I think the thing they do not take into account is that you cannot do active PT all day, so when you are sitting watching TV when you are not icing or elevating your leg, the CPM can keep the knee from getting stiff with the passive movement. The lymph system works by moving the joint and moving out the swelling. So it is less about the CPM for PT than keeping the knee active and moving out the fluid.
I had cpm for first knee replacement and I used 2-3 hours a day minimum on top of pt starting the day after surgery in the hospital. I didn't have excessive swelling so it felt like the right thing to do. I was riding my bike 4 mos after surgery with no pain and over 120 degrees of flex. For my second knee replacement I had lots of swelling that caused nerve compression with pain when my leg was lowered below my waist,like sitting or standing. My surgeon, supposedly going by the data, didn't prescribe me a cpm even though I told him for me, it improved my motivation to move a lot more between exercise sessions. Because of discomfort due to the swelling movement came slowly and delayed developing scar tissue that couldn't be addressed thru a single manipulation unde anaesthesia. I've been stuck at a little more than 90 degrees for 1 1/2 years with not much hope for further improvement without additional surgery. I even bought a used cpm 6 mos after surgery but it was to late. Looking back these are my thoughts on the subject, I believe you should give the patient "every available" technology and therapy to at least try. My first replacement I attained over 120 degrees flex, I swear because of the continuous and religious use of the cpm machine, much more than prescribed. If 1 patient out of 200 benefits from it that's all well and good because the surgeon cannot tell who the 1/200 patient will be. To do otherwise gambles with each patient's outcome by withholding therapy's do work for some, those who are really dedicated to get back asap. Over the long haul they say there may be no different, but getting back much quicker is a major benefit. I wouldn't use a surgeon who wouldn't at least let you try a cpm for a few weeks. I rented mine at my expense for an extra 3 months I felt so strongly about the benefit. Remember your milage may very and you won't know what that mileage is until you try everything. Best of luck!
I used a CPM for both my knees in the past year. I was able to sleep with the machine and used it every night for three weeks after each surgery. It was covered by insurance. I feel that it was of benefit. I did my prescribed post-op exercises every day.
I used a CPM machine. It was delivered to my home and the rep set the machine up for me and told me that I needed to use this at least 3 hours a day. My first day home I used it for about 2 hours and then started bleeding and to keep the story short and not be "gross" I ended up in the emergency room and my knee was immobilized in a split for 4 days. I did use the machine after that. I am not sure of the benefits of the machine. But beware and do not be shamed by a medical rep who has not had a knee replacement or used the machine and if it hurts using the machine stop. The machine also hurt my hip and my back. The same rep came back to pick up the machine a month later. He asked how I liked the machine I told him, and I do not think he listened to a word I said, and he did not care. Do the best you can with your rehab exercises and do not let others shame you. Everyone is different. Also do not let them tell if, you do not get back your range of motion within a month that it will not come back. I am proof this is not true... I am playing tennis and no check hockey two of the things I love to do and grateful!
I don't care how much training a physician has but i have to ask "How in the hell can you learn how to do such complex surgery. You guys are amazing in what you do!
Thank you. And lots of practice during 4 years of medical school and 5 years of residency. What is exciting now is virtual reality that is allowing students to practice surgeries over and over wearing a headset and operating in a virtual operating room.
On the video about knee pain at night, your theory is that the knee not moving causes the pain. So you need to wake up and move the knee-and a CPM is perfect for that. I’m on my second TKR, both times with a CPM, and if I could keep it for the first two months I would! Anytime the knee gets stiff or painful, into the CPM I go and the pain is much less in awhile. Yes, I do the active exercises as well. But I’m at three weeks and soon to lose the CPM machine. I’ll really miss it!
