Burks R, Daniel D, Losse G
Am J Sports Med. 1984 Jul-Aug;12(4):323-7. doi: 10.1177/036354658401200414.
This study was undertaken to examine the immediate effect of continuous passive motion (CPM) on anterior cruciate ligament (ACL) reconstruction stability. Cadaver knees were tested with a knee arthrometer with the anterior cruciate intact and then with the anterior cruciate sectioned. One of three anterior cruciate reconstructions was then performed and stability was restored to the knee and it was again tested with the knee arthrometer. Stability was defined as being within 2 mm of the intact measurement. The three operations selected were the Marshall-MacIntosh "over-the-top," (OTT) a patellar bone-patellar tendon-tubercle bone (BTB) graft, and a semitendinosis reconstruction. The specimens were placed on a CPM device in a cooler at 38 degrees F and put through a range of motion of 20 to 70 degrees at 10 cycles per minute for 3 days. A success was less than a 2 mm increase in the post-CPM measurement compared to pre-CPM. All three bone-tendon-bone operations failed. The semitendinosis operation was successful in only three out of eight specimens. The OTT operation was successful in eight out of nine specimens. The possible reasons for success and failure are discussed. Because of the potential problems with failure of an ACL with CPM it is suggested that the particular technique being used for an anterior cruciate reconstruction be tested prior to it being used with CPM clinically.
本研究旨在探讨持续被动运动（CPM）对前交叉韧带（ACL）重建稳定性的即时影响。使用膝关节测角仪对尸体膝关节进行测试，首先测试前交叉韧带完整时的情况，然后切断前交叉韧带再次进行测试。随后进行三种前交叉韧带重建手术之一，恢复膝关节稳定性，并再次使用膝关节测角仪进行测试。稳定性定义为与完整测量值相差在2毫米以内。所选的三种手术分别是马歇尔-麦金托什“过顶”（OTT）手术、髌腱-髌骨-结节骨（BTB）移植手术和半腱肌重建手术。将标本置于38华氏度的冷却器中的CPM装置上，以每分钟10个周期的速度进行20至70度的活动范围，持续3天。CPM后测量值与CPM前相比增加小于2毫米即为成功。所有三种骨-腱-骨手术均失败。半腱肌手术在八个标本中仅三个成功。OTT手术在九个标本中有八个成功。讨论了成功与失败的可能原因。由于CPM可能导致ACL失败的潜在问题，建议在临床将特定的前交叉韧带重建技术与CPM一起使用之前，先对其进行测试。
