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Author Topic: Can I do w/out the CPM?  (Read 4010 times)

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Offline @lpha_female

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Can I do w/out the CPM?
« on: December 27, 2005, 02:18:12 AM »
I'm going to have ACL reconstruction (hamstring graft) and get the handle part of my bucket-handle medial meniscal tear removed next week. I did the damage in 2002... It will be my second knee surgery, but this time itís the other knee.
My question is: My OS recommends that I rent a cryo cuff and CPM machines for 2 weeks to use everyday at home, 12-14 hours. My insurance doesn't cover them 'cause there is no scientific evidence that their use makes a difference in the long run (I know, I checked the literature). They're very expensive (for my budget anyway) and I wonder if there's anybody out there who did just fine without them? Could pulling my leg towards me to do a flexion using a towel placed under my heel be enough for instance?
Comments, answers, recommendations, anything, please?
Thanks!
R ACL Recons gracilis muscle graft + menisectomy (lateral but MRI said medial...) on Jan. 3 '06 -> Injured while boxing in Jan. '02
L ACL partial tear + medial and lateral meniscal tear = medial menisectomy '00

Offline blackbeltgirl

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Re: Can I do w/out the CPM?
« Reply #1 on: December 27, 2005, 02:18:34 PM »
can't help you with the cpm, but I'd buy a cryo-cuff instead of renting.  My insurance company paid for mine, but it took the medical supplier 5 phone calls and 2 months to send the return mail label (they were supposed to send it within 2 weeks).  They sent a bill for almost $2000.  You can find less expensive versions for about $200 new, or probably less on ebay.  And it really was worth it to keep the knee iced all day, vs. going back and forth with the stupid bag of peas.
ACI was supposed to be 2/21/06.  On 6/29/06 Insurance co said have another scope, and if it still looks good, they'll ok the ACI.
Microfracture Dec 7, 2004
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Offline shade

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Re: Can I do w/out the CPM?
« Reply #2 on: December 27, 2005, 02:27:26 PM »
Hi,

I'd follow your OS's protocol.  There is a reason that this machine is recommended.  I have not read literature stating that these machines do not help.  They really give a jump start to rehab.....  Many surgeons are now using the CPM after other surgeries as it makes a huge difference with swelling after surgery. 
They are expensive, but you should rent a maching for even a week after surgery - you would see results.  It cost me $250 for a weeks rental and my insurance did not cover, but it sure helped with swelling after my surgery. 

Good luck with your surgery.  Cryo-cuff units are also great and help alot with swelling.

http://www.orthopedictechreview.com/issues/julaug03/pg28.htm
July '05†(RK) - LR/debridement
Mar '06†(RK) - Open LR + Allograft w/OBI TruFit Plug + Fulkerson TTT
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Offline jb-knee-geek

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Re: Can I do w/out the CPM?
« Reply #3 on: December 27, 2005, 08:43:14 PM »
one of my consulting OS's has said he prefers light rehab in lieu of the CPM machine. My guess is it's cost-related....

Cryo units are a standard in my area. 
torn RK ACL March 2001, surgery Aug. 14 2006, after 4 knee sprains since Oct. '05.  Allograft, ~40% medial meniscus removed, some wear in the trochlear groove. Everything else looks good.

Post-op diary: http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=29749.

Offline jb-knee-geek

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Re: Can I do w/out the CPM?
« Reply #4 on: December 28, 2005, 06:01:41 AM »
well done heather, seems like CPM is effective for multiple procedures, I assume that means ACL recon with meniscetomy.

I'll ask my OS about it. I think I asked him about it *before* I damaged my meniscus, my bad......

thanks,

torn RK ACL March 2001, surgery Aug. 14 2006, after 4 knee sprains since Oct. '05.  Allograft, ~40% medial meniscus removed, some wear in the trochlear groove. Everything else looks good.

Post-op diary: http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=29749.

Offline Ferris

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Re: Can I do w/out the CPM?
« Reply #5 on: December 28, 2005, 08:31:38 AM »
While I'm sure that the CPM and Cyro-cuff are helpful, I do not believe that they are essential (for an ACL reconstruction at least) and that if you are not prescribed them or if the cost prohibits them I don't believe that you should panic.  In the UK, they are not commonly prescribed like they are in the USA and yet people myself included do make successful recoveries from ACL reconstructions.  Make sure that you do the initial exercises  that your OS or the hospital PT gives you prior to discharge as often as you are told to.  Also don't forget to ice even if you don't have a cyro-cuff - I found that a frozen gel pack for the front of my knee and a pack of frozen peas to mould into the back of my knee worked wonders.

If your OS prescribed the CPM and cyro-cuff then I would push for them (and/or get the OS's office to push for them) but that if you are still denied them then don't get too stressed about it.

