Continuous Passive Motion (CPM)
I’ve read and heard a little about Continuous Passive Motion (CPM) devices, but they’re apparently going out of favor, at least for knee surgeries. CPM devices are sometimes prescribed to patients who will undergo knee replacement or Anterior Cruciate Ligament (ACL) replacement surgery {that’s me}. Using the CPM device causes the patient’s knee to slowly and repeatedly be put through its desired range of motion. It was thought this immediate return to use would help reduce joint stiffness, adhesions and other issues associated with knee surgeries. However, research indicates no long-term benefits to using a CPM device post-operatively over a patient-driven return to mobility (using crutches for 3+ weeks post operatively, accompanied by a gradual increase in weight-bearing plus exercises to strengthen the leg muscles, and supervised physical therapy.) The CPM machines aren’t useless. They have proven to provide an immediate benefit in mobility post-operatively, and provide patients with an immediate sense of participating in their recovery. However, over the long-term they don’t provide any advantages over other methods — patients with or without a CPM machine end up healing to the same level of mobility and joint flexibility.
Given the research, it’s no surprise that my specialist is not prescribing the CPM device for my post-operative recovery. I can’t say I’ll miss it, since the device is typically used for many hours a day, including when a patient sleeps. It takes me long enough to fall asleep, without having a device strapped to a post-operative knee that’s forcing it through the full range of motion while I attempt to sleep!
bob said,
April 5, 2005 @ 10:57 am
Pain medications are used in acute cases, such as a post operative phase to control pain. They have no long term effect once discontinued. CPM’s are used in the acute post op phase and have been proven to reduce pain, swelling and speed reteun to activity. What’s the difference? Does that mean you shouldn’t take pain meds since there’s no long term effect?
Shannon said,
April 5, 2005 @ 11:02 am
Very good point, Bob. As you’ll see if you read further along in my Knee Journal, I was actually prescribed and used a CPM for nearly 14 days post-op from my knee surgery. So my agreement with the article shifted dramatically once I realized A) My OS was prescribing me a CPM, based on his protocols for ACL reconstruction patients with meniscus repairs and B) once I realized how quickly I regained my flexion and how well the CPM paired with a cryo cuff managed my swelling and pain.
That’s the wonder of keeping a journal — it’s easy to see how opinions, knowledge and emotions change through the process of pre- and post-op and rehabilitation.
Thanks for posting!
- Shannon (8 weeks & 4 days post-op, today)
anita hale said,
July 5, 2006 @ 9:02 am
The CPM had worked great for me. I am 8 days post op from knee replacement. I have little or no swelling or redness. The machine gets me comfortable first thing in the morning when I’m the stiffest. I think it’s great.