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 .
A controlled evaluation of continuous passive motion in patients undergoing total knee arthroplasty.
OBJECTIVE To evaluate the efficacy of continuous passive motion ( CPM ) in the postoperative management of patients undergoing total knee arthroplasty . DESIGN A r and omized controlled single-blind trial of CPM plus st and ardized rehabilitation vs st and ard rehabilitation alone . SETTING A referral hospital for arthritis and musculoskeletal care . PATIENTS Consecutive patients with end-stage osteoarthritis or rheumatoid arthritis undergoing primary total knee arthroplasty who had at least 90 degrees of passive knee flexion . One hundred fifty-four patients were eligible and 102 patients agreed to participate and were r and omized . Ninety-three patients completed the study protocol . INTERVENTION Continuous passive motion machines programmed for rate and specified arc of motion within 24 hours of surgery with range increased daily as tolerated with st and ardized rehabilitation program compared with st and ardized rehabilitation program alone . MAIN OUTCOME MEASURES Primary outcomes were pain , active and passive knee range of motion , swelling ( or circumference ) , quadriceps strength at postoperative day 7 , as well as complications , length of stay , and active and passive range of motion and function at 6 weeks . RESULTS Use of CPM increased active flexion and decreased swelling and the need for manipulations but did not significantly affect pain , active and passive extension , quadriceps strength , or length of hospital stay . At 6 weeks there were no differences between the two groups in either range of motion or function . In this series , use of CPM result ed in a net savings of $ 6764 over conventional rehabilitation in achieving these results . CONCLUSION For the average patient undergoing total knee arthroplasty , CPM is more effective in improving range of motion , decreasing swelling , and reducing the need for manipulation than is conventional therapy and lowers cost
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 .