Randomized Controlled Trial of the Effectiveness of Continuous Passive Motion After Total Knee Replacement

Objective

To determine the effects of using a continuous passive motion (CPM) device for individuals with poor range of motion (ROM) after a total knee replacement (TKR) admitted for postacute rehabilitation.

Design

Randomized controlled trial.

Setting

Inpatient rehabilitation facility (IRF).

Participants

Adults (N=141) after TKR with initial active knee flexion <75° on admission to the IRF.

Intervention

Two randomized groups: group 1 (n=71) received the conventional 3 hours of therapy per day, and group 2 (n=70) received the addition of daily CPM use for 2 hours throughout their length of stay.

Main Outcome Measures

The primary outcome measure was active knee flexion ROM. Secondary outcome measures included active knee extension ROM length of stay, estimate of function using the FIM and Timed Up and Go test, girth measurement, and self-reported Western Ontario and McMaster Universities Osteoarthritis Index scores.

Results

All subjects significantly improved from admission to discharge in all outcome measures. However, there were no statistically significant differences in any of the discharge outcome measures of the CPM group compared with the non-CPM group.

Conclusions

CPM does not provide an additional benefit over the conventional interventions used in an IRF for patient after TKR, specifically in patients with poor initial knee flexion ROM after surgery.     

人工膝关节置换术后连续被动活动对关节功能的影响

目的观察连续被动活动(CPM)对人工膝关节置换术后膝关节功能的恢复情况,进行临床对照研究评估连续被动活动在全膝置换术后康复中的作用。方法将本院行首次全膝置换的44例患者以单纯随机抽签方法分成两组,23例术后除行物理康复治疗外辅助应用CPM康复治疗,21例患者仅行物理康复治疗。对所有患者进行术后随访,记录术后第7,10,14天,6周,6个月及1年时的关节活动范围(ROM)。结果与未应用CPM组相比,应用CPM组患者平均膝关节活动度在术后7,10,14d,6周,3,6个月及1年时分别多19°,15°,10°,8°,8°,2°和5°(t=4.763,3.621,3.529,2.614,2.507,2.178,2.117,P<0.05)。结论CPM有助于全膝置换患者术后较早恢复膝关节活动度。     

Exercise combined with continuous passive motion or slider board therapy compared with exercise only: a randomized controlled trial of patients following total knee arthroplasty

BACKGROUND AND PURPOSE: The primary purpose of this randomized controlled trial was to determine which method of mobilization - (1) standardized exercises (SE) and continuous passive motion (CPM), (2) SE and slider board (SB) therapy, using an inexpensive, nontechnical device that requires minimal knee active range of motion (ROM), or (3) SE alone-achieved the maximum degree of knee ROM in the fIrst 6 months following primary total knee arthroplasty (TKA). The secondary purpose was to compare health-related quality of life among these 3 groups. SUBJECTS: The subjects were 120 patients (n=40/group) who received a TEA at a teaching hospital between June 1997 and July 1998 and who agreed to participate in the study. METHODS: Subjects were examined preoperatively, at discharge, and at 3 and 6 months after surgery. The examination consisted of measurement of knee ROM and completion of the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index and the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). RESULTS: The 3 treatment groups were similar with respect to age, sex, and diagnosis at the start of the study. There were no differences in knee ROM or in WOMAC Osteoarthritis Index or SF-36 scores at any of the measurement intervals. The rate of postoperative complications also was not different among the groups. DISCUSSION AND CONCLUSION: When postoperative rehabilitation regimens that focus on early mobilization of the patient are used, adjunct ROM therapies (CPM and SB) that are added to daily SE sessions are not required. Six months after TEA, patients attain a satisfactory level of knee ROM and function.     

