Romness D W, Rand J A
Orthopaedic Surgery, Mayo Medical School, Rochester, MN 55905.
Clin Orthop Relat Res. 1988 Jan(226):34-7.
A retrospective study of 94 knees with postoperative continuous passive motion (CPM) therapy was compared with a control group of 116 knees with no postoperative CPM following kinematic condylar total knee arthroplasty (TKA) performed in 1983. The diagnoses were similar in both groups, with osteoarthritis in 167 knees, rheumatoid arthritis in 34 knees, osteonecrosis in four knees, traumatic arthritis in four knees, and psoriatic arthritis in one knee. Average flexion at hospital discharge was 87.7 degrees in the control group and 90.2 degrees in the CPM group (p less than 0.02). Seventy-four percent of the CPM group and 60% of the control group had achieved 90 degrees of flexion by the time of hospital discharge. The number of days to achieve 90 degrees averaged 10.3 in the control group and 7.7 in the CPM group (p less than 0.001). There was no significant difference in flexion at two or three months or at one year after operation between the two groups. Five knees in the control group and one in the CPM group required manipulation. The duration of hospitalization was not significantly different between the two groups. Hemoglobin levels, operative blood loss, and transfusion requirements were not significantly different. Patients with CPM following TKA achieve motion earlier than those without CPM, but ultimate motion and complications are not affected.
对94例接受术后持续被动运动（CPM）治疗的膝关节进行回顾性研究，并与1983年进行动力学髁型全膝关节置换术（TKA）后未接受术后CPM治疗的116例膝关节组成的对照组进行比较。两组的诊断相似，167例为骨关节炎，34例为类风湿关节炎，4例为骨坏死，4例为创伤性关节炎，1例为银屑病关节炎。对照组出院时的平均屈曲度为87.7度，CPM组为90.2度（p<0.02）。CPM组74%的患者和对照组60%的患者在出院时达到了90度的屈曲度。达到90度所需的天数在对照组平均为10.3天，在CPM组为7.7天（p<0.001）。两组在术后两个月、三个月或一年时的屈曲度无显著差异。对照组有5例膝关节需要手法治疗，CPM组有1例。两组的住院时间无显著差异。血红蛋白水平、术中失血量和输血需求无显著差异。TKA术后接受CPM治疗的患者比未接受CPM治疗的患者更早获得活动度，但最终活动度和并发症不受影响。
