The use of Continuous Passive Motion (CPM) in the rehabilitation of patients after total knee arthroplasty.

Background. Total knee alloplasty (TKA) is standard treatment for advanced gonarthrosis. Proper rehabilitation of the operated joint and the patient is essential in order to achieve a satisfactory functional outcome. The aim of our study was to compare rehabilitation methods used for patients recovering from TKA in the Orthopedic Clinic of the Medical University in Łódź, Poland. Material and methods. We studied 186 patients operated for advanced gonarthrosis, ranging in age from 29 to 80 (average 65.8), who had received 197 endoprotheses. From 1986 to 1989 the rehabilitation program included isometric exercises of the muscles in the operated joint, general fitness exercises in bed, and passive exercises of the knee conducted by a physiotherapist. The average stay during this period was 19.7 +/- 2.5 days. In 1989, continuous passive motion (CPM) using an electric rail was introduced to the rehabilitation program. Results. Thanks to the earlier additional flexibility of the operated joint, active exercises and weight bearing on the operated limb could be accelerated. The patients left the Clinic 2 weeks after surgery (13.6 +/- 2.5 days). The change in the rehabilitation program produced a statistically significant increase in the average range of flexion in the operated joint (p = 0.000001) in a significantly shorter time (p = 0.0000). Conclusion. Introducing CPM to the rehabilitation of TKA patients accelerates their progress and reduces hospitalization time, which improves the patients' emotional comfort and enables a faster return to an active life in society.