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Continuous Passive Motion
Introduction
There is sound basic science support for the concept of continuous passive motion (CPM) as an adjunct for the treatment of a joint. It has been shown that this modality can promote chondrogenesis and control hematoma formation and edema after insult. Recognizing that the physiologic response to acute trauma is an inflammatory reaction characterized by swelling and inflammation that often leads to joint stiffness, the use of CPM in this setting would seem advantageous. However, evidence suggests the value is primarily realized when introduced immediately after injury. This fact plus changes in length of hospital stay, limited availability of portable machines and their difficulty of use, and problems with reimbursement have restricted the use of CPM machines since the last publication of this book.
Indications
This modality is used after surgery when there is a need to maintain motion of the elbow. The important distinction is that splints are used to attain motion, while CPM maintains motion. For the reasons mentioned previously, current use of CPM in our practice is limited to postsurgical patients with articulated external fixators (see Chapter 48 ).
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