***TASK*** the task is to summarize an input biomedical literature in six sentences 
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    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: Purpose . Continuous passive motion is frequently used post-operatively to increase knee range of motion after total knee arthroplasty in spite of little conclusive evidence . The aim of this study was to examine whether continuous passive motion ( CPM ) as an adjunct to active exercises had any short time effects ( after one week and three months ) on pain , range of motion , timed walking and stair climbing . Method . A r and omized controlled trial was conducted . A total of 63 patients undergoing primary TKA were r and omly assigned into an experimental group receiving CPM and active exercises and a control group receiving active exercises only . Outcomes were assessed by goniometer , visual analogue scale ( VAS ) , timed ‘ Up and Go ’ test ( TUG ) , timed 40 m walking distance and timed stair climbing . Results . There were no statistical differences between the treatment groups for any outcome measures either at one week or after three months . For the whole group , a significant and 50 % reduction in pain score was found after three months ( p < 0.01 ) . Compared with before surgery , a significantly impaired knee flexion range of motion ( p < 0.01 ) and a significantly decreased number of patients able to climb stairs were found after three months ( p < 0.01 ) . Conclusion . CPM was not found to have an additional short-time effect compared with active physiotherapy . After three months considerable pain relief was obtained for the whole group , the patients preoperative ROM was not restored and the number of patients able to climb stairs had decreased The aim of the study was to quantify the incidence and timing of venous thromboembolic events ( VTE )  after total knee replacement ( TKR ) . Data from 5100 consecutive TKRs performed over 10 years were prospect ively collected . Cases were review ed to identify thromboprophylaxis given , the diagnosis of VTE , treatment and adverse outcomes . There were 3 deaths ( 0.059 % ) from pulmonary embolism ( PE ) . Of 123 VTEs identified , 55 had PE , 17 had above knee deep vein thrombosis ( DVT ) , 28 had calf DVT and 14 had been incorrectly coded as VTE . There was considerable inappropriate treatment of calf DVT with result ant morbidity . There was an increase in diagnosis of PE between days 1 and 5 post surgery in the later part of the study , corresponding with increasing use of CT Pulmonary Angiography . Increasing diagnosis of PE may be due to detection of embolic debris from surgery due to greater vigilance rather than post-operative thromboembolism . Death from PE is rare following TKR 68 consecutive patients who had primary knee arthroplasties because of arthrosis were r and omized to postoperative continuous passive motion ( CPM ) or active physical therapy ( APT ) . Rehabilitation in both groups was initiated on the first postoperative day . The CPM group sustained less postoperative knee swelling with more rapid initial improvement in knee flexion than did the APT group , but there were no differences between the groups in knee flexion at discharge . Postoperative pain rating and hospitalization times were similar in the two groups Introduction This prospect i ve study was design ed to confirm risk factors and to assess the incidence of deep vein thrombosis after total hip and surface replacement arthroplasty in Korean patients not receiving anticoagulation prophylaxis and to determine efficacy of plasma D-dimer levels as a screening test . Material s and methods From May 2003 to August 2004 , 221 consecutive patients undergoing unilateral total hip arthroplasty and hip resurfacing were evaluated . All patients underwent ultrasonography preoperatively and venography and /or ultrasonography on postoperative day 7 . Plasma D-dimer levels were estimated by latex immuno-assay preoperatively and on days 3 and 7 postoperatively . Results Of the 221 patients in our cohort , 23 developed deep vein thrombosis ( 10.4 % ) . Age ( r = 0.245 , P < 0.001 ) and gender ( r = 0.155 , P = 0.021 ) significantly correlated with deep vein thrombosis . Rise in incidence paralleled increase in age ( X2 = 32.860 , P < 0.001 ) . D-dimer levels on postoperative days 3 ( γ = 0.364 , P < 0.001 ) and 7 ( γ = 0.470 , P < 0.001 ) were significantly correlated to the development of DVT . Conclusion While incidence of deep vein thrombosis in Korean population after THA was lower than that in the West ; it increased with age , and in female gender . Significant correlation was found between D-dimer levels and the development of deep vein thrombosis A prospect i ve r and omized single blind investigation after total knee arthroplasty was performed to evaluate two rehabilitation protocol s ( one with CPM and the other without CPM ) . A series of 87 consecutive total knee arthroplasties in 76 patients ( 72 women and 4 men ) was analyzed . The average age of the patients was 64.7 years .  Kinesitherapy with CPM was performed in 30 ( 34.5 % ) cases , where as in 57 ( 65.5 % ) cases kinesitherapy without CPM was performed . Early functional results according to the HSS scale were assessed on the 14th day after surgery . In the group treated with CPM there were 26.7 % excellent results , 70.0 % good results and 3.3 satisfactory results . The group treated without CPM there were 26.3 % excellent results , 70.2 % good results and 3.5 % satisfactory results . No statistically significant differences were noted between the results yielded by these two rehabilitation protocol A r and omised , controlled study of the use of postoperative continuous passive motion ( CPM ) and immobilisation regimen after total condylar knee arthroplasty was performed . CPM result ed in a significant increase in both the early and late range of knee flexion . This increase occurred in both rheumatoid and osteoarthritic patients . The improvement of 10 degrees at 12 months allowed additional important function to be attained . CPM result ed in significantly earlier discharge from hospital . It did not increase the clinical incidence of wound healing problems , nor did it significantly increase the postoperative fixed flexion deformity or the extension lag .  