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Guideline Continuous passive motion compared with intermittent mobilization after total knee arthroplasty. Elaboration of French clinical practice guidelines. 2007
Postel JM, Thoumie P, Missaoui B, Biau D, Ribinik P, Revel M, Rannou F, Anonymous00070. · Clinique Arago, 95, boulevard Arago, 75014 Paris, France. · Ann Readapt Med Phys. · Pubmed #17412445 No free full text.
Abstract: OBJECTIVE: To develop clinical practice guidelines concerning the use of continuous passive motion (CPM) compared with intermittent mobilization after total knee arthroplasty (TKA). METHOD: We used the SOFMER (French Physical Medicine and Rehabilitation Society) methodology, combining systematic literature review and collection of everyday clinical practice concerning postoperative rehabilitation techniques and external review by a multidisciplinary expert panel, to develop the guidelines. RESULTS: The literature contains no evidence of the advantages of CPM over other techniques of mobilization, although CPM could be adjuvant therapy used to accelerate short-term recovery. However, in France, CPM remains widely used after TKA, both in orthopedic surgery units and in physical medicine and rehabilitation services. CONCLUSION: Good methodological quality studies are needed to assess different CPM modalities and compare them to alternative intermittent mobilization techniques, particularly those with therapy starting from a flexed position.
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Review [Knee orthosis. Evaluation of clinical efficiency with a review of the literature] 2002
Thoumie P, Sautreuil P, Mevellec E. · Service de reééducation neuro-orthopédique, hôpital Rothschild, 33, boulevard de Picpus, 75012 , Paris, France. · Ann Readapt Med Phys. · Pubmed #11844590 No free full text.
Abstract: INTRODUCTION: The aim of this work was to collect literature data to assess the knee orthosis use with controlled clinical trials. METHOD: The international literature relating to the years 1980-2000 was carried out with the Medline data bank. RESULTS: Five hundred and twelve articles were collected and 35 were retained, 32 related to clinical studies and three related to toxicity. The evaluations were performed with either functional tests or clinical studies. The open-non controlled clinical trials are far higher than prospective comparative clinical trials that were developed only during last years. Main criteria of judgement are articular stability, functional pain and clinical index. Most of studies focused the anterior cruciate ligament lesions, patellar pains and osteoarthritis. DISCUSSION: This review of the literature may help to determine the interest and the limits of orthosis use as well as side effect occurrence. Both these clinical and experimental data point out the methodological difficulties facing the investigatory clinician in knee orthosis evaluation.CONCLUSION: Many studies contributed to the clinical evaluation of the knee orthosis. This work highlights various clinical indications for the same orthosis and variable results for the same indication. These methodological difficulties may not prevent a further evaluation of these devices to improve their use in current practice.
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