Hi Doc!, Enjoy your videos. Currently recovering from my left TKR. 4 1/2 weeks out from surgery. 68 year old, male. Coming along good, I think. When I had my right knee done 2 1/2 years ago, I had a hospital stay of 3 days. Hospital nursing staff put me in the CPM. Doc came in during his rounds and had it removed. He didn't order it or want it. He wanted me up and moving. With my left TKR, I was in surgery at 7:15am and home by 1:15pm same day. Hasn't been a cake walk, but much better than the right. Doing my work at home 3 times daily, and getting my butt kicked in outpatient PT 3 times a week. Doc prescribed me a "Kneehab XP" to use 3x daily for 5 days, with 2 days off. I believe his is helping to strengthen my left quads. Just came back inside from doing some very light yard work. I know the quicker I get into my normal activities, the quicker the pain, stiffness and swelling goes away. I found videos like yours to be very valuable for expectation setting and motivation during this recovery. I know I will get there. Thank you Doctor Rosen and may God continue to bless you, your family and your practice.
I had my TKR last June and had a CPM machine. I do not think it helped me at all. It did aggravate my sciatic nerve on my left side and that made my PT a little more difficult as the sciatic pain really was a downer as it hurt! I will not use this when I have my other knee done. Thank you so much for touching on this subject.
Hi Dr. Rosen, older surgeon here. I like your videos and have shared with some of my patients. Have you seen any studies about patient satisfaction using CPM? My sense is people that have it are happier. But, there are lots of confounding variables. Thanks
Thank you...even if it is all 'mental' but it seems to make the patient more hopeful of a quicker return to normal it's worth it!! But I don't see how it would not benefit using one in addition to your regular pt that you were going to do anyway
Dr. Salter operated on me as a child, he was a dear friend until 85 years of age. I recently had a knee replacement due to a cancerous tumour and multiple surgeries have created a lot of scar tissue that is preventing my knee from bending. It sounds like a cpm could help a lot with stiffness. Thank you for your opinions.
Nothing like anecdotal evidence, I used a CPM when I had my ACL repair in 1995, seemed to have made a difference, but I had nothing to compare it to. I’m now getting ready for knee replacement, and was wondering if it would be a benefit for this. I think I will skip pursuing the CPM, and use that for motivation for the active movement during recovery.
Totally disagree. I used it for 3 weeks along with regular PT and I’m convinced that it hasten my healing to the point that I was back on the tennis court within 6 weeks!
It was torture for me because I couldn't bend my knee before surgery and I had just had a huge surgery done and was put on this machine and I screamed so loudly my parents thought I was dying 😭😭
Does anyone know of a specialist for post knee replacement scar removal? My surgeon only deals with it a couple of times a year. That's not a specialist on the subject.
I have cerebral palsy and wonder if it may be beneficial to maintain range of motion that I don’t have myself . I have had a total hip excision and want to be able to bend my leg again so I won’t be able to dress myself. I have had much problem with the development of scar tissue internally and I want to try and get some level of independence back.
No CPM machine was used on me after my TKR, but during recovery, I got a new order for my PT to be concentrated on an inflamed SI JOINT and IT band. They used the CPM machine then, but not before. Was that necessary? I was confused to why they did that.
@@oldgoat50 I appreciate your compliment and all and I'm glad to hear you had enough sense to vote Trump...but you really need to understand that these charges that you're actually BELIEVING are trumped up charges to keep him from running...they're not true JUST like the Russian hoax.. he did more for our entire country in 4 years than all the presidents put together over the last 40!! All while fighting a corrupt DEEP state... remember the 'phone call'?? That was him asking Zelensky to look in to what was happening in Ukraine...look at Ukraine NOW!!! MAN... you gotta regain your common sense and look with your eyes ...hear with your ears!!!
I think the thing they do not take into account is that you cannot do active PT all day, so when you are sitting watching TV when you are not icing or elevating your leg, the CPM can keep the knee from getting stiff with the passive movement. The lymph system works by moving the joint and moving out the swelling. So it is less about the CPM for PT than keeping the knee active and moving out the fluid.
