During my home health visits each week I will talk with my patients on a large number of issues regarding their recovery and prognosis after total knee replacement surgery.
One area that I gravitated to since getting out of school is orthopedics’s as I have always been intrigued with the human skeleton, fracture repair and of course my favorite knee and hip replacement surgery and recovery.
One of the questions I received regularly with total knee replacement patients is ” What do you think about those CPM machines”? Now they are devices that no doubt have worked well for some patients and there are many orthopedic doctors who recommend them after surgery.
CPM which stands for continuous passive motion is a device that applies as the name of it insinuates, continuous passive range of motion to the operated knee to help not only with starting on a range of motion but also pain relief and helping to reduce swelling, these are just a few of its selling points.
I have also run into a few of these working with shoulder replacement patients as well which I saw earlier in my career.
As with just about all topics these days, there are arguments which can be given for the pros and cons of the CPM and both can make a good case. I think it comes down to personal preference.
If I was an orthopedic doctor I would likely be in the camp that does not use them as I have not seen the results that lead me to believe they are superior in getting outstanding results during my time in physical therapy with my knee replacement patients.
These machines which can be used non-stop 24-7 if you wish does the work I feel the patient should be doing on their own. Remember, As I have mentioned in my earlier posts, I had a knee replaced in 1999, I did not have a CPM and I can speak first hand on this and I can tell you my knee came out just fine.
The CPM is effective in lessening the negative effects of joint immobilization for example pain relief which is the case for patients that need to get the joint moving as there are some patients that will not do the work needed to acquire the flexion and extension to make the surgery a success.
There is a laundry list of the benefits of the CPM which was developed by a Canadian physician around 1979-1980. You will find two schools of thought on this device the orthopedic doctors that use them and the ones that will not. I find that both have very good points to make backing their position however, I have not seen the evidence or results in the end that would sway me to be a big believer in the CPM.
In the hospital for the most part, unless you have a good orthopedic team of nurses and CNAs and they are on the ball, these machines will occupy your window sill more than being placed properly on your knee.
If the CPM is not placed properly and aligned as it should be the sensation to the patient is as if someone is twisting their knee with each revolution and it nullifies the effectiveness of the machine.
Underneath your bed is also a popular place to find the CPM as well in some orthopedic units some of the hospital help are intimidated with the device. I find the proper application, for the most part, is not correct or the unit is not anchored properly in bed and it will slowly shift throughout the day or evening again causing ineffectiveness.
Bottom line is this, you can get the same results without the CPM IF you are willing to complete the exercise program you were prescribed to obtain the needed flexion and extension with a sprinkle of mental toughness thrown in as well.
I have treated knee replacement patients for 23 years now and I can assure you together we can get the results without the CPM. Determination and the desire to get better and improve is the key, nothing will replace hard work that’s the way it always has been and will always be.
Richard Haynes PTA, CPT
Total Joint Fitness LLC