Cochrane in CORR®: Continuous Passive Motion Following Total Knee Arthroplasty in People With Arthritis (Review)

T otal knee arthroplasty (TKA) effectively reduces pain and improves function in most patients. It is also one of the most commonly performed orthopaedic procedures [7]; one projection suggests that in the United States alone, more than 1.3 million TKAs will be performed per year by 2020 [12]. However, knee stiffness complicates approximately 1.3% of TKAs, severely limiting patients’ function [11], reducing quality of life, and resulting in early revision [13]. Continuous Passive Motion (CPM) refers to the use of a motorized device that is applied to a patient’s lower extremity, and continuously moves the patient’s knee through a predefined arc of motion [8]. This device is typically used during the immediate postoperative period, and it has been theorized that early passive range-of-motion (ROM) can prevent the formation of adhesions that cause joint stiffness [15]. However, the cost of CPM devices can be high, and the efficacy of CPM is uncertain. This Cochrane systematic review and metaanalysis evaluated the efficacy of CPM in patients undergoing primary TKA [8]. Based on evidence from 24 randomized trials (pooled n = 1445), the authors concluded that there is very little advantage of using CPM after TKA.