Maloney W J, Schurman D J, Hangen D, Goodman S B, Edworthy S, Bloch D A
Department of Orthopaedic Surgery, Palo Alto Medical Clinic, California.
Clin Orthop Relat Res. 1990 Jul(256):162-8.
All primary condylar total knee replacement arthroplasties (TKAs) performed from 1977 to 1984 at the authors' institution were divided into two groups based on the use of continuous passive motion (CPM) in the immediate postoperative period. The control group consisted of 73 patients who were treated with 95 TKAs without postoperative CPM. The average age was 65.4 years. The study group consisted of 38 patients who had 51 TKAs in which CPM was used postoperatively. The mean patient age was 62.8 years. The most common diagnoses in both groups were osteoarthritis and rheumatoid arthritis. Range of motion (ROM) was recorded preoperatively, at discharge, at three months, one year, two years, and at the last follow-up visit. There were no statistically significant differences in the ROM between the two groups at any of these time periods. At two years, the mean flexion and extension in the study group were 99 degrees and -4 degrees, respectively, compared to 103 degrees and -5 degrees in the control group. The average hospital stay was 11.2 days in the study group, whereas it was 15.1 days in control group. In the control group, there was one superficial infection, no deep infections, and four pulmonary emboli compared with three superficial infections, two deep infections, and no pulmonary emboli in the study group. There was no difference in the transfusion requirements between the two groups. CPM is advocated by the authors to help achieve discharge ROM earlier, but the protocol has been changed to begin CPM on the second postoperative day to allow the wound to stabilize.
1977年至1984年在作者所在机构进行的所有初次髁型全膝关节置换术（TKA），根据术后早期是否使用持续被动运动（CPM）分为两组。对照组由73例接受95次TKA治疗且术后未使用CPM的患者组成。平均年龄为65.4岁。研究组由38例患者组成，他们接受了51次TKA，术后使用了CPM。患者平均年龄为62.8岁。两组中最常见的诊断为骨关节炎和类风湿关节炎。在术前、出院时、三个月、一年、两年以及最后一次随访时记录活动范围（ROM）。在这些时间段中的任何一个，两组之间的ROM均无统计学显著差异。在两年时，研究组的平均屈曲和伸展角度分别为99度和-4度，而对照组为103度和-5度。研究组的平均住院天数为11.2天，而对照组为15.1天。对照组有1例表浅感染，无深部感染，4例肺栓塞；研究组有3例表浅感染，2例深部感染，无肺栓塞。两组之间的输血需求无差异。作者提倡使用CPM以帮助更早达到出院时的ROM，但方案已改为术后第二天开始使用CPM，以便伤口稳定。
