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Author Topic: use of CPM machine at home after TTT with lateral release and microfracture  (Read 5238 times)

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Offline spig3357

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Hi, this is my first post (so hope its in right place).  Why dont uk surgeons/physios recommend cpm machines at home?  am having a ttt, with lateral release and microfracture of the patella next week.  hospital have said i will wake up from surgery in one, but wont need one at home and it would be a waste of money to hire one.  if i dont need it why will they put me in one in the hospital.  I have read all kinds of nightmare stories about scar tissue and further operations to force movement so why was the physio so negative when i mentioned hiring a cpm today.  Correct me if I'm wrong but dont they ensure that you have a cpm in the USA before they let you go home after this kind of surgery?

Has anyone else in the UK used a cpm at home or not (on the advise of physio or surgeon) and then regretted it?  Am running out of time to make a decision as need to confirm with the cpm hire company this week and now im am so confused do i get one or dont I?  Worried about operation anyway and this physio has made me worry even more.

please help, any advise would be truly welcome.

Offline Pinkie

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Hi spig,

I am having an intra articular osteotomy at Oswestry (UK) at the beginning of July and my surgeon has advised that I get a CPM machine at home - I guess it varies from one surgeon to the next. Have you tried asking the surgeon rather than just the physio? Ultimately they are most aware of your particular needs and so can advise accordingly. I will say, however, that following my tibial plateau fracture, I was put in an immobilising brace and by the time I was allowed to weight-bear, I could neither bend nor straighten my knee properly.

If you're concerned and you can afford to do it, just get the machine for your own piece of mind. Ultimately you're responsible for your own recovery and if you think it might help, then go for it!

Hope that helps a bit and that your operation goes well.

Take care,
Sarah

Offline spig3357

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thanks for replying so quickly Sarah,
I mentioned it to the surgeon when i saw him last and  although he said i would wake up in one after surgery and be on it while in hospital he said "you probably wont need one at home".  I dont want to take any chances with my recovery so will probably just hire one anyway, it was just the physios attitude that she had never heard of anyone needing one at home before or that that has ever happened in the Uk.  she almost called the company who hire them cowboys until i told her their name and she then had to admit that they probably were not cowboys as they supplied their hospital and did all the maintence and checks on theirs.  she made me feel really stupid!

Offline crankerchick

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It definitely varies from surgeon to surgeon, whether it is UK or US or AUS or wherever. THe important thing for maintaining/regaining ROM after surgery is movement. Ask your surgeon what the the protocol for bending and using the limb is after the surgery. That will better help you answer the question of if you want/need the CPM at home or not. If you will be moving the limb sufficiently on your own at home, then the CPM is likely unnecessary.

Research CPM and their effectiveness and you just might find that good old fashioned active motion ranks high compared to the CPM anyway.
Mar '07 - plica excision
Oct '09 - femoral + tibial derotational osteotomy & TTT
Aug '10 - hardware removal
"You control your leg. Don't let it control you." -Smart trainer
"Get your a$$ in gear and go for it! Nothing will happen until you make it!" -Smart doctor

Offline Pinkie

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Out of interest, where were you considering hiring from? I have been in touch with Phoenix Healthcare about mine but woudl be interested if you'd found an alternative place - the cheaper the better (obviously without compromising quality!)  ;)

Agree with Crankerchick though - there's probably no substitute for good old fashioned exercises (and sticking to them!)

S

Offline Stasha83

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I think it varies from OS/hospital. After my first op I got Arthrofibrosis which was and still is an absolute nightmare. I was not offered, or had even heard of, a CPM. I had surgery again in February and was on a CPM for 6 weeks after. Both my surgeries were private. I'm not sure the NHS would offer them to take home?

I got my CPM from Pheonix too, they were really helpful and the machine seemed to do the job.
June 2010 - R knee TPF & Hoffa removal
Dec 2010 - R knee- Arthrofibrosis
Dec 2010 - L knee Myxoid degeneration of meniscus
Jan 2011 - R Knee 11 steroid injections & Synvisc1
Feb 11 - MUA & LOA
June 11- Steroid inj, EMG & nerve tests
Aug 11 - MUA & LOA
Feb 12 - R Knee denervation

Offline JoanneLP

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For those of you who have used the CPM, is it helpful months after surgery (repair of fractured patella), when ROM improvement is not progressing?

