Use of Inpatient Continuous Passive Motion Versus No CPM in Computer-Assisted Total Knee Arthroplasty

Alkire, Martha; Swank, Michael

doi:10.1097/nor.0b013e3181c8ce23

Cited by 43 publications

(49 citation statements)

References 10 publications

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“…To the previously mentioned papers, which were about conventional TKA, Alkire et al [32] added a prospective randomized trial in 2010 which examined the effectiveness of the use of CPM in computer-assisted TKA: they concluded that CPM did not offer any significant benefit concerning the range of knee motion, pain, swelling, and knee function [32] . Additionally, the use of CPM was discouraged by the review of randomized controlled trials by Harvey et al [33] also in 2010, who supported that, in the patients who participated, range of knee motion, pain, swelling, quadriceps strength, length of hospital stay, and incidence of manipulation under anesthesia, did not show significant improvement after the use of CPM [33] .…”

Section: Tourniquet Use or Notmentioning

confidence: 99%

“…This effect is too small to clinically justify the use of CPM. Weak evidence that CPM reduces the need for manipulation under anesthesia Alkire et al [32] Prospective randomized study. CPM use or not for computer-assisted TKA No statistically significant difference in flexion, edema or drainage, function, or pain between groups 3 mo post-surgery Lensenn et al [31] Randomised controlled trial.…”

Section: No Evidence That Cpm Reduces Vte After Tkrmentioning

confidence: 99%

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Common controversies in total knee replacement surgery: Current evidence

Nikolaou¹

2014

WJO

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Total knee replacement (TKR) is a widely used operation that has radically improved the quality of life of millions of people during the last few decades. However, some technical details, concerning the surgical procedure and the rehabilitation following total knee arthroplasty, are still a matter of a strong debate. In this review of the literature, we have included the best evidence available of the last decade, in an effort to shed light on some of the most controversial subjects related to TKR surgery. Posterior-stabilized or cruciate-retaining prosthesis? To use a tourniquet during operation or not? Do patients need continuous passive motion for their post-surgery rehabilitation? To resurface patella or not? These are some of the most controversial topics that until now have been persistent dilemmas for the orthopedic surgeon. Results of this systematic review of the literature are highly controversial. These conflicting results are an indication that larger and more well conducted high quality trials are needed in order to gain more secure answers. At the same time, it is becoming apparent that a meticulous operative technique, respecting the soft tissue envelope and knowing the principles of alignment and soft tissue balancing, are some of the parameters that might contribute more to achieving the optimal results for the patients. Key words: Total knee replacement; Controversy; Literature review; Patella resurfacing; Patella eversion; Posterior stabilized; Cruciate retaining; Tourniquet; Continuous passive motion Core tip: A literature review has been conducted in an effort to present the best available evidence of the last decade and to shed light on some of the most controversial subjects related to total knee replacement surgery. Patella resurfacing or not? Posterior cruciate retaining or sacrificing? Continuous passive motion or not? Tourniquet or not? These are some of the most debatable topics that until now have been persistent dilemmas for the orthopedic surgeon. Results of this systematic review of the literature are highly controversial. These conflicting results are an indication that larger and better conducted high quality trials are needed in order to gain more secure answers.Nikolaou VS, Chytas D, Babis GC. Common controversies in total knee replacement surgery: Current evidence. World J Orthop 2014; 5(4

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Section: Tourniquet Use or Notmentioning

confidence: 99%

Section: No Evidence That Cpm Reduces Vte After Tkrmentioning

confidence: 99%

Common controversies in total knee replacement surgery: Current evidence

Nikolaou¹

2014

WJO

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“…Alkire MR y col 24 . Determinar si el uso de CPM junto con el tratamiento estándar contribuye a reducir la hospitalización y mejora de pacientes sometidos a ATR.…”

Section: Medidasunclassified

Recuperación de la artroplastia de rodilla a través de la movilización pasiva continua

Mayo

Rodríguez-Mansilla

Sánchez

2015

Anales Sis San Navarra

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“…Similarly, another recent randomised study demonstrated that there was no statistical difference in flexion and oedema in the CPM group versus the no- CPM group [38]. Another study aimed to compare mean knee flexion in patients on continuous passive motion and those without it after total knee arthroplasty (76 patients, 38 in each group: standardised physiotherapy from 1 st postoperative day and physiotherapy and one hour of continuous passive motion twice a day from 1 st postoperative day until discharge): again the conclusion was that continuous passive motion had no influence on knee range of motion after total knee arthroplasty at the time of discharge [39].…”

Section: Continuous Passive Motionmentioning

confidence: 99%

“…The use of CPM in the classic way after TKA can have a beneficial effect on knee flexion, post-surgery pain, knee oedema and hospitalisation, but it has no effect on extension recovery, wound healing or reduction of thromboembolic risk. Continuous passive motion can be considered as an adjuvant device to increase results in the short-term, but the effects of CPM on ROM are too small to justify its use, even if there is some evidence that CPM may reduce the need for subsequent manipulation under anaesthesia [28][29][30][31][32][33][34][35][36][37][38][39].…”

Section: Continuous Passive Motionmentioning

confidence: 99%

Rehabilitation and Physical Therapy before and after Total Knee Arthroplasty: A Literature Review and Unanswered Questions

Aless¹,

Bistolfi²,

Federico³

et al. 2016

Int J Phys Med Rehabil

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This review focuses on the validity and the effectiveness of rehabilitation techniques and physical therapies before and after total knee arthroplasty (TKA). The intent is to drive surgeons and rehabilitation specialists in the choice of the strategies for the treatment after TKA. The Data sources were MEDLINE, PubMed, CINAHL, EMBASE, and PsychINFO databases using the selected key words. Three authors independently selected studies for review using as criteria English, adults, any clinical population, and intervention for. Among several published studies of rehabilitation after TKA, only a few were based on scientific evidence. Moreover, many studies were heterogeneous and included different outcomes and evaluations. There is consensus that a complete and specific rehabilitation post-operative programme is effective in reducing the length of hospitalisation and the incidence of early complications. However, it is not clear what "complete and specific rehabilitation" may mean: the real efficacy of every specific treatment (continuous passive motion, cryotherapy, magneto therapy, neuro muscular electrical stimulation, whole body vibration, hydrotherapy, pre-operative physiotherapy) is still questionable, and often related to the experience of the authors. In conclusion, patients undergoing physiotherapy obtain a better and faster outcome achievement than non-treated patients; however, evidence-based treatments, protocols and clinical trials are recommended.

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Use of Inpatient Continuous Passive Motion Versus No CPM in Computer-Assisted Total Knee Arthroplasty

Abstract: 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.

Cited by 43 publications

References 10 publications

Common controversies in total knee replacement surgery: Current evidence

Common controversies in total knee replacement surgery: Current evidence

Recuperación de la artroplastia de rodilla a través de la movilización pasiva continua

Rehabilitation and Physical Therapy before and after Total Knee Arthroplasty: A Literature Review and Unanswered Questions

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