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 after primary total knee arthroplasty. Does it offer any benefits?
We report a prospect i ve r and omly controlled trial to examine the effectiveness of continuous passive motion ( CPM ) in improving postoperative function and range of movement  after total knee arthroplasty ( TKA ) . We allocated 53 patients ( 57 knees ) to one of three postoperative regimes : no CPM ( n = 19 ) ; CPM at 0 to 40 degrees ( 0 to 40 CPM ; n = 18 ) ; and CPM at 0 to 70 degrees ( 0 to 70 CPM ; n = 20 ) . Those in the CPM groups had CPM for 48 hours and all patients had an identical regime of physiotherapy . There was an even distribution of various cemented and cementless TKAs in each group . Patients were assessed preoperatively and at one week and at one year postoperatively . At one week , there was a statistically significant increase in the range of flexion and total range of movement in the 0 to 70 CPM group compared with the no-CPM group . At one year we found no significant differences in mean flexion , overall range of movement , fixed flexion deformity or functional results in the three groups . Those who had CPM had a significant increase in analgesic requirement ( p = 0.04 ) . There was an increased mean blood drainage postoperatively in those who had 0 to 70 CPM ( 1558 ml ) compared with those with no CPM ( 956 ml ) ( t = 2.96 , p = 0.005 ) and with 0 to 40 CPM ( 1017 ml ) ( t = 2.62 , p = 0.01 ) . Our findings show that CPM had no significant advantage in terms of improving function or range of movement , and that its use increased blood loss and analgesic requirements
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 .