CONTINUOUS PASSIVE MOTION AFTER TOTAL KNEE ARTHROPLASTY - ANALYSIS OFCOST AND BENEFITS

The authors report the results of a prospective study examining the be nefits of daily continuous passive motion combined with physical thera py, compared with physical therapy alone, in 103 consecutive osteoarth ritic patients undergoing primary total knee arthroplasty, The first 5 1 patients received continuous passive motion initiated in the recover y room and the next 52 patients did not receive continuous passive mot ion, Both groups underwent an identical physical therapy protocol star ting on the first postoperative day, At discharge, there was a signifi cant increase in active flexion in the continuous passive motion group , There were no significant differences regarding pain, wound healing, knee swelling, wound drainage, pulmonary embolism, or length of hospi tal stay between the 2 groups, At 2 years, there were no clinical diff erences in the motion or knee scores, Knee manipulation was done for < 50 degrees flexion after the tenth postoperative day, There were 5 man ipulations in the noncontinuous passive motion group and none in the c ontinuous passive motion group, The entire costs associated with the 5 manipulations was $48,274 or $937 per patient not receiving continuou s passive motion, The average daily inpatient rental of the machine wa s $60 per day, Continuous passive motion is efficacious in increasing short-term flexion and decreasing the need for knee manipulation witho ut increasing costs.