Brosseau Lucie, Milne Sarah, Wells George, Tugwell Peter, Robinson Vivian, Casimiro Lynn, Pelland Lucie, Noel Marie-Josée, Davis Jennifer, Drouin Hugo
School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada.
J Rheumatol. 2004 Nov;31(11):2251-64.
The objective of this metaanalysis is to examine the effectiveness of continuous passive motion (CPM) following total knee arthroplasty (TKA).
This metaanalysis used the methodology proposed by the Cochrane Collaboration.
This review of 14 studies (952 patients) found significant improvements in active knee flexion and analgesic use 2 weeks postoperatively with the use of CPM and physiotherapy (PT) compared to PT alone. In addition, length of hospital stay and need for knee manipulations were significantly decreased in the CPM group. Not enough data were available to compare the degree of knee flexion applied or number of hours of application of CPM. However, significant results were not found for other comparisons such as short term CPM application versus longterm CPM application and wide treatment range versus small treatment range for the outcomes of active knee flexion, passive knee flexion and extension, presence of a fixed flexion deformity, use of analgesic, or total knee range of motion.
CPM combined with PT may offer beneficial results for patients post-TKA. However, the potential benefits will need to be carefully weighed against the inconvenience and expense of CPM. More research is necessary to assess the differences in effectiveness with different characteristics of application such as total duration of treatment and intensity of CPM interventions.
本荟萃分析的目的是检验全膝关节置换术(TKA)后持续被动运动(CPM)的有效性。
本荟萃分析采用了Cochrane协作网提出的方法。
这项对14项研究(952例患者)的综述发现,与单纯物理治疗(PT)相比,术后2周使用CPM和PT可使主动膝关节屈曲和镇痛药物使用情况有显著改善。此外,CPM组的住院时间和膝关节手法操作需求显著减少。没有足够的数据来比较CPM的应用程度或应用时长。然而,对于其他比较,如短期CPM应用与长期CPM应用、主动膝关节屈曲、被动膝关节屈曲和伸展、固定性屈曲畸形的存在、镇痛药物的使用或全膝关节活动范围等结果的广泛治疗范围与小治疗范围,未发现显著结果。
CPM联合PT可能对TKA术后患者有益。然而,需要仔细权衡CPM的潜在益处与不便之处和费用。有必要进行更多研究以评估不同应用特征(如治疗总时长和CPM干预强度)在有效性方面的差异。