Offline spig3357

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thanks for all the replies and Pinkie mine is from Pheonix Healthcare too!  It is not that i wanted the NHS to supply me one, if it will stop the build up of scar tissue and the likelyhood of more surgery later because ROM has not come back well enough i am more than happy to pay for one myself.  I totally understand that as long as i do enough exercises I could easily do without hiring a CPM, but its the sticking to them and making sure that you are doing them to the right degree, progressively and often enough that i am worried about.  Just thinking that if i remove a bit of the human factor and opt for a machine it may mean a lot less worry and aggravasion in the long run.  I have a partner who is a lorry driver and away alot, a small holding with pigs, chickens, horses and dogs and dont want to have to rely on my mum for too long to look after everything, just wanted to make sure i was doing enough and doing it right for the best recovery possible.  think i am going to get it anyway at least for the first week, and if dont use it, i can send it back.

Offline Stasha83

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Hi JoanneLP

For me the CPM was essential as my last surgery was to remove scar tissue (arthrofibrosis). The scar tissue had restricted my ROM to 80/90 degrees flexion. If I had not had the CPM my surgery would have been a waste of time as the scar tissue would simply have come back.

I think you need to establish why your ROM is struggling. Has your physio/OS indicated that it is due to scar tissue? With Arthrofibrosis it is usually necessary to remove the scar tissue prior to using a CPM. There could be other reasons that are causing your problems though.

Good luck, I hope you find a solution.
June 2010 - R knee TPF & Hoffa removal
Dec 2010 - R knee- Arthrofibrosis
Dec 2010 - L knee Myxoid degeneration of meniscus
Jan 2011 - R Knee 11 steroid injections & Synvisc1
Feb 11 - MUA & LOA
June 11- Steroid inj, EMG & nerve tests
Aug 11 - MUA & LOA
Feb 12 - R Knee denervation

Offline mouk786

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bump..

how did you get on with the CPM machine

I am thinking of hiring one out from phenix too perhaps - what was the process like.

I am thinking of getting one for a month.

Offline Stasha83

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I have hired a CPM for the second time (being delivered on the 16th August) ready for my next surgery on the 19th from Pheonix.

They are really helpful and efficient, I have had no problems with them.
June 2010 - R knee TPF & Hoffa removal
Dec 2010 - R knee- Arthrofibrosis
Dec 2010 - L knee Myxoid degeneration of meniscus
Jan 2011 - R Knee 11 steroid injections & Synvisc1
Feb 11 - MUA & LOA
June 11- Steroid inj, EMG & nerve tests
Aug 11 - MUA & LOA
Feb 12 - R Knee denervation

Offline mouk786

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Did the CPM help prevent scar tissueafter your last op

What you going back in for?

is it possible to get the NHS to pay for the machine?

Offline Stasha83

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I have Arthrofibrosis so my case is not so clear cut.

It did prevent the scar tissue at the time, but it has come back since. I am having another surgery to remove more scar tissue and the remainder of my fat pad as we now suspect it is fibrotic and causing a lot of the inflammation.

I am pretty sure that the NHS will not pay. I have BUPA so have my surgery privately. I have paid for my CPM on both occasions. Considering that a CPM is vital for me, ie not worth having the surgery without one, you would think the NHS would cover it but no such luck.
June 2010 - R knee TPF & Hoffa removal
Dec 2010 - R knee- Arthrofibrosis
Dec 2010 - L knee Myxoid degeneration of meniscus
Jan 2011 - R Knee 11 steroid injections & Synvisc1
Feb 11 - MUA & LOA
June 11- Steroid inj, EMG & nerve tests
Aug 11 - MUA & LOA
Feb 12 - R Knee denervation

Offline mouk786

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I also have issues with scar tissue.

I have had an LOA and MUA already but got scarring in a different palce.

This tiem I will sue the CPM (didnt have last time) and will not weight bear for a few weeks (based on good experiences by someone else on here)

What brought back your scar tissue?

Offline Stasha83

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I think it is worth getting a CPM if you can, I wouldn't go through surgery without one. Some people don't have them and they're ok, different things for different knees I think.

I don't know why it has come back again, we did all the right things last time. I was doing great for the first 6-8 weeks and then the old symptoms began to return. I just hope this time is third time lucky for me as I'm only 27 and want my life back.

I eas on crutches for about 2 months last time, but I was weight bearing within my comfort zone whilst using them. I know a couple of people have chosen not to weight bear for the first few weeks so it may be worth trying, I'll see how I am after surgery this Friday.

When is your next op planned? Are you having another LOA?
June 2010 - R knee TPF & Hoffa removal
Dec 2010 - R knee- Arthrofibrosis
Dec 2010 - L knee Myxoid degeneration of meniscus
Jan 2011 - R Knee 11 steroid injections & Synvisc1
Feb 11 - MUA & LOA
June 11- Steroid inj, EMG & nerve tests
Aug 11 - MUA & LOA
Feb 12 - R Knee denervation