Continuous passive motion compared with intermittent mobilization after total knee arthroplasty. Elaboration of French clinical practice guidelines - 24/05/07

Doi : 10.1016/j.annrmp.2007.03.002

J.-M. Postel ^a,^{^{1
These two authors have contributed equally to this work.},}^⁎, P. Thoumie ^b,^{^{1
These two authors have contributed equally to this work.}} , B. Missaoui ^b, D. Biau ^c, P. Ribinik ^d, M. Revel e, F. Rannou e
^a Clinique Arago, 95, boulevard Arago, 75014 Paris, France
^b Service de rééducation neuro-orthopédique, hôpital Rothschild, APHP, université Pierre-et-Marie-Curie, 75012 Paris, France
^c Service de chirurgie orthopédique et traumatologique B, APHP, université René-Descartes, groupe hospitalier Cochin, 75014 Paris, France
^d Service de MPR, centre hospitalier de Gonesse, 25, rue Pierre-de-Theilley, BP 30071, 95500 Gonesse, France
^e Service de rééducation, groupe hospitalier Cochin, APHP, université René-Descartes, 75014 Paris, France

Corresponding author.

Abstract

Objective

To develop clinical practice guidelines concerning the use of continuous passive motion (CPM) compared with intermittent mobilization after total knee arthroplasty (TKA).

Method

We used the SOFMER (French Physical Medicine and Rehabilitation Society) methodology, combining systematic literature review and collection of everyday clinical practice concerning postoperative rehabilitation techniques and external review by a multidisciplinary expert panel, to develop the guidelines.

Results

The literature contains no evidence of the advantages of CPM over other techniques of mobilization, although CPM could be adjuvant therapy used to accelerate short-term recovery. However, in France, CPM remains widely used after TKA, both in orthopedic surgery units and in physical medicine and rehabilitation services.

Conclusion

Good methodological quality studies are needed to assess different CPM modalities and compare them to alternative intermittent mobilization techniques, particularly those with therapy starting from a flexed position.

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Keywords : Osteoarthritis, Knee arthroplasty, Postoperative rehabilitation, Recommendations, Guidelines, Clinical practice, Physiotherapy, Physical therapy, Arthroplasty, Continuous passive motion

Plan

Systematic literature review

Daily practice

Elaboration of guidelines and external review by a reading committee

Results

Meta-analysis

High-power level 1 randomized controlled trials

Level 2 studies

Professional practice

Discussion

Conclusion

Clinical practice guidelines

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Vol 50 - N° 4

P. 251-257 - mai 2007 Retour au numéro

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Intérêt de la mobilisation passive continue par rapport aux mobilisations intermittentes après pose d'une prothèse totale de genou. Élaboration de recommandations françaises pour la pratique clinique
P. Thoumie, J.-M. Postel, B. Missaoui, D. Biau, P. Ribinik, M. Revel, F. Rannou

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Continuous passive motion compared with intermittent mobilization after total knee arthroplasty. Elaboration of French clinical practice guidelines - 24/05/07

Abstract

Objective

Method

Results

Conclusion

Plan

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