CPM can be recommended as a safe and effective modality to achieve more rapid and more successful postoperative rehabilitation after knee arthroplasty Background Adequate and intensive rehabilitation is an important requirement for successful total knee arthroplasty . Although research suggests that Continuous Passive Motion ( CPM ) should be implemented in the first rehabilitation phase after surgery , there is substantial debate about the duration of each session and the total period of CPM application . A Cochrane review on this topic concluded that short-term use of CPM leads to greater short-term range of motion . It also suggested , however , that future research should concentrate on the treatment period during which CPM should be administered . Methods In a r and omised controlled trial we investigated the effectiveness of prolonged  CPM  use in the home situation as an adjunct to st and ardised PT . Efficacy was assessed in terms of faster improvements in range of motion ( RoM ) and functional recovery , measured at the end of the active treatment period , 17 days after surgery . Sixty patients with knee osteoarthritis undergoing TKA and experiencing early postoperative flexion impairment were r and omised over two treatment groups . The experimental group received CPM + PT for 17 consecutive days after surgery , whereas the usual care group received the same treatment during the in-hospital phase ( i.e. about four days ) , followed by PT alone ( usual care ) in the first two weeks after hospital discharge . From 18 days to three months after surgery , both groups received st and ardised PT . The primary focus of rehabilitation was functional recovery ( e.g. ambulation ) and regaining RoM in the knee . Results Prolonged use of CPM slightly improved short-term RoM  in patients with limited RoM at the time of discharge after total knee arthroplasty when added to a semi-st and ard PT programme . Assessment at 6 weeks and three months after surgery found no long-term effects of this intervention Neither did we detect functional benefits of the improved RoM at any of the outcome assessment s. Conclusion Although results indicate that prolonged CPM use might have a small short-term effect on RoM , routine use of prolonged CPM in patients with limited RoM at hospital discharge should be reconsidered , since neither long-term effects nor transfer to better functional performance was detected . Trial Registration IS RCT INTRODUCTION There is controversy as to whether continuous passive motion ( CPM ) after total knee arthroplasty ( TKA ) , which is the st and ard treatment , confers significant benefit with respect to outcome . The primary purpose of this study was to determine if CPM or slider-board ( SB ) therapy , used as adjuncts to st and ardized exercises ( SEs ) during the acute-care hospital stay , result ed in a reduced total length of hospitalization and post-discharge rehabilitation in patients who underwent primary TKA . METHODS We carried out a r and omized , clinical trial on 120 patients who received a TKA at the University of Alberta Hospital , Edmonton , a tertiary care institution . The study horizon began at the point of discharge from the hospital and continued up to 6 months after operation . Postoperatively , patients ( 40 in each group ) received CPM and SEs , SB therapy and SEs or SEs alone while in the tertiary Health service use was compared using transfer institution length of stay(LOS ) , post-discharge rehabilitation , readmission and complication rates and their associated costs . RESULTS There were no differences in health service use or costs among the 3 groups over the 6-month study . The rates of postoperative complications and readmissions also were similar among the groups . Increased health service use associated with knee flexion that was less than 60 degrees at discharge , but similar proportions of patients with poor knee range of movement ( ROM ) at discharge were found in each group . CONCLUSIONS This finding suggests that adjunctive ROM therapy , as used in this study , does not reduce health service use . Further research is required to determine if adjunctive ROM therapy after discharge from the surgical hospital decreases health service utilization in those patients who have poor knee ROM at the time of discharge The authors report the results of a prospect i ve study examining the benefits of daily continuous passive motion combined with physical therapy , compared with physical therapy alone , in 103 consecutive osteoarthritic patients undergoing primary total knee arthroplasty . The first 51 patients received continuous passive motion initiated in the recovery room and the next 52 patients did not receive continuous passive motion . Both groups underwent an identical physical therapy protocol starting on the first postoperative day . At discharge , there was a significant increase in active flexion in the continuous passive motion group . There were no significant differences regarding pain , wound healing , knee swelling , wound drainage , pulmonary embolism , or length of hospital stay between the 2 groups . At 2 years , there were no clinical differences in the motion or knee scores . Knee  manipulation was done for < 50 degrees flexion after the tenth postoperative day . There were 5 manipulations in the noncontinuous passive motion group and none in the continuous passive motion group . The entire costs associated with the 5 manipulations was $ 48,274 or $ 937 per patient not receiving continuous passive motion . The average daily inpatient rental of the machine was $ 60 per day . Continuous passive motion is efficacious in increasing short-term flexion and decreasing the need for knee manipulation without increasing costs OBJECTIVE To evaluate the efficacy of continuous passive motion ( CPM ) in the postoperative management of patients undergoing total knee arthroplasty . DESIGN A r and omized controlled single-blind trial of CPM plus st and ardized rehabilitation vs st and ard rehabilitation alone . SETTING A referral hospital for arthritis and musculoskeletal care . PATIENTS Consecutive patients with end-stage osteoarthritis or rheumatoid arthritis undergoing primary total knee arthroplasty who had at least 90 degrees of passive knee flexion . One hundred fifty-four patients were eligible and 102 patients agreed to participate and were r and omized . Ninety-three patients completed the study protocol . INTERVENTION Continuous passive motion machines programmed for rate and specified arc of motion within 24 hours of surgery with range increased daily as tolerated with st and ardized rehabilitation program compared with st and ardized rehabilitation program alone . MAIN OUTCOME MEