CONTINUOUS PASSIVE MOTION FOLLOWING METACARPOPHALANGEAL JOINT ARTHROPLASTY

To determine whether a postoperative rehabilitation protocol incorpora ting continuous passive motion would increase the total range of motio n obtained 6 months following silicone interposition arthroplasty of t he metacarpophalangeal joints in patients with rheumatoid arthritis, a prospective trial randomizing patients to receive either continuous p assive motion or the standard dynamic splint protocol (modified Madden protocol) was undertaken. Fifteen hands (60 joints) were treated with the modified Madden protocol and 10 hands (40 joints) had continuous passive motion. The mean 6-month postoperative range of motion was 7 d egrees in the modified Madden cohort compared with 39 degrees in the c ontinuous passive motion cohort, representing an improvement of 22 deg rees in the modified Madden cohort compared with an improvement of onl y 5 degrees in the continuous passive motion cohort. Residual ulnar de viation 8 degrees vs 12 degrees and grip strength (2.3 kgf v 3.7 kgf) were both lower in the continuous passive motion cohort. Incorporation of the continuous passive motion machine in the postoperative rehabil itation protocol does not offer sufficient advantages to justify the a dded costs. Copyright (C) 1998 by the American Society for Surgery of the Hand.