Poster 4: Comparative efficacy of 3 in-hospital rehabilitation programs on knee flexion after total knee arthroplasty: a randomized controlled trial

Objective: To compare the efficacy of 3 in-hospital rehabilitation programs with and without continuous passive motion (CPM) on knee flexion after a primary total knee arthroplasty (TKA). Design: Randomized controlled trial. Setting: Acute care hospital. Patients: 81 patients who underwent a TKA for a diagnosis of osteoarthritis were randomly assigned to 3 groups immediately after TKA: group I: conventional rehabilitation (CONV) only (n=27); group II: CONV and CPM 35min/d (n=26); and group III: CONV and CPM 2h/d (n=28). Interventions: Rehabilitation programs began the day after TKA and continued once a day until discharge. All patients were evaluated twice: before TKA and 7 to 8 days after. Main Outcome Measure: The primary measure was active knee flexion as measured with a manual goniometer in seated position by a physical therapist blinded to the study. Results: Patients’ baseline characteristics were similar. No difference between groups was found for knee flexion after intervention (ANOVA, P=.33; 95% CI of group differences: groups I-II: −5.8° to 9.2°; groups I-III: −10.3° to 4.5°; groups II-III: −12.1° to 2.9°). Conclusion: Our results did not support the use of CPM, as applied in this study, during the acute phase of rehabilitation after TKA.     

人工膝关节置换术早期康复的卫生经济学评价

目的:探讨早期康复治疗对人工膝关节置换术(TKA)的卫生经济学影响。方法:TKA患者64例,随机分为对照组与康复组各32例,对照组给予常规骨科治疗、骨科康复知识宣教与连续被动运动(CPM)机训练等;康复组此基础上加入早期康复介入治疗。术后第2天与出院前采用关节活动度(ROM)、肢体周径、日常生活活动能力(ADL)评分、美国特种外科医院评分系统(HSS)等指标评定2组患者功能恢复效果;采用平均住院日、住院各项费用等指标评估2组患者经济效果。结果:2组患者出院时与术后第2天比较,ROM、ADL、HSS均有显著改善(P0.05),且康复组以上指标均优于对照组(P0.05)。康复组平均住院日明显低于对照组(P0.05),2组住院费用差别无统计学意义。结论:早期康复治疗可有效改善TKA患者功能状态,缩短患者住院周期,增加床位周转率,是值得临床推广的有效、经济、合理的治疗方法。     

Continuous Passive Motion After Total Knee Arthroplasty: A Systematic Review and Meta-analysis of Associated Effects on Clinical Outcomes

ObjectiveTo evaluate the efficacy of continuous passive motion (CPM) after total knee arthroplasty (TKA) and whether the use of CPM is related to improved clinical and functional outcomes.Data SourcesA systematic MEDLINE search via Web of Science, Cochrane Library, and PubMed databases was conducted.Study SelectionEnglish-language articles published between January 2000 and May 2018 reporting the related clinical outcomes of CPM after TKA were included. A total of 3334 titles and abstracts were preliminarily reviewed, of which 16 studies were included according to the eligibility criteria.Data ExtractionTwo different reviewers were selected to perform the study extraction, independent of each other. If there were any disagreements regarding the final list of studies, the third reviewer reviewed the list as an arbitrator for completeness.Data SynthesisA total of 16 trials with 1224 patients were included. The pooled results revealed that use of CPM did not show a statistically significant improvement of postoperative knee range of motion (ROM) except for middle-term passive knee extension and long-term active knee flexion ROM. Also, CPM therapy did not show a significant positive effect on the functional outcomes. No significant reduction in length of stay (LOS) and incidence of adverse events (AEs) was identified.ConclusionAmong patients undergoing TKA, neither the ROM nor the functional outcomes could be improved by CPM therapy. Moreover, the risk of AEs and LOS could not be reduced by application of CPM. The current available evidence suggested that this intervention was insufficient to be used routinely in clinical practice.     

Short-Term Effect of Peer Volunteers in Providing Inpatient Rehabilitative Exercises for Patients After Total Knee Arthroplasty

