Efficacy and safety of continuous passive motion and physical therapy in recovery from knee arthroplasty: a systematic review and meta-analysis

Abstract

Abstract Background Continuous passive motion (CPM) is commonly used as a postoperative rehabilitation treatment, along with physical therapy, for postoperative knee rehabilitation. However, the comparison between the two in terms of efficacy in postoperative knee replacement recovery is unclear. Purpose To compare efficacy and safety of combined CPM versus physical therapy alone in postoperative rehabilitation after knee arthroplasty. Methods PubMed, Embase, and Web of Science databases were used to retrieve and access clinical studies on the efficacy of CPM compared with physical therapy. Review Manager software was used for study publication bias assessment and data analysis based on inclusion criteria. Results A total of 6 articles covering 557 patients were included in the study. In terms of range of motion (ROM), passive knee flexion was similar between CPM and physical therapy (PT) (WMD, − 0.17; 95% CI, − 0.98–0.64; p = 0.68). At long-term follow-up, passive knee extension was similar between CPM and physical therapy (PT) (WMD, − 0.28; 95% CI, − 1.47 to − 0.92; I 2 = 65%, p =0.65). In addition, CPM generates significantly higher in length of stay (WMD, 0.50; 95% CI, − 0.31 to 0.69; I 2 = 3%, p < 0.001). CPM generates significantly higher treatment costs and incurs more care costs relative to physical therapy. Conclusion Compared to PT, combined with CPM failed to significantly improve ROM of the knees and patient’s satisfaction. In addition, CPM treatment significantly increased the cost of hospitalization.

Keywords

• Total knee arthroplasty
• Continuous passive motion
• Physical therapy
• Range of motion
• Meta-analysis