Continuous passive motion following total knee arthroplasty in people with arthritis
Bibliographic record
Abstract
BACKGROUND: Total knee arthroplasty is a common intervention for patients with arthritis. Post-surgical rehabilitation often includes continuous passive motion. However, it is not clear whether continuous passive motion is effective. OBJECTIVES: To evaluate the effectiveness of continuous passive motion following total knee arthroplasty in people with arthritis. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2009, Issue 3), MEDLINE (January 1966 to January 2009), EMBASE (January 1980 to January 2009), CINAHL (January 1982 to January 2009), AMED (January 1985 to January 2009) and PEDro (to January 2009). SELECTION CRITERIA: Randomised controlled trials in which the experimental group received continuous passive motion, and both the experimental and control groups received similar postoperative care and therapy following total knee arthoplasty in people with arthritis. DATA COLLECTION AND ANALYSIS: Two reviewers independently selected trials for inclusion. Data were then extracted and the quality of trials assessed. The primary outcomes were active knee flexion range of motion, passive knee flexion range of motion, active knee extension range of motion, passive knee extension range of motion, length of hospital stay, function and incidence of manipulation under anaesthesia. The secondary outcomes were pain, swelling and quadriceps strength. Effects were estimated as weighted mean differences or standardised mean differences with 95% confidence intervals (CI). Meta-analyses were performed using random-effects models for continuous variables. MAIN RESULTS: Twenty randomised controlled trials of 1335 participants met the inclusion criteria. There is high-quality evidence that continuous passive motion increases passive knee flexion range of motion (mean difference 2 degrees, 95% CI 0 to 5) and active knee flexion range of motion (mean difference 3 degrees, 95% CI 0 to 6). These effects are too small to be clinically worthwhile. There is low-quality evidence that continuous passive motion has no effect on length of hospital stay (mean difference -0.3 days; 95% CI -0.9 to 0.2) but reduces the need for manipulation under anaesthesia (relative risk 0.15; 95% CI 0.03 to 0.70). AUTHORS' CONCLUSIONS: The effects of continuous passive motion on knee range of motion are too small to justify its use. There is weak evidence that continuous passive motion reduces the subsequent need for manipulation under anaesthesia.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.012 | 0.058 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.009 | 0.007 |
| Bibliometrics | 0.004 | 0.005 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.004 | 0.002 |
| Insufficient payload (model declined to judge) | 0.006 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".