ObjectiveTo investigate the short-term outcomes at discharge of patients who receive additional postoperative rehabilitative exercises by peer volunteers after total knee arthroplasty (TKA).DesignRetrospective cohort study.SettingTertiary teaching hospital.ParticipantsA total of 476 adult patients who had undergone a primary elective unilateral TKA (N=467).InterventionsAn intervention group received a standardized postoperative rehabilitative exercise protocol taught and supervised by peer volunteers in additional to standard physiotherapy (n=309) compared with a control group receiving standard physiotherapy alone (n=167).Main Outcome MeasuresDischarge outcomes were the pain score using the Numeric Rating Scale pain score, passive knee flexion and extension range of motion (ROM), length of hospitalization, ability to perform an unassisted straight leg raise of the operated leg, ambulation distance, ability in independent walking, walking aids required, discharge destination, and adverse events.ResultsOn multivariate analysis, patients in the intervention group had an increased discharge passive knee flexion ROM of 7.89 degrees (95% confidence interval, 5.47-10.33; P<.001). There were no significant differences for the other outcome measures between the intervention and control group.ConclusionsA rehabilitative exercise program by peer volunteers is feasible and safe after TKA in addition to standard physiotherapy and is associated with improved knee flexion ROM on discharge.     

Continuous passive motion after total knee arthroplasty: a prospective study

OBJECTIVE: Continuous passive motion (CPM) has been shown to increase significantly the amount of knee flexion for patients with total knee arthroplasty in the acute care hospital. Whether there is any additional benefit to using CPM for these patients who are transferred to a rehabilitation hospital is not known. There have been no prospective, randomized, controlled studies in this area. DESIGN: Fifty-one such patients on an inpatient rehabilitation service were randomly assigned to two groups. Group 1 (n = 23) received CPM for 5 consecutive hours per day plus physical therapy, whereas group 2 (n = 28) received only physical therapy. Knee flexion was measured by a blinded physical therapist on admission, on the third and seventh days of hospitalization, and at the time of discharge. RESULTS: The results indicated no significant difference in passive range of motion between group 1 and group 2. Patients in group 1 achieved an average increase in passive range of motion of 16 degrees, whereas those in group 2 achieved an average of 19 degrees (P = 0.33). CONCLUSION: Although power analysis indicated the need for differences in results for 32 patients per group to achieve significance, the difference between the two groups suggested neither statistical nor clinical significance. We concluded that the use of CPM in the rehabilitation hospital is likely of no added benefit to patients admitted after single total-knee replacement.     

远程康复指导对全膝关节置换术后膝关节功能的影响

目的:探讨远程指导的家庭康复治疗对全膝关节置换(TKA)术后患者膝关节功能恢复的影响。方法:TKA术后患者120例,随机分成观察组和对照组各60例,2组患者在住院期间均进行早期康复治疗,对照组出院后在家中继续延续院内训练方式自行训练。观察组患者在家通过远程家庭康复指导进行康复,两组患者均由同一康复治疗师在治疗前、术后1、3、6、9和12周,分别采用骨关节指数(WOMAC)、关节活动度(ROM)进行膝关节功能评定。结果:治疗1、3、6、9及12周后,2组WOMAC指数(疼痛,功能障碍,僵硬程度)均较治疗前明显下降(P0.05),2组膝关节主、被动ROM均较治疗前明显提高(P0.05);且观察组在出院后(治疗6、9及12周后),WOMAC指数(膝关节疼痛、功能障碍和僵硬程度)较对照组下降更显著(P0.05),膝关节主、被动ROM较对照组提高更显著(P0.05)。结论:远程指导的家庭康复治疗对TKA术后患者膝关节功能具有较好的疗效,值得临床推广。     

Continuous passive motion in the postoperative treatment of patients with total knee replacement. A retrospective study

The purpose of this study was to evaluate the effects of adding three 1-hour sessions of continuous passive motion (CPM) each day to the entire postoperative program of patients who received a total knee replacement (TKR). A retrospective chart review was completed for 55 patients (8 with bilateral involvement, totaling 63 knees) who received a TKR between 1981 and 1984. The data analysis compared the following variables for 32 patients who received CPM and 23 patients who received no CPM: the length of hospital stay (LOS), the number of postoperative days (PODs) before discharge, the frequency of postoperative complications, and the knee range of motion at discharge. The CPM Group showed significant decreases in the frequency of complications (p less than .05), the LOS (p less than .01), and in the number of PODs (p less than .001). No difference was demonstrated in the ROM of the two groups. These results support the use of postoperative applications of CPM, but not as strongly as those reported from studies that used longer periods of CPM. Further research is indicated to delineate the minimum dosage of CPM needed to obtain the maximum beneficial effects.     