I had cpm for first knee replacement and I used 2-3 hours a day minimum on top of pt starting the day after surgery in the hospital. I didn't have excessive swelling so it felt like the right thing to do. I was riding my bike 4 mos after surgery with no pain and over 120 degrees of flex. For my second knee replacement I had lots of swelling that caused nerve compression with pain when my leg was lowered below my waist,like sitting or standing. My surgeon, supposedly going by the data, didn't prescribe me a cpm even though I told him for me, it improved my motivation to move a lot more between exercise sessions. Because of discomfort due to the swelling movement came slowly and delayed developing scar tissue that couldn't be addressed thru a single manipulation unde anaesthesia. I've been stuck at a little more than 90 degrees for 1 1/2 years with not much hope for further improvement without additional surgery. I even bought a used cpm 6 mos after surgery but it was to late. Looking back these are my thoughts on the subject, I believe you should give the patient "every available" technology and therapy to at least try. My first replacement I attained over 120 degrees flex, I swear because of the continuous and religious use of the cpm machine, much more than prescribed. If 1 patient out of 200 benefits from it that's all well and good because the surgeon cannot tell who the 1/200 patient will be. To do otherwise gambles with each patient's outcome by withholding therapy's do work for some, those who are really dedicated to get back asap. Over the long haul they say there may be no different, but getting back much quicker is a major benefit. I wouldn't use a surgeon who wouldn't at least let you try a cpm for a few weeks. I rented mine at my expense for an extra 3 months I felt so strongly about the benefit. Remember your milage may very and you won't know what that mileage is until you try everything. Best of luck!
I used a CPM for both my knees in the past year. I was able to sleep with the machine and used it every night for three weeks after each surgery. It was covered by insurance. I feel that it was of benefit. I did my prescribed post-op exercises every day.
I used a CPM machine. It was delivered to my home and the rep set the machine up for me and told me that I needed to use this at least 3 hours a day. My first day home I used it for about 2 hours and then started bleeding and to keep the story short and not be "gross" I ended up in the emergency room and my knee was immobilized in a split for 4 days. I did use the machine after that. I am not sure of the benefits of the machine. But beware and do not be shamed by a medical rep who has not had a knee replacement or used the machine and if it hurts using the machine stop. The machine also hurt my hip and my back. The same rep came back to pick up the machine a month later. He asked how I liked the machine I told him, and I do not think he listened to a word I said, and he did not care. Do the best you can with your rehab exercises and do not let others shame you. Everyone is different. Also do not let them tell if, you do not get back your range of motion within a month that it will not come back. I am proof this is not true... I am playing tennis and no check hockey two of the things I love to do and grateful!
did you get up yo 120 degrees range of motion & if so, how long did it take?
I don't care how much training a physician has but i have to ask "How in the hell can you learn how to do such complex surgery. You guys are amazing in what you do!
Thank you. And lots of practice during 4 years of medical school and 5 years of residency. What is exciting now is virtual reality that is allowing students to practice surgeries over and over wearing a headset and operating in a virtual operating room.
The idea is to use CPM together with active motion. If you use it properly, the improvement in flexion is visible.
On the video about knee pain at night, your theory is that the knee not moving causes the pain. So you need to wake up and move the knee-and a CPM is perfect for that.
I’m on my second TKR, both times with a CPM, and if I could keep it for the first two months I would! Anytime the knee gets stiff or painful, into the CPM I go and the pain is much less in awhile.
Yes, I do the active exercises as well. But I’m at three weeks and soon to lose the CPM machine. I’ll really miss it!
Hi Doc!, Enjoy your videos. Currently recovering from my left TKR. 4 1/2 weeks out from surgery. 68 year old, male. Coming along good, I think. When I had my right knee done 2 1/2 years ago, I had a hospital stay of 3 days. Hospital nursing staff put me in the CPM. Doc came in during his rounds and had it removed. He didn't order it or want it. He wanted me up and moving. With my left TKR, I was in surgery at 7:15am and home by 1:15pm same day. Hasn't been a cake walk, but much better than the right. Doing my work at home 3 times daily, and getting my butt kicked in outpatient PT 3 times a week. Doc prescribed me a "Kneehab XP" to use 3x daily for 5 days, with 2 days off. I believe his is helping to strengthen my left quads. Just came back inside from doing some very light yard work. I know the quicker I get into my normal activities, the quicker the pain, stiffness and swelling goes away. I found videos like yours to be very valuable for expectation setting and motivation during this recovery. I know I will get there. Thank you Doctor Rosen and may God continue to bless you, your family and your practice.