Rachel

Offline heather k from wales

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Re: Can I do w/out the CPM?
« Reply #6 on: December 28, 2005, 09:39:52 AM »
Ive been through ACL reconstruction twice, 1st time there were multiple porblems fixed in the same surgery and 2nd time it was just the ACL recon.
I never had a CPM or Cryo Cuff for either operation, or any of the 7 knee operations I have had.  These are not standard practices here in UK, although some OS's do use a CPM just while the patient is in hospital.
They were never recommended by my OS's.  I was always told to do heel slides regularly with a rolled up sock to save my heel from becoming sore on the floor.  I always regained full ROM without much problem.
Ice was highly recommended every time though.  A bag of frozen peas is great, keep a few bags so you never run out of frozen peas.  (I did buy a Cryo Cuff once though after a haematoma developed in my thigh, requiring around the clock icing, but havent used it since).  Always wrap a tea towel around the area to be iced before applying to avoid ice burns.
I have never suffered with the problems Heather M mentions, but Im sure that if I had, Id also be highly recommending a CPM.

It may be well worth your while discussing these issues with your OS before surgery.  Maybe he can come up with a solution for you.

Best of luck,

Heather ;)
91 Mangled Right knee on trials motorbike
94 Meniscus Repair
95 ACL/LCLrec,notchplasty,bone graft
01 90% Menisectomy
02 Scope
03 ACLrec,LAD
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Offline ACLGirl

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Re: Can I do w/out the CPM?
« Reply #7 on: December 31, 2005, 06:26:10 AM »
I been through ACL recon with Meniscus shaving on Oct 31 of this year and my doctor created a plan that my PT had/has to follow until I am done with all my sessions of PT.  He felt that the CPM and the Cryo cuff was not necessary in my recovery and I must say I agree.  Don't fret if you are unable to get the machine.  Just continue to do your exercises at home and you will be fine.

Yolanda
Yolanda

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ACL Reconstruction w/Allograft (Cadaver) 10/31/05
Meniscus shave 10/31/05
Injury date (Dancing at a Conference) 4/05

Offline kendra

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Re: Can I do w/out the CPM?
« Reply #8 on: December 31, 2005, 09:10:11 PM »
I had the same question about the CPM machine, although now I'm 2 weeks post PCL and MCL reconstruction.  my OS never once mentioned the CPM machine. 
11/6/05 Grade 3 tear PCL/MCL in horse accident, tore both menisci
12/15/05 PCL/MCL recons, menisci fixed
3/28/06 Finally over the hump in rehab, things are lookin' good!

Offline kendra

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Re: Can I do w/out the CPM?
« Reply #9 on: December 31, 2005, 09:44:39 PM »
Yes, perhaps you could hire a "pool cleaner" to come and bend your leg for you for 9 hours a day.  Plus, you'd have the added benefit of constant company. 

kidding - good luck finding what you need
11/6/05 Grade 3 tear PCL/MCL in horse accident, tore both menisci
12/15/05 PCL/MCL recons, menisci fixed
3/28/06 Finally over the hump in rehab, things are lookin' good!

Offline @lpha_female

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Re: Can I do w/out the CPM?
« Reply #10 on: January 02, 2006, 04:18:03 PM »
Well first of all thanks for everyone advices. Didn't think this topic would trigger such interest...
I did get the CPM and cryocuff afterall. I did another search for articles supporting their use for ACL reconstruction; still couldn't find anything. However, often results show a difference short term (6 weeks or so) but not long term.
My surgery is tomorrow. I'll have plenty of time in the following days, I'll try to post the references.

Thank you all for your advices and sharing your experiences.
Wish me luck!

Sleepless and anxious @lpha female
R ACL Recons gracilis muscle graft + menisectomy (lateral but MRI said medial...) on Jan. 3 '06 -> Injured while boxing in Jan. '02
L ACL partial tear + medial and lateral meniscal tear = medial menisectomy '00

Offline jb-knee-geek

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Re: Can I do w/out the CPM?
« Reply #11 on: January 02, 2006, 04:34:09 PM »
good luck alpha, keep posting. I'm due for the same surgery in the next couple of months.
torn RK ACL March 2001, surgery Aug. 14 2006, after 4 knee sprains since Oct. '05.  Allograft, ~40% medial meniscus removed, some wear in the trochlear groove. Everything else looks good.

Post-op diary: http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=29749.

Offline stgiles16

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Re: Can I do w/out the CPM?
« Reply #12 on: January 02, 2006, 05:44:57 PM »
Best of luck alpha female. there were several messages on you post last nite that were deleted during the eveing. It was nothing.  We all wish you the best.


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