CPM ) .
CPM is applied by a machine that passively and repeatedly moves the knee through a specified range of motion ( ROM ) .
It is believed that CPM increases recovery of knee ROM and has other therapeutic benefits .
However , it is not clear whether CPM is effective .
OBJECTIVES To assess the benefits and harms of CPM and st and ard postoperative care versus similar postoperative care , with or without additional knee exercises , in people with knee arthroplasty .
This review is an up date of a 2003 and 2010 version of the same review .
Continuous passive motion with accelerated flexion after total knee arthroplasty.
The use of continuous passive motion after total knee arthroplasty remains controversial . A new approach , starting continuous passive motion at 70 degrees to 100 degrees flexion in the recovery room ( Group I ) was evaluated . A r and omized , prospect i ve study of 210 consecutive total knee arthroplasties was performed at two institutions . The control population ( Group II ) started continuous passive motion at 0 degree to 30 degrees , and progressed toward 100 degrees flexion . Flexion at postoperative Day 3 ( Group I = 82.5 degrees , Group II = 72.8 degrees ) , and at discharge ( Group I = 89.1 degrees , Group II = 84.3 degrees ) were significantly different . There was no significant difference between the groups at 4 weeks ( Group I = 5.0 degrees-104.1 degrees , Group II = 5.6 degrees-102.0 degrees ) , 6 weeks ( Group I = 2.3 degrees-104.8 degrees , Group II = 2.7 degrees-103.6 degrees ) , 12 weeks ( Group I = 1.7 degrees-107.7 degrees , Group II = 4.7 degrees-108.2 degrees ) , or at 1 year ( Group I = 0.5 degree-113.2 degrees , Group II = 1.8 degrees-110.5 degrees ) . In Group I , wound necrosis developed in one patient that required a gastrocnemius flap . This major complication was caused by a tight dressing , and not necessarily to the accelerated flexion continuous passive motion . This investigation shows that continuous passive motion using accelerated flexion allows increased flexion during the hospital stay without increased risk of complications , pain , or blood loss . This has significant implication s for achieving safe , early discharge . However , no difference was found at followup of 4 weeks or greater , and this did not add significantly to the final outcome
The estimates for risk of manipulation and adverse events are very imprecise and the estimate for the risk of adverse events does not distinguish between a clinical ly important increase and decrease in risk .
There was insufficient evidence to determine the effect of CPM on participants ' global assessment of treatment effectiveness .
CPM does not have clinical ly important effects on active knee flexion ROM , pain , function or quality of life to justify its routine use .
BACKGROUND Arthritis of the knee is a common problem causing pain and disability .
If severe , knee arthritis can be surgically managed with a total knee arthroplasty .
Rehabilitation following knee arthroplasty often includes continuous passive motion ( CPM ) .
CPM is applied by a machine that passively and repeatedly moves the knee through a specified range of motion ( ROM ) .
It is believed that CPM increases recovery of knee ROM and has other therapeutic benefits .
However , it is not clear whether CPM is effective .
OBJECTIVES To assess the benefits and harms of CPM and st and ard postoperative care versus similar postoperative care , with or without additional knee exercises , in people with knee arthroplasty .
This review is an up date of a 2003 and 2010 version of the same review .