“Is Continuous Passive Motion Beneficial for Early Post Operative Period in TKA Patients?”

Objective: To evaluate the effectiveness of Continuous Passive Motion in adjunctive with conventional physical therapy in early post operative Total Knee Arthroplasty patients.Methods: Total 150 patients were enrolled, randomly selected in two groups, CPM (n=73) and Control group (n=75), as 2 patients from CPM group refuse to participate in study.In control group patients received conventional physical therapy intervention alone, while in CPM group patients received conventional physical therapy intervention along with CPM application.Assessment of all patients were carried out twice by experience physical therapist, once at the preoperative visit 2 weeks prior to TKA for baseline measurements and second at discharge after 7 days post operatively.Outcome assessed among both group by assessing active knee range of motion primarily flexion and extension by using Goniometry and as secondarily outcome pain, stiffness and functional difficulty by using WOMAC questionnaire score.Result: Out of 150 patients, 148 were analyzed in the study to compare the effectiveness of CPM along with standard physiotherapy and physiotherapy alone in early postoperative period after TKA.No statistical significant difference found in Flexion and extension pre operative 2 weeks prior to surgery and post operative assessment at discharge after 7 days among both groups, as p-value was found to be insignificant.Similarly WOMAC Score (for Pain, Stiffness and functional difficulty assessment) were evaluated among both groups, it was noted that there were decreased in scores but it was also statistically insignificant.Conclusion: Continuous Passive Motion does not provide an additional benefit over the conventional physical therapy interventions employed in an inpatient rehabilitation facility for patient following TKA, more specifically in patients had poor initial knee range of motion specially flexion following surgery, perhaps it increases the financial burden to the patients.So we concluded that Conventional physical therapy alone could be the convenient and sufficient method for rehabilitation in early post operative TKA patients.As it was a single centre prospective study and small sample size; therefore the results of the present study should be exercised with caution.