ABSTRACT
BACKGROUND: Continuous passive motion (CPM) has shown positive effects on tissue healing, edema, hemarthrosis, and joint function (L. Brosseau et al., 2004). CPM has also been shown to increase short-term early flexion and decrease length of stay (LOS) ( L. Brosseau et al., 2004; C. M. Chiarello, C. M. S. Gundersen, & T. O'Halloran, 2004). The benefits of CPM for the population of patients undergoing computer-assisted total knee arthroplasty (TKA) have not been examined. PURPOSE: The primary objective of this study was to determine whether the use of CPM following computer-assisted TKA resulted in differences in range of motion, edema/drainage, functional ability, and pain. METHODS: This was an experimental, prospective, randomized study of patients undergoing unilateral, computer-assisted TKA. The experimental group received CPM thrice daily and physical therapy (PT) twice daily during their hospitalization. The control group received PT twice daily and no CPM during the hospital stay. Both groups received PT after discharge. Measurement included Knee Society scores, Western Ontario McMaster Osteoarthritis Index values, range of motion, knee circumference, and HemoVac drainage. Data were collected at various intervals from preoperatively through 3 months. RESULTS: Although the control group was found to be higher functioning preoperatively, there was no statistically significant difference in flexion, edema or drainage, function, or pain between groups through the 3-month study period.
Subject(s)
Arthroplasty, Replacement, Knee/rehabilitation , Edema , Motion Therapy, Continuous Passive/methods , Surgery, Computer-Assisted/rehabilitation , Activities of Daily Living , Aged , Arthroplasty, Replacement, Knee/adverse effects , Arthroplasty, Replacement, Knee/methods , Edema/etiology , Female , Hematocrit , Humans , Length of Stay/statistics & numerical data , Male , Motion Therapy, Continuous Passive/nursing , Pain Measurement , Pain, Postoperative/diagnosis , Pain, Postoperative/etiology , Physical Therapy Modalities , Postoperative Care/methods , Prospective Studies , Range of Motion, Articular , Surgery, Computer-Assisted/adverse effects , Surgery, Computer-Assisted/methods , Treatment OutcomeABSTRACT
BACKGROUND: Since its March 2006 FDA approval in the United States, Birmingham hip resurfacing (BHR) has been a popular alternative to hip arthroplasty for the younger patient population. Data to date has shown a trend toward low incidence of dislocation and good survivorship. METHODS: 128 patients operated on by a single surgeon from July 2006 to December 2008 were reviewed for complications, pain, and function. A group of single incision, minimally invasive standard total hip replacements (106 cases) in 2008 was used for comparison of the same outcomes. CONCLUSION: Pain, function, and total Harris Hip scores were all improved by the 2 year mark and better than the total hip group. Overall incision lengths decreased over the study time period. The average age of the BHR recipient was 51 years, approximately 14 years less than the total hip mean age. Pain in the Birmingham group improved by 32 points at the 3 month mark. By the end of 2 years, the Birmingham group Harris Hip score mean was nearly perfect at 98.5 points. Rare incidence of complications, marked decreased pain scores and marked elevation in function were results found in this sample of Birmingham resurfacing.