The purpose of this study was to examine the effects of continuous passive motion (CPM) immediately following an arthroscopically assisted anterior cruciate ligament reconstruction (ACL) utilizing a bone patella bone (BPTB) autograft on the clinical signs of the inflammatory phase of soft tissue healing. The clinical signs that were examined are acute pain, swelling, and knee function. During the inflammatory phase, the study investigated the relationship between CPM and blood loss when utilizing a hemovac drain during the first post-operative 24 hours. Another purpose of this study was to determine the effects of CPM during the fibroplastic phase of soft tissue healing. During this phase, the relationship between CPM and swelling, and CPM and knee function was also investigated.
Thirty patients (15-45 yrs. old) participated in this study. The patients in this study were randomly placed into one of four groups. The first (chronic ACL) (n = 11) and second (acute ACL) (n = 4) groups used the CPM and began knee motion immediately following surgery. The third (chronic ACL (n = 9) and fourth (acute ACL) (n = 6) groups did not use the CPM following the surgery. All groups followed an identical post-operative rehabilitation program with the exception of the CPM groups using a CPM device. The design of this study included the collection of data during the inflammatory (1-3 days postsurgery) and fibroplastic phases (4-21 days postsurgery) of soft tissue healing.
The results indicated that the initiation of CPM immediately following an ACL reconstruction had a significant ($<$.05) effect on decreasing the amount of medication consumed by the patient, and a significant ($<$.05) decrease in the patient's need for medication during the inflammatory phase. There was no statistical significance in the level of perceived pain between the groups. Patients that received CPM had a significantly ($<$.01) greater decrease in joint ellusion and hemarthrosis during the inflammatory phase. The use of CPM during the fibroplastic phase resulted in a significant ($<$.025) decrease in hemarthrosis. There was no statistically significant difference in the amount of blood that was collected in the hemovac between groups. There was a statistically greater ($<$.05) increase in the degrees of active and passive knee flexion attained by patients that utilized CPM during the inflammatory and fibroplastic phases. No statistically significant difference was found between groups in the degrees of knee extension during these phases of soft tissue healing.
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McCarthy, M. R. (1990). The effects of immediate continuous passive motion on the clinical signs of soft tissue healing following an anterior cruciate ligament reconstruction. University of Virginia). ProQuest Dissertations and Theses, , 128-128 p.
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