Rehabilitation and Assessment of Knee Function After Total Knee Arthroplasty

Abstract

The continuous passive motion (CPM) machine has been a tremendous advance in the postoperative care of total knees. We begin motion in the recovery room at 20–30° at the rate of one flexion per minute. Patients tolerate the activity quite well. The patient will continue in the CPM machine except at night until flexion of 90° is achieved. This is usually present by 1 week postoperatively. Active motion is begun on the third postoperative day. The only reason for cessation of active range of motion or continuous passive motion is the onset of drainage. Because the infection rate was 5% in total knees with drainage compared to 0% in those without [1], we recommend that whenever drainage is present the knee be immobilized (canvas knee splint) until the wound is sealed. Three years ago we did not begin range of motion until the tenth postoperative day and now, with constant passive motion, the patient is discharged from the hospital by the tenth postoperative day!