Continuous passive motion (CPM) Machine

Posted by brockagain @brockagain, Sep 22, 2023

I can only find messages that are several years old on this subject, so hoping for some information. I am scheduled for left TKR in a couple of weeks. I just received a call that they will be delivering a CPM machine the day before surgery. This was news to me. I had my left TKR in 2018 and did not use a machine and had no problem. Has anyone had experience with and/or without machine?

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I started using the cpm a month after surgery and never did have good ROM. Please use it!

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I started using one right after my surgery and it really helped. I used it for a few weeks or so until I had good range of motion.

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As an RN who worked for years on an orthopedic surgery unit, and having had a TKR almost a year ago, my understanding of postoperative TKR care is that the CPM machine is no longer the accepted standard of care. It was explained to me by my orthopedic surgeon that CPM was found to increase the amount of postoperative pain (and thus increased the use of narcotic pain medication), but did not do much to enhance ROM. What does make a difference is early PT, and the hospital where I had my surgery done uses at-home PT for the initial two weeks after surgery; then outpatient PT. All that being said, your surgeon may believe otherwise, and you need to do what makes you the most comfortable,

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I had bilateral TKAs (three months apart) and also a THA (left hip) and now a Reverse shoulder arthroplasty. (My years of over enthusiastic exercising with weights, etc., may have been partially responsible but I loved it.)
I was told after all three surgeries that the best PT would be walking. So walk I did -- up and down the hotel walls at first and then the streets. I never needed PT, per se. I just walked and walked for miles. At first with a walker and then without. With my hip, I discarded the walker after four days after asking my care team.
I had minimal pain with any of these surgeries. With the hip and shoulder I needed only tylenol and some Celebrex too.

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@nursefran68

As an RN who worked for years on an orthopedic surgery unit, and having had a TKR almost a year ago, my understanding of postoperative TKR care is that the CPM machine is no longer the accepted standard of care. It was explained to me by my orthopedic surgeon that CPM was found to increase the amount of postoperative pain (and thus increased the use of narcotic pain medication), but did not do much to enhance ROM. What does make a difference is early PT, and the hospital where I had my surgery done uses at-home PT for the initial two weeks after surgery; then outpatient PT. All that being said, your surgeon may believe otherwise, and you need to do what makes you the most comfortable,

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My surgeon said the same about CPM machines no longer being used much postoperatively, and does not use them. I wonder though, if there are cases where they should be, if the patient is in a situation where they won't or can't do the rehab exercises on their own for whatever reason. It seems to me that forced motion, even if it does not go to the extreme stretch, is better than doing nothing. When my brother-in-law had his TKR done around 15 years ago, while in the hospital, he would turn on his CPM machine to run much of the time, over and above what the nurses would set it for. He did not have it at home. He had a very good recovery, and knowing him, I doubt he spent as much time going to rehab as I did. But everyone is different, and what works for some may not work for everyone.

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