髌骨骨折后影响屈膝功能恢复的相关因素分析

目的探讨髌骨骨折后影响屈膝功能恢复的相关因素,预测中、短期康复疗效.方法髌骨骨折后膝关节屈曲功能受限者23例,接受门诊常规康复治疗,其中部分患者配合局部热疗.结果康复前屈膝度数(X1)、髌骨后缘不平整(X2)、关节制动时间(X3)是影响康复后1个月膝关节屈曲度数(Y1)和康复后3个月膝关节屈曲度数(Y2)的相关因素,Y1亦受到手术治疗(X4)的影响(部分回归系数P<0.05).屈膝功能恢复的回归方程Y1=49.327+0.736X1-11.977X2-0.137X3-10.826X4;Y2=78,037+0.535X1-25.779X2-0.158X3.23例Y1和Y2的平均理论值和实测值相差分别是5.6%和4.2%.结论康复前屈膝度数、髌骨后缘是否平整、关节制动时间长短是影响髌骨骨折后中、短期屈膝功能恢复的相关因素,其中短期恢复亦受到是否手术治疗的影响,回归方程可作为对中、短期康复效果的初步预测.     

The use of Continuous Passive Motion (CPM) in the rehabilitation of patients after total knee arthroplasty

Background. Total knee alloplasty (TKA) is standard treatment for advanced gonarthrosis. Proper rehabilitation of the operated joint and the patient is essential in order to achieve a satisfactory functional outcome. The aim of our study was to compare rehabilitation methods used for patients recovering from TKA in the Orthopedic Clinic of the Medical University in ?ód?, Poland. Material and methods. We studied 186 patients operated for advanced gonarthrosis, ranging in age from 29 to 80 (average 65.8), who had received 197 endoprotheses. From 1986 to 1989 the rehabilitation program included isometric exercises of the muscles in the operated joint, general fitness exercises in bed, and passive exercises of the knee conducted by a physiotherapist. The average stay during this period was 19.7 +/- 2.5 days. In 1989, continuous passive motion (CPM) using an electric rail was introduced to the rehabilitation program. Results. Thanks to the earlier additional flexibility of the operated joint, active exercises and weight bearing on the operated limb could be accelerated. The patients left the Clinic 2 weeks after surgery (13.6 +/- 2.5 days). The change in the rehabilitation program produced a statistically significant increase in the average range of flexion in the operated joint (p = 0.000001) in a significantly shorter time (p = 0.0000). Conclusion. Introducing CPM to the rehabilitation of TKA patients accelerates their progress and reduces hospitalization time, which improves the patients' emotional comfort and enables a faster return to an active life in society.     

Continuous Passive Motion Following Primary Total Knee Arthroplasty:short- and Long-term Effects on Range of Motion

Abstract

Study design: a systematic review of randomised controlled trials.

Background: Knee arthroplasties are a common surgical procedure for patients suffering from knee osteoarthritis. Continuous passive motion (CPM) is frequently used to increase range of motion (ROM) in the knee and promote rapid postoperative recovery of patients undergoing total knee arthroplasty (TKA). Many clinical trials have tried to assess its efficacy, but results have been contradictory.

Objectives: To review the efficacy in terms of ROM of CPM in the postoperative management of patients undergoing TKA.

Methods: Medline, Embase, Cinahl and Cochrane databases and bibliographic indexes and relevant citations were searched. All relevant studies were assessed for methodological quality using a validated scoring instrument.

Data collection and analysis: Two reviewers independently extracted data and assessed trial quality. Results of a meta-analysis of ROM data were divided into short-term effects (i.e. 7-14 days after surgery) and long-term effects (i.e. 6-12 months after surgery). Where possible, data from individual trials were combined in a meta-analysis. Data were analysed using weighted mean differences (WMD with 95% confidence intervals [CI]) between treatment and control groups in the short and long term, weight being the inverse of variance.

Main results: Fifteen studies investigating the effect of continuous passive motion in the management of TKA patients were included in the review. Study quality ranged from poor (2 points on a 10-point scale) to good (8 points). The evidence on the efficacy of CPM after TKA is conflicting. Positive short-term effects of adding CPM to standardised physical therapy (PT) have been reported on flexion ROM. Five studies were included in a pooled analysis, for a total of 317 patients (pooled effect size WMD 8.27; 95% CI -1.60, 18.15)

Conclusions: There is evidence of a moderate positive, short-term effect of adding CPM to standardised PT after total knee arthroplasty. There is no relevant long-term effect of CPM use.     

