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Continuous passive motion and its effects on knee flexion after total knee arthroplasty in patients with knee osteoarthritis

  • Knee
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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

This study evaluated the effects of continuous passive motion (CPM) on accelerated flexion after total knee arthroplasty (TKA) and whether CPM application measures (i.e. initial angle and daily increment) are associated with functional outcomes.

Methods

A retrospective investigation was conducted at the rehabilitation centre of a university-based teaching hospital. Patients who received CPM therapy immediately after TKA surgery were categorized into rapid-, normal-, and slow-progress groups according to their response to CPM during their acute inpatient stay. Knee pain, passive knee flexion, and knee function—measured using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)—were assessed preoperatively at discharge and at 3- and 6-month outpatient follow-up visits.

Results

A total of 354 patients were followed for 6 months after inpatient-stay discharge. The patients in the rapid-progress group (n = 119) exhibited significantly greater knee flexions than those in the slow-progress group did (n = 103) at the 3-month follow-up [mean difference (MD) = 10.3°, 95 % confidence interval (CI) 4.3°–16.3°, p < 0.001] and 6-month follow-up (MD = 10.9°, 95 % CI 6.3°–15.6°, p < 0.001). Significant WOMAC score differences between the rapid- and slow-progress groups were observed at the 3-month follow-up (MD = 7.2, 95 % CI 5.4–9.1, p < 0.001) and 6-month follow-up (MD = 16.1, 95 % CI 13.4–18.7, p < 0.001). CPM initial angles and rapid progress significantly predicted short- and long-term outcomes in knee flexion and WOMAC scores (p < 0.001).

Conclusion

When CPM is used, early application with initial high flexion and rapid progress benefits knee function up to 6 months after TKA.

Level of evidence

II.

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Acknowledgments

We thank all the research nurses and assistants who helped us identify eligible patients and collect data through chart review.

Author information

Authors and Affiliations

  1. Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan

    Chun-De Liao, Li-Fong Lin & Tsan-Hon Liou

  2. Department of Exercise and Health Science, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan

    Yi-Ching Huang

  3. Department of Orthopedics, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan

    Yen-Shuo Chiu

  4. Department of Nursing, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan

    Jui-Chen Tsai

  5. Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei, Taiwan

    Chun-Lung Chen

  6. Graduate Institute of Injury Prevention and Control, Taipei Medical University, Taipei, Taiwan

    Tsan-Hon Liou

  7. Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, No. 250, Wu-Hsing Street, Taipei, Taiwan

    Chun-Lung Chen & Tsan-Hon Liou

  8. School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan

    Chun-De Liao

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  1. Chun-De Liao
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Correspondence to Tsan-Hon Liou.

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Liao, CD., Huang, YC., Lin, LF. et al. Continuous passive motion and its effects on knee flexion after total knee arthroplasty in patients with knee osteoarthritis. Knee Surg Sports Traumatol Arthrosc 24, 2578–2586 (2016). https://doi.org/10.1007/s00167-015-3754-x

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  • DOI: https://doi.org/10.1007/s00167-015-3754-x

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