My surgeon was adamant about not using one.
Thank you--nobody talks aboout this.
Thanks Dr. Rosen for the very helpful video as always!
My pleasure!
I had my TKR last June and had a CPM machine. I do not think it helped me at all. It did aggravate my sciatic nerve on my left side and that made my PT a little more difficult as the sciatic pain really was a downer as it hurt! I will not use this when I have my other knee done. Thank you so much for touching on this subject.
Glad you liked it. Good luck on knee #2.
Very informative. Thank you
Very welcome. Thanks for watching.
Hi Dr. Rosen, older surgeon here. I like your videos and have shared with some of my patients. Have you seen any studies about patient satisfaction using CPM? My sense is people that have it are happier. But, there are lots of confounding variables. Thanks
Good question but no. Lots of studies on patient satisfaction after TKA but none that I know of regarding satisfaction of the machine.
Thank you...even if it is all 'mental' but it seems to make the patient more hopeful of a quicker return to normal it's worth it!! But I don't see how it would not benefit using one in addition to your regular pt that you were going to do anyway
Thanks! Been wondering about this.
Glad to help!
Dr. Salter operated on me as a child, he was a dear friend until 85 years of age. I recently had a knee replacement due to a cancerous tumour and multiple surgeries have created a lot of scar tissue that is preventing my knee from bending. It sounds like a cpm could help a lot with stiffness. Thank you for your opinions.
Nothing like anecdotal evidence, I used a CPM when I had my ACL repair in 1995, seemed to have made a difference, but I had nothing to compare it to. I’m now getting ready for knee replacement, and was wondering if it would be a benefit for this. I think I will skip pursuing the CPM, and use that for motivation for the active movement during recovery.
Sounds like a good plan. Wishing you a speedy recovery.
Totally disagree. I used it for 3 weeks along with regular PT and I’m convinced that it hasten my healing to the point that I was back on the tennis court within 6 weeks!
It was torture for me because I couldn't bend my knee before surgery and I had just had a huge surgery done and was put on this machine and I screamed so loudly my parents thought I was dying 😭😭
Does anyone know of a specialist for post knee replacement scar removal? My surgeon only deals with it a couple of times a year. That's not a specialist on the subject.
Do you have a video on ice machines after TKR?
No, but I will put that on the to-do list.
I have cerebral palsy and wonder if it may be beneficial to maintain range of motion that I don’t have myself . I have had a total hip excision and want to be able to bend my leg again so I won’t be able to dress myself. I have had much problem with the development of scar tissue internally and I want to try and get some level of independence back.
No CPM machine was used on me after my TKR, but during recovery, I got a new order for my PT to be concentrated on an inflamed SI JOINT and IT band. They used the CPM machine then, but not before. Was that necessary? I was confused to why they did that.
CPM ha. No doctor by me does this. You're on your own!
Don't you think that as a supplement to your pt it would be good for joint movement?
@@oldgoat50 Welp I'm sorry you're so sad 😒😒
@@oldgoat50 I appreciate your compliment and all and I'm glad to hear you had enough sense to vote Trump...but you really need to understand that these charges that you're actually BELIEVING are trumped up charges to keep him from running...they're not true JUST like the Russian hoax.. he did more for our entire country in 4 years than all the presidents put together over the last 40!! All while fighting a corrupt DEEP state... remember the 'phone call'?? That was him asking Zelensky to look in to what was happening in Ukraine...look at Ukraine NOW!!! MAN... you gotta regain your common sense and look with your eyes ...hear with your ears!!!
when can i smoke a cigg after TKR
never, its bad for your health.