Pre-arthroplasty rehabilitation is effective in reducing hospital stay

BACKGROUND: The purpose of the trial was to evaluate the effect on length of stay of individually tailored rehabilitation for clients who were undergoing hip or knee arthroplasty. METHOD: Clients (n = 133) with complex needs (comorbid conditions or limited social support) were randomly assigned to receive preoperative usual care (UC) or rehabilitation (R). Usual care clients received a single preoperative clinic visit. Rehabilitation clients were individually assessed and received multi disciplinary rehabilitation to optimize functional capacity, education about the in-hospital phase and early discharge planning. All rehabilitation subjects received interdisciplinary counseling/education focused on preparation for discharge home. The intervention for approximately half the rehabilitation clients was a single, cost-effective session, while others received physical conditioning. RESULTS: Clients receiving rehabilitation achieved discharge criteria earlier (R = 5.4, UC = 8 days) and had a shorter actual length of stay (R = 6.5, UC = 10.5 days). CLINICAL IMPLICATIONS: This preoperative, individually tailored, rehabilitation program reduced length of stay.     

Continuous passive motion compared with intermittent mobilization after total knee arthroplasty. Elaboration of French clinical practice guidelines.

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.     

Which factors affect the duration of inpatient rehabilitation after total knee arthroplasty in the absence of complications?

ObjectiveThe aim of this study was to determine which preoperative factors might predict the duration of inpatient rehabilitation for total knee arthroplasty (TKA) patients in the absence of complications.MethodsWe included 282 patients who had undergone primary TKA for osteoarthritis. The aim of the rehabilitation program was to recover 90 degrees of active knee flexion and good enough functional status to allow direct discharge to the patient's home. Patients presenting complications were excluded. The following preoperative parameters were recorded: demographic factors, comorbidity, previous lower limb arthroplasty, the presence of a home help, the pain level (on a visual analogue scale, VAS) and functional scores. The length of stay in the orthopaedic surgery unit was also taken into consideration. Predictive factors for the duration of inpatient rehabilitation were analyzed using univariate and then multivariate linear regression.ResultsIn a univariate analysis, the length of stay (24.1 ± 8.1 days) depended on female gender, living alone, the presence of a home help and previous arthroplasty (p < 0.25). However, when these factors were introduced into a multivariate predictive model, only 2% of the variation in the length of stay was accounted for.ConclusionThe duration of inpatient rehabilitation for TKA patients in the absence of complications cannot be statistically modelled from the preoperative parameters studied here.     

Effectiveness of intensive rehabilitation on functional ability and quality of life after first total knee arthroplasty: A single-blind randomized controlled trial

OBJECTIVE: To evaluate the effectiveness of a new intensive functional rehabilitation (IFR) program on functional ability and quality of life (QOL) in persons who underwent a first total knee arthroplasty (TKA). DESIGN: Randomized controlled trial. SETTING: Ambulatory care. PARTICIPANTS: Seventy-seven people with knee osteoarthritis. INTERVENTION: Two months after TKA, subjects were randomly assigned to either a group with IFR (n=38), who received 12 supervised rehabilitation sessions combined with exercises at home between months 2 and 4 after TKA, or to a control group (n=39), who received standard care. All participants were evaluated by a blind evaluator at baseline (2mo after TKA), immediately after IFR (2mo later; POST1), and 2 and 8 months later (POST2 and POST3).Main outcome measures The primary outcome measure with respect to effectiveness was the 6-minute walk test (6MWT) at POST2. Secondary outcome measures were the 6MWT at the other evaluations and the Western Ontario and McMaster Universities Osteoarthritis Index and Medical Outcomes Study 36-Item Short-Form Health Survey. RESULTS: Subjects in the IFR group walked longer distances (range, 23-26m) in 6 minutes at the 3 POST evaluations than subjects in the control group. At POST1 and POST2, they also had less pain, stiffness, and difficulty in performing daily activities. Positive changes in QOL in favor of the IFR were found only at POST2. CONCLUSIONS: The IFR was effective in improving the short-term and mid-term functional ability after uncomplicated primary TKA. The magnitude of the IFR effect on the primary outcome was modest but consistent. More intensive rehabilitation should be promoted in the subacute recovery period after TKA, to optimize functional outcomes in the first year after surgery.     

