Skip to main content
Top
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 10/2009

01-10-2009 | Knee

Clinical value of regular passive ROM exercise by a physical therapist after total knee arthroplasty

Authors: Tae Kyun Kim, Kwan Kyu Park, Su Won Yoon, Sung Ju Kim, Chong Bum Chang, Sang Cheol Seong

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 10/2009

Login to get access

Abstract

Regular passive ROM exercise (PROME) by a physical therapist is often incorporated in rehabilitation protocols after total knee arthroplasty (TKA). This randomized, controlled trial examined whether or not the incorporation of PROME to a postoperative rehabilitation protocol would offer a better clinical outcome after TKA. Fifty consecutive patients who underwent bilateral TKAs staged 2 weeks apart received PROME for one knee and not for the other. The pain level (7D and 14D), patient’s preference (before discharge, 6M), maximum flexion (7D, 14D, 3M, 6M) and American Knee Society and WOMAC scores (6M) were determined in the knees with and without PROME and compared. There were no significant differences in the maximum flexion, pain level, patient’s preference, AKS scores and WOMAC scores. This study demonstrates that the incorporation of PROME does not offer additional clinical benefits to the patients after TKA. Our findings may suggest that encouraging patients to perform active ROM exercise would be a better option and that a physiotherapy session by a physical therapist can focus on more functional rehabilitation, such as preparing to return to daily activities.
Literature
1.
go back to reference Akagi M, Nakamura T, Matsusue Y, Ueo T, Nishijyo K, Ohnishi E (2000) The bisurface total knee replacement: a unique design for flexion. Four-to-nine-year follow-up study. J Bone Joint Surg Am 82-A:1626–1633PubMed Akagi M, Nakamura T, Matsusue Y, Ueo T, Nishijyo K, Ohnishi E (2000) The bisurface total knee replacement: a unique design for flexion. Four-to-nine-year follow-up study. J Bone Joint Surg Am 82-A:1626–1633PubMed
2.
go back to reference Argenson JN, Komistek RD, Mahfouz M, Walker SA, Aubaniac JM, Dennis DA (2004) A high flexion total knee arthroplasty design replicates healthy knee motion. Clin Orthop Relat Res 428:174–179PubMedCrossRef Argenson JN, Komistek RD, Mahfouz M, Walker SA, Aubaniac JM, Dennis DA (2004) A high flexion total knee arthroplasty design replicates healthy knee motion. Clin Orthop Relat Res 428:174–179PubMedCrossRef
3.
go back to reference Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW (1988) Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol 15:1833–1840PubMed Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW (1988) Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol 15:1833–1840PubMed
4.
go back to reference Bin SI, Nam TS (2007) Early results of high-flex total knee arthroplasty: comparison study at 1 year after surgery. Knee Surg Sports Traumatol Arthrosc 15:350–355PubMedCrossRef Bin SI, Nam TS (2007) Early results of high-flex total knee arthroplasty: comparison study at 1 year after surgery. Knee Surg Sports Traumatol Arthrosc 15:350–355PubMedCrossRef
5.
go back to reference Bohannon RW (2005) Manual muscle testing: does it meet the standards of an adequate screening test? Clin Rehabil 19:662–667PubMedCrossRef Bohannon RW (2005) Manual muscle testing: does it meet the standards of an adequate screening test? Clin Rehabil 19:662–667PubMedCrossRef
6.
go back to reference Chang CB, Han I, Kim SJ, Seong SC, Kim TK (2007) Association between radiological findings and symptoms at the patellofemoral joint in advanced knee osteoarthritis. J Bone Joint Surg Br 89:1324–1328PubMedCrossRef Chang CB, Han I, Kim SJ, Seong SC, Kim TK (2007) Association between radiological findings and symptoms at the patellofemoral joint in advanced knee osteoarthritis. J Bone Joint Surg Br 89:1324–1328PubMedCrossRef
7.
go back to reference Chen B, Zimmerman JR, Soulen L, DeLisa JA (2000) Continuous passive motion after total knee arthroplasty: a prospective study. Am J Phys Med Rehabil 79:421–426PubMedCrossRef Chen B, Zimmerman JR, Soulen L, DeLisa JA (2000) Continuous passive motion after total knee arthroplasty: a prospective study. Am J Phys Med Rehabil 79:421–426PubMedCrossRef
