Continuous passive motion following total knee arthroplasty

摘要: Background Knee arthroplasty (KA) is a common intervention that can enhance the quality of life for patients with osteoarthritis (OA) and rheumatoid arthritis (RA). Post-surgery rehabilitation protocols often include continuous passive motion (CPM). However, CPM vary considerably amongst institutions. Objectives The purpose current meta-analysis to evaluate effectiveness following total knee arthroplasty. Search strategy An electronic search MEDLINE (1966 2002), EMBASE (1988 CINAHL (1982 HEALTH STAR (1991 1994) CURRENT CONTENTS (1997 2002) was conducted identify randomized controlled trials. Selection criteria Following an priori protocol, only trials treatment participants post KA were eligible. Subjects 18 years age or older had pre-surgery diagnosis degenerative joint disease. Both experimental control groups received physiotherapy. In addition physiotherapy intervention, group CPM. Data collection analysis Two reviewers independently selected inclusion. Data then extracted trial assessed using predetermined forms. Outcome measures interest were: active range (ROM) length hospital stay, pain, swelling quadriceps strength. A fixed effects model used throughout variables, except where heterogeneity existed; in which case, random used. Results analyzed as weighted mean differences (WMD) 95% confidence intervals (CI). Standardized (SMD) when different scales measure same concept (e.g. pain). Dichotomous outcomes presented relative risk. Main results Fourteen retained analysis. favouring found main comparison combined (PT) versus PT alone at end treatment. For primary interest, statistically significantly increase flexion (WMD 4.30 degrees, CI: 1.96, 6.63) decrease stay -0.69 days, -1.35, -0.03). also need post-operative manipulation (RR 0.12, 0.03, 0.53). did not improve extension. Authors' conclusions CPM PT, may offer beneficial results compared short term arthroplasty.