A critical appraisal of “Prospective Randomized Trial of the Efficacy of Continuous Passive Motion Post Total Knee Arthroplasty: Experience of the Hospital for Special Surgery”
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A clinical question about the effectiveness of continuous passive motion (CPM) compared to passive stretching for increasing knee range of motion (ROM) prompted a literature review and a subsequent critical appraisal of a 2015 article by Joshi et al. from The Journal of Arthroplasty. The article was selected based off its recency, strong experimental design, and its relevance to the clinical question. It addressed the ability of CPM to give better outcomes in ROM, clinical outcomes and complications, and discharge disposition for patients following total knee arthroplasty (TKA). This appraisal found that the introduction, methods, results, and discussion sections all had few errors and/or limitations. This prompted strong reasoning to support the results of the article. These results being that CPM therapy after TKA produced no significant differences in ROM gains or the other outcomes, and CPM should be removed from the standard of care to improve hospital costs. These results give an answer to the clinical question in that CPM is probably not any more effective than passive stretching in physical therapy.