8.
go back to reference Crowninshield RD, Rosenberg AG, Sporer SM (2006) Changing demographics of patients with total joint replacement. Clin Orthop Relat Res 443:266–272PubMedCrossRef Crowninshield RD, Rosenberg AG, Sporer SM (2006) Changing demographics of patients with total joint replacement. Clin Orthop Relat Res 443:266–272PubMedCrossRef
9.
go back to reference Denis M, Moffet H, Caron F, Ouellet D, Paquet J, Nolet L (2006) Effectiveness of continuous passive motion and conventional physical therapy after total knee arthroplasty: a randomized clinical trial. Phys Ther 86:174–185PubMed Denis M, Moffet H, Caron F, Ouellet D, Paquet J, Nolet L (2006) Effectiveness of continuous passive motion and conventional physical therapy after total knee arthroplasty: a randomized clinical trial. Phys Ther 86:174–185PubMed
10.
go back to reference Dupont WD, Plummer WD Jr (1990) Power and sample size calculations. A review and computer program. Control Clin Trials 11:116–128PubMedCrossRef Dupont WD, Plummer WD Jr (1990) Power and sample size calculations. A review and computer program. Control Clin Trials 11:116–128PubMedCrossRef
11.
go back to reference Han I, Chang CB, Choi JA, Kang YG, Seong SC, Kim TK (2007) Is the degree of osteophyte formation associated with the symptoms and functions in the patellofemoral joint in patients undergoing total knee arthroplasty? Knee Surg Sports Traumatol Arthrosc 15:372–377PubMedCrossRef Han I, Chang CB, Choi JA, Kang YG, Seong SC, Kim TK (2007) Is the degree of osteophyte formation associated with the symptoms and functions in the patellofemoral joint in patients undergoing total knee arthroplasty? Knee Surg Sports Traumatol Arthrosc 15:372–377PubMedCrossRef
12.
go back to reference Huang HT, Su JY, Wang GJ (2005) The early results of high-flex total knee arthroplasty: a minimum of 2 years of follow-up. J Arthroplasty 20:674–679PubMedCrossRef Huang HT, Su JY, Wang GJ (2005) The early results of high-flex total knee arthroplasty: a minimum of 2 years of follow-up. J Arthroplasty 20:674–679PubMedCrossRef
13.
go back to reference Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the knee Society clinical rating system. Clin Orthop Relat Res 248:13–14PubMed Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the knee Society clinical rating system. Clin Orthop Relat Res 248:13–14PubMed
14.
go back to reference Kim JM, Moon MS (1995) Squatting following total knee arthroplasty. Clin Orthop Relat Res 313:177–186PubMed Kim JM, Moon MS (1995) Squatting following total knee arthroplasty. Clin Orthop Relat Res 313:177–186PubMed
15.
go back to reference Kim YH, Sohn KS, Kim JS (2005) Range of motion of standard and high-flexion posterior stabilized total knee prostheses. A prospective, randomized study. J Bone Joint Surg Am 87:1470–1475PubMedCrossRef Kim YH, Sohn KS, Kim JS (2005) Range of motion of standard and high-flexion posterior stabilized total knee prostheses. A prospective, randomized study. J Bone Joint Surg Am 87:1470–1475PubMedCrossRef
16.
go back to reference Kramer JF, Speechley M, Bourne R, Rorabeck C, Vaz M (2003) Comparison of clinic- and home-based rehabilitation programs after total knee arthroplasty. Clin Orthop Relat Res 410:225–234PubMedCrossRef Kramer JF, Speechley M, Bourne R, Rorabeck C, Vaz M (2003) Comparison of clinic- and home-based rehabilitation programs after total knee arthroplasty. Clin Orthop Relat Res 410:225–234PubMedCrossRef
17.
go back to reference Kumar PJ, McPherson EJ, Dorr LD, Wan Z, Baldwin K (1996) Rehabilitation after total knee arthroplasty: a comparison of 2 rehabilitation techniques. Clin Orthop Relat Res 331:93–101PubMedCrossRef Kumar PJ, McPherson EJ, Dorr LD, Wan Z, Baldwin K (1996) Rehabilitation after total knee arthroplasty: a comparison of 2 rehabilitation techniques. Clin Orthop Relat Res 331:93–101PubMedCrossRef
18.
go back to reference Kurosaka M, Yoshiya S, Mizuno K, Yamamoto T (2002) Maximizing flexion after total knee arthroplasty: the need and the pitfalls. J Arthroplasty 17:59–62PubMedCrossRef Kurosaka M, Yoshiya S, Mizuno K, Yamamoto T (2002) Maximizing flexion after total knee arthroplasty: the need and the pitfalls. J Arthroplasty 17:59–62PubMedCrossRef