Is discharge knee range of motion a useful and relevant clinical indicator after total knee replacement? Part 2

Objective Knee range of motion (ROM) at discharge from acute care is used as a clinical indicator following total knee replacement (TKR) surgery. This study aimed to assess the clinical relevance of this indicator by determining whether discharge knee ROM predicts longer‐term knee ROM and patient‐reported knee pain and function. Methods A total of 176 TKR recipients were prospectively followed after discharge from acute care. Outcomes assessed included knee ROM and Oxford knee score post rehabilitation and 1 year post surgery. Discharge ROM and other patient factors were identified a priori as potential predictors in multiple linear regression modelling. Results A total of 133 (76%) and 141 (80%) patients were available for follow‐up post rehabilitation [mean postoperative week 8.1 (SD 2.7)] and at 1 year [mean postoperative month 12.1 (SD 1.4)], respectively. Greater discharge knee flexion was a significant (P < 0.001) predictor of greater post‐rehabilitation flexion but not 1‐year knee flexion (P < 0.083). Better discharge knee extension was a significant predictor of better post‐rehabilitation (P = 0.001) and 1‐year knee extension (P = 0.013). Preoperative Oxford score and post‐rehabilitation knee flexion independently predicted post‐rehabilitation Oxford score, and gender predicted 1‐year Oxford score. Discharge ROM did not significantly predict Oxford score in either model. Conclusion The finding that early knee range predicts longer‐term range provides clinical evidence favouring the relevance of discharge knee ROM as a clinical indicator. Although longer‐term patient‐reported knee pain and function were not directly associated with discharge knee ROM, they were associated with ROM when measured concurrently in the sub‐acute phase. No causal effect has been demonstrated, but the findings suggest it may be important for physiotherapists to maximize range in the early and sub‐acute periods.     

Modelling knee range of motion post arthroplasty: clinical applications

Purpose: To model change in knee range of motion (ROM) post total knee arthroplasty (TKA) and to show how this information can be incorporated into clinical decision making.Method: We applied a variable-occasion repeated-measures study design. Patients' knee flexion and extension ROM were assessed pre- and post arthroplasty over the ensuing 60 weeks. We examined change in ROM post TKA using linear and nonlinear mixed-effects modelling, and examined whether age, body mass index, prearthroplasty ROM, and gender were determinants of recovery in post-arthroplasty ROM.Results: Of 93 eligible patients, 74 provided pre- and post-arthroplasty data. A random intercept nonlinear model fit the flexion data best, and a random intercept linear model fit the extension data best. Pre-arthroplasty ROM was found to be a determinant of recovery in ROM post arthroplasty. This finding was common to both flexion and extension models.Conclusions: Our study showed that the greatest improvement for knee ROM took place during the first 12 weeks post arthroplasty. Of the variables examined, only pre-arthroplasty ROM was a determinant of outcome (p<0.05). The study results provide clinicians with data to determine expected rates of improvement for patients as well as the projected maximum ROM, facilitating improved clinical decision making.     

全膝关节置换后系统康复的随机对照

背景:国内外对人工全膝关节置换后的康复有较多的研究,但往往局限于一种康复方法。目的:分析系统康复对人工全膝关节置换后康复进程的影响。方法:选择行单侧人工全膝关节置换的50例骨性关节炎患者,随机分为两组,干预组置换前给予康复指导,置换后由康复治疗师给予康复锻炼,同时行CPM锻炼和冷敷,对照组给予传统CPM锻炼。结果与结论:干预组置换后24h～6d疼痛目测类比评分均低于对照组(P<0.05),置换后2d～6周时膝关节活动度高于对照组(P<0.05),置换后2,6周时HSS评分高于对照组(P<0.05),两组均无局部切口并发症发生。说明人工全膝关节置换后系统康复可加快康复进程,减轻患者疼痛,改善关节活动度,且不会增加并发症。