This study compared the effect of continuous passive motion (CPM) as part of a total knee arthroplasty (TKA) rehabilitation protocol versus a protocol without CPM. Both protocols included leg strengthening exercises, passive and active knee range of motion exercises and gait training with an assistive device. Two hundred twenty-one TKA patients' charts from five hospitals were reviewed retrospectively. Passive and active range of motion recovery (PROM and AROM), length of postoperative stay, and postoperative complication frequency were used as the study's outcome variables. This study found that the inclusion of CPM in a post-TKA rehabilitation protocol significantly increased the PROM recovery at time of hosptial discharge, had no effect on AROM recovery, did not shorten hospitalization time when pre-existing medical complications were taken into account, and had no effect on frequency of postoperative complications. The results of this study suggest that 2) increased PROM recovery may not be sufficient criteria for adding CPM to a TKA rehabilitation protocol; 2) further study is needed to develop a protocol that includes minimal level of CPM necessary to prevent joint contratures and maximum AROM recovery through therapeutic exercise; and 3) a post-hosptial study may be the most effective way to check the efficacy of TKA protocols in returning patients to functional status.
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