19.
go back to reference Li G, Schule SL, Zayontz SJ, Maloney WJ, Rubash HE (2003) Improving flexion in total knee arthroplasty. In: Callaghan JJ, Rosenberg AG, Rubash HE, Simonian PT, Wickiewicz TL (eds) The adult knee, vol 2. Lippincott Williams & Wilkins, Philadelphia, pp 1233–1244 Li G, Schule SL, Zayontz SJ, Maloney WJ, Rubash HE (2003) Improving flexion in total knee arthroplasty. In: Callaghan JJ, Rosenberg AG, Rubash HE, Simonian PT, Wickiewicz TL (eds) The adult knee, vol 2. Lippincott Williams & Wilkins, Philadelphia, pp 1233–1244
20.
go back to reference MacDonald SJ, Bourne RB, Rorabeck CH, McCalden RW, Kramer J, Vaz M (2000) Prospective randomized clinical trial of continuous passive motion after total knee arthroplasty. Clin Orthop Relat Res 380:30–35PubMedCrossRef MacDonald SJ, Bourne RB, Rorabeck CH, McCalden RW, Kramer J, Vaz M (2000) Prospective randomized clinical trial of continuous passive motion after total knee arthroplasty. Clin Orthop Relat Res 380:30–35PubMedCrossRef
21.
go back to reference Mahomed NN, Koo Seen Lin MJ, Levesque J, Lan S, Bogoch ER (2000) Determinants and outcomes of inpatient versus home based rehabilitation following elective hip and knee replacement. J Rheumatol 27:1753–1758PubMed Mahomed NN, Koo Seen Lin MJ, Levesque J, Lan S, Bogoch ER (2000) Determinants and outcomes of inpatient versus home based rehabilitation following elective hip and knee replacement. J Rheumatol 27:1753–1758PubMed
22.
go back to reference Maloney WJ, Schurman DJ, Hangen D, Goodman SB, Edworthy S, Bloch DA (1990) The influence of continuous passive motion on outcome in total knee arthroplasty. Clin Orthop Relat Res 256:162–168PubMed Maloney WJ, Schurman DJ, Hangen D, Goodman SB, Edworthy S, Bloch DA (1990) The influence of continuous passive motion on outcome in total knee arthroplasty. Clin Orthop Relat Res 256:162–168PubMed
23.
go back to reference Montgomery F, Eliasson M (1996) Continuous passive motion compared to active physical therapy after knee arthroplasty: similar hospitalization times in a randomized study of 68 patients. Acta Orthop Scand 67:7–9PubMed Montgomery F, Eliasson M (1996) Continuous passive motion compared to active physical therapy after knee arthroplasty: similar hospitalization times in a randomized study of 68 patients. Acta Orthop Scand 67:7–9PubMed
24.
go back to reference Mulholland SJ, Wyss UP (2001) Activities of daily living in non-Western cultures: range of motion requirements for hip and knee joint implants. Int J Rehabil Res 24:191–198PubMedCrossRef Mulholland SJ, Wyss UP (2001) Activities of daily living in non-Western cultures: range of motion requirements for hip and knee joint implants. Int J Rehabil Res 24:191–198PubMedCrossRef
25.
go back to reference Park KK, Chang CB, Kang YG, Seong SC, Kim TK (2007) Correlation of maximum flexion with clinical outcome after total knee replacement in Asian patients. J Bone Joint Surg Br 89:604–608PubMedCrossRef Park KK, Chang CB, Kang YG, Seong SC, Kim TK (2007) Correlation of maximum flexion with clinical outcome after total knee replacement in Asian patients. J Bone Joint Surg Br 89:604–608PubMedCrossRef
26.
go back to reference Park KK, Shin KS, Chang CB, Kim SJ, Kim TK (2007) Functional disabilities and issues of concern in female Asian patients before TKA. Clin Orthop Relat Res 461:143–152PubMed Park KK, Shin KS, Chang CB, Kim SJ, Kim TK (2007) Functional disabilities and issues of concern in female Asian patients before TKA. Clin Orthop Relat Res 461:143–152PubMed
27.
go back to reference Pope RO, Corcoran S, McCaul K, Howie DW (1997) Continuous passive motion after primary total knee arthroplasty. Does it offer any benefits? J Bone Joint Surg Br 79:914–917PubMedCrossRef Pope RO, Corcoran S, McCaul K, Howie DW (1997) Continuous passive motion after primary total knee arthroplasty. Does it offer any benefits? J Bone Joint Surg Br 79:914–917PubMedCrossRef
28.
