PURPOSE: The aim of the study was to evaluate the effects of an early application of continuous passive motion (CPM) regime on knee mobility after total knee arthroplasty. The early use of CPM for attaining knee flexion has been supported in a previous study, however, as yet there has been no randomised controlled trial to verify its effect as suggested. METHOD: Fifty-five subjects were randomly allocated to one of three groups. Subjects in group A were given an early flexion regimen of CPM. CPM was begun in the high dependency unit after operation with the range set at 70 degrees to 100 degrees flexion. Extension was advanced by 20 degrees on the first postoperative day (50 degrees to 100 degrees) and to full extension on the second postoperative day (0 degrees to 100 degrees). Subjects in group B adhered to the conventional program, that is, CPM was begun after operation with the range set at 0 degrees to 40 degrees flexion and progressed at daily increments of 10 degrees. The CPM was implemented for two hours per session with two sessions per day. Subjects in the group C had no CPM. All three groups received physiotherapy. Baseline measurements included the active and passive knee range of motion and number of days required to achieve 90 degrees knee flexion. The universal goniometer was employed to measure the active and passive range of motion of the operated knee. The number of post-operative days (POD) to achieve 90 degrees of passive knee flexion (discharge criteria) was recorded. Range of motion measurements were analysed using parametric tests of two-way (group by time) Analysis of Variance (ANOVA). Data regarding number of days to achieve 90 degrees of knee flexion were analysed using the Kruskal, Wallis test. The alpha level for all statistical tests was set as 0.05. RESULTS: There was no significant interaction between group by time. The main effects demonstrated no significant differences between active and passive knee flexion and extension at baseline, third, fifth and seventh day post-operation. However, the median number of days required to achieve 90 degrees of active knee flexion was shown to be statistically different at p < 0.05. CONCLUSION: There was no significant difference in the range of motion outcome between groups of patients who had been given two-hourly CPM twice per day, early flexion CPM and the control group. However, the study demonstrated the early flexion regimen of CPM was more effective in achieving 90 degrees knee flexion than the conventional CPM program and no CPM.

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