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Early outcome measurement of the effectiveness of conventional physical therapy versus continuous passive motion in knee function following retrograde femoral nailing—a prospective randomized controlled trial

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A Letter to the Editor to this article was published on 31 August 2023

Abstract

Purpose

This study evaluated the efficacy of continuous passive motion (CPM) versus conventional physical therapy (CPT) in the early postoperative period following retrograde femoral nailing (RFILN). Based on the principles of operation of CPM, we hypothesized that it would improve knee function and decrease pain after open reduction and internal fixation with a retrograde femoral interlocking nail.

Patients and methods

Eighty-eight patients over the age of 18 years who met the inclusion criteria got randomized into one of two groups. The experimental group had CPM, while the control group had CPT. Postoperative knee functions assessed were the degree of knee stiffness, the total arc of motion, and knee pain. Knee stiffness, defined as the range of motion ≤ 90° assessed one week, two weeks, and six weeks postoperatively, while knee pain was measured using the visual analog scale (VAS) on days one, two, three, four, five, six and seven postoperatively.

Results

The CPM group had a significantly lower incidence of knee stiffness at one week, two weeks, and six weeks postoperatively than the CPT group (all p < 0.0001). The VAS scores of the CPM group on days one, two, three, four, five, six and seven were significantly lower than those of the CPT group (p < 0.006 for day one and p < 0.001 for the remaining days). Similarly, the total arc of motion gained postoperatively was significantly greater in the CPM group than in the CPT (all p < 0.001).

Conclusion

The continuous passive motion effectively reduced the number of patients with knee stiffness and knee pain. It increased the total arc of motion in the early postoperative period compared to CPT. Therefore, we recommend CPM for patients undergoing retrograde femoral nailing use in the early postoperative period.

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Data Availability

The data for this study is available upon reasonable request from the corresponding author.

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Authors and Affiliations

  1. Department of Surgery, Faculty of Clinical Medicine and Dentistry, Kampala International University (Western Campus), Ishaka-, Bushenyi, Uganda

    Anthony Ayotunde Olasinde & Joshua Muhumuza

  2. Department of Orthopaedic Surgery, Federal Medical Centre, Owo, Ondo State, Nigeria

    Anthony Ayotunde Olasinde & Olusegun Olisa

  3. Department of Surgery, College of Medicine, Ekiti State University, Ado-Ekiti, Ekiti State, Nigeria

    Kehinde Sunday Oluwadiya

Authors
  1. Anthony Ayotunde Olasinde
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  2. Olusegun Olisa
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  3. Joshua Muhumuza
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  4. Kehinde Sunday Oluwadiya
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Contributions

Anthony Ayotunde Olasinde developed the concept, wrote the article, and gave it to other authors for their contributions. Olusegun Olisa wrote the initial proposal, collected the data, and funded the work; Joshua Muhumuza did the statistical analysis and contributed to the writing; and Kehinde Sunday Oluwadiya was involved in the formatting and correction of the manuscript. All authors have read and agreed to the submission to this journal.

Corresponding author

Correspondence to Anthony Ayotunde Olasinde.

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Ethical approval

This study was performed in accordance with the principles of the Declaration of Helsinki. Approval was granted by the Health Research Ethics Committee of the Federal Medical Center, Owo, Ondo State, Nigeria. (Date: 25th March 2014./No FMC/OW.380/VOL.XXI/124).

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Informed consent was obtained from all individual participants included in the study.

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The authors declare no competing interests.

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Olasinde, A.A., Olisa, O., Muhumuza, J. et al. Early outcome measurement of the effectiveness of conventional physical therapy versus continuous passive motion in knee function following retrograde femoral nailing—a prospective randomized controlled trial. International Orthopaedics (SICOT) 47, 2085–2093 (2023). https://doi.org/10.1007/s00264-023-05854-2

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  • DOI: https://doi.org/10.1007/s00264-023-05854-2

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