MacDonald S J, Bourne R B, Rorabeck C H, McCalden R W, Kramer J, Vaz M
Division of Orthopaedic Surgery, University of Western Ontario London Health Sciences Centre, Canada.
Clin Orthop Relat Res. 2000 Nov(380):30-5. doi: 10.1097/00003086-200011000-00005.
The authors report the results of a prospective randomized clinical trial using continuous passive motion after total knee arthroplasty. One hundred twenty patients were assigned randomly to one treatment group: No continuous passive motion (Group I), continuous passive motion from 0 degrees to 50 degrees and increased as tolerated (Group II), and continuous passive motion from 70 degrees to 110 degrees (Group III). The continuous passive motion was initiated in the recovery room and was maintained for a maximum of 24 hours at which point all patients began identical postoperative physiotherapy regimens. Patients were assessed preoperatively, during their hospital stay, at 6 weeks, 12 weeks, 26 weeks, and 52 weeks after their surgery. There were no statistical differences between any of the treatment groups regarding cumulative analgesic requirements, range of motion at any measured interval, length of stay (Group I, 5.1 days; Group II, 5.2 days; Group III, 5 days) or Knee Society scores. The current study does not support the use of short-term continuous passive motion after total knee replacement. A standard and a high flexion continuous passive motion protocol failed to show any advantage over physiotherapy alone in the parameters evaluated.
作者报告了一项在全膝关节置换术后使用持续被动运动的前瞻性随机临床试验结果。120名患者被随机分配到一个治疗组：不进行持续被动运动（第一组）、从0度至50度进行持续被动运动并根据耐受程度增加角度（第二组），以及从70度至110度进行持续被动运动（第三组）。持续被动运动在恢复室开始，最多维持24小时，此时所有患者开始相同的术后物理治疗方案。在术前、住院期间、术后6周、12周、26周和52周对患者进行评估。在任何治疗组之间，关于累积镇痛需求、任何测量时间点的活动范围、住院时间（第一组，5.1天；第二组，5.2天；第三组，5天）或膝关节协会评分均无统计学差异。当前研究不支持在全膝关节置换术后使用短期持续被动运动。在评估的参数方面，标准和高屈曲持续被动运动方案未显示出比单纯物理治疗有任何优势。
