HOME CONTINUOUS PASSIVE MOTION MACHINE VERSUS PROFESSIONAL PHYSICAL THERAPY FOLLOWING TOTAL KNEE REPLACEMENT

A vigorous rehabilitation program following discharge from the hospita l is necessary for patients having a total knee arthroplasty to mainta in and improve range of motion and function. To compare the effectiven ess of the continuous passive motion (CPM) machine as a home therapy p rogram versus professional physical therapy, a prospective, comparativ e, randomized clinical study of 103 consecutive primary total knee art hroplasties in 80 patients (23 bilateral) was performed. The CPM group consisted of 37 patients (49 knees), and the physical therapy group c onsisted of 43 patients (54 knees). At 2 weeks, knee flexion was simil ar in the two groups, but a flexion contracture was noted in the CPM g roup (4.2 degrees). This difference is felt by the authors to be clini cally insignificant. At 6 months, there were no differences in knee sc ores, knee flexion, presence of flexion contracture, or extensor lag b etween the two groups. The cost for the CPM machine group was $10,582 ($286 per patient), and the cost for professional therapy was $23,994 ($558 per patient). We conclude that the CPM machine after the hospita l discharge of patients having total knee replacement is an adequate r ehabilitation alternative with lower cost and with no difference in re sults compared with professional therapy.