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The Application Of Continuous Passive Motion After Total Knee Arthroplasty Does Not Affect The Knee Motion, Postoperative Pain And Surgical Wound Aspect

The Application Of Continuous Passive Motion After Total Knee Arthroplasty Does Not Affect The Knee Motion, Postoperative Pain And Surgical Wound Aspect

Sergi Gil Gonzalez, MD, SPAIN Ricardo Andrés Barja, MD, SPAIN Laura Valls, MD, SPAIN Hector Hormigó, MD, SPAIN Antonio Luis García Cebrián, MD, SPAIN Enrique Fernandez Bengoa, MD, SPAIN Antoni López Pujol, MD, SPAIN Juan Ignacio Erquicia, MD, SPAIN Xavier Pelfort, PhD, SPAIN Joan Leal-Blanquet, MD, PhD, SPAIN

Hospital Universitari d’Igualada, Igualada, Barcelona, SPAIN


2021 Congress   ePoster Presentation     Not yet rated

 

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Summary: A randomized controlled trial was made to assess whether the use of CPM can improve range of motion in patients after TKA in comparison to a conventional self-assisted rehabilitation program without CPM. Additionally, we evaluate the level of pain and the relationship between the use of CPM and the surgical wound aspect after TKA.


OBJECTIVES. Historically, continuous passive motion (CPM) was used to improve knee mobility and reduce stiffness after total knee arthroplasty (TKA). However, the high cost of CPM devices, lack of direct supervision and the doubtful effectiveness, merits reconsideration of their use. Moreover, we do not know how this device affects the evolution of knee surgical wounds.
We performed a randomized controlled trial with the main objective to assess whether use of CPM can improve range of motion in patients after TKA in comparison with a conventional self-assisted rehabilitation program without CPM. In addition, we assessed the relationship between use or not of CPM and the surgical wound aspect (SWA) after TKA.
METHODS. Between January and December 2018, all patients who were implanted a primary TKA were included in the study. We randomized 210 patients, 102 patients in the CPM group, who received a standard rehabilitation protocol together with CPM application; and 108 patients in the no-CPM group, with the same rehab program without CPM. Variables as knee motion (flexion, extension, range of motion) and pain was measured before surgery, on the 1st, 2nd and 3rd postoperative day, and in the 2nd, 6th, 12th and 24th postoperative weeks following TKA. The SWA was determined by the “surgical wound aspect score” (SWAS) 48 hours after surgery. This scale analyses 5 parameters: swelling, erythema, haematoma, blood drainage and blisters.
Results. There was an improvement in the knee motion over the course of follow-up in both groups, without significant difference in flexion parameter. We found no significant differences in the total score of SWA, except for haematoma, with less severity in the CPM group. Furthermore, we found no differences in the others SWAS parameters and pain. No patient had knee stiffness that required any surgical procedure or forced mobilization.
Conclusions.The application of CPM does not provide benefit to our patients undergoing TKA in terms of either improved mobility or decreased pain. No relationship was found between the use of CPM and the SWA following a TKA, except for a decrease in haematoma appearance.