go back to reference Rajan RA, Pack Y, Jackson H, Gillies C, Asirvatham R (2004) No need for outpatient physiotherapy following total knee arthroplasty: a randomized trial of 120 patients. Acta Orthop Scand 75:71–73PubMedCrossRef Rajan RA, Pack Y, Jackson H, Gillies C, Asirvatham R (2004) No need for outpatient physiotherapy following total knee arthroplasty: a randomized trial of 120 patients. Acta Orthop Scand 75:71–73PubMedCrossRef
29.
go back to reference Restrepo C, Parvizi J, Dietrich T, Einhorn TA (2007) Safety of simultaneous bilateral total knee arthroplasty. A meta-analysis. J Bone Joint Surg Am 89:1220–1226PubMedCrossRef Restrepo C, Parvizi J, Dietrich T, Einhorn TA (2007) Safety of simultaneous bilateral total knee arthroplasty. A meta-analysis. J Bone Joint Surg Am 89:1220–1226PubMedCrossRef
30.
go back to reference Ritter MA, Gandolf VS, Holston KS (1989) Continuous passive motion versus physical therapy in total knee arthroplasty. Clin Orthop Relat Res 244:239–243PubMed Ritter MA, Gandolf VS, Holston KS (1989) Continuous passive motion versus physical therapy in total knee arthroplasty. Clin Orthop Relat Res 244:239–243PubMed
31.
go back to reference Seon JK, Song EK, Lee JY (2005) Comparison of range of motion of high-flexion prosthesis and mobile-bearing prosthesis in total knee arthroplasty. Orthopedics 28(10 Suppl):s1247–1250PubMed Seon JK, Song EK, Lee JY (2005) Comparison of range of motion of high-flexion prosthesis and mobile-bearing prosthesis in total knee arthroplasty. Orthopedics 28(10 Suppl):s1247–1250PubMed
32.
go back to reference Sullivan MG, Heislein DM, Doherty RF, Fishbein R (2003) Rehabilitation principles after total knee arthroplasty. In: Callaghan JJ, Rosenberg AG, Rubash HE, Simonian PT, Wickiewicz TL (eds) The adult knee, vol 1. Lippincott Williams & Wilkins, Philadephia, pp 455–463 Sullivan MG, Heislein DM, Doherty RF, Fishbein R (2003) Rehabilitation principles after total knee arthroplasty. In: Callaghan JJ, Rosenberg AG, Rubash HE, Simonian PT, Wickiewicz TL (eds) The adult knee, vol 1. Lippincott Williams & Wilkins, Philadephia, pp 455–463
33.
go back to reference Ververeli PA, Sutton DC, Hearn SL, Booth RE Jr, Hozack WJ, Rothman RR (1995) Continuous passive motion after total knee arthroplasty. Analysis of cost and benefits. Clin Orthop Relat Res 321:208–215PubMed Ververeli PA, Sutton DC, Hearn SL, Booth RE Jr, Hozack WJ, Rothman RR (1995) Continuous passive motion after total knee arthroplasty. Analysis of cost and benefits. Clin Orthop Relat Res 321:208–215PubMed
34.
go back to reference Weiss JM, Noble PC, Conditt MA, Kohl HW, Roberts S, Cook KF, Gordon MJ, Mathis KB (2002) What functional activities are important to patients with knee replacements? Clin Orthop Relat Res 404:172–188PubMedCrossRef Weiss JM, Noble PC, Conditt MA, Kohl HW, Roberts S, Cook KF, Gordon MJ, Mathis KB (2002) What functional activities are important to patients with knee replacements? Clin Orthop Relat Res 404:172–188PubMedCrossRef
35.
go back to reference Worland RL, Arredondo J, Angles F, Lopez-Jimenez F, Jessup DE (1998) Home continuous passive motion machine versus professional physical therapy following total knee replacement. J Arthroplasty 13:784–787PubMedCrossRef Worland RL, Arredondo J, Angles F, Lopez-Jimenez F, Jessup DE (1998) Home continuous passive motion machine versus professional physical therapy following total knee replacement. J Arthroplasty 13:784–787PubMedCrossRef
36.
go back to reference Yashar AA, Venn-Watson E, Welsh T, Colwell CW Jr, Lotke P (1997) Continuous passive motion with accelerated flexion after total knee arthroplasty. Clin Orthop Relat Res 345:38–43PubMedCrossRef Yashar AA, Venn-Watson E, Welsh T, Colwell CW Jr, Lotke P (1997) Continuous passive motion with accelerated flexion after total knee arthroplasty. Clin Orthop Relat Res 345:38–43PubMedCrossRef
Metadata
Title
Clinical value of regular passive ROM exercise by a physical therapist after total knee arthroplasty
Authors
Tae Kyun Kim
Kwan Kyu Park
Su Won Yoon
Sung Ju Kim
Chong Bum Chang
Sang Cheol Seong
Publication date
01-10-2009
Publisher
Springer-Verlag
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 10/2009
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-009-0731-2

Other articles of this Issue 10/2009

Knee Surgery, Sports Traumatology, Arthroscopy 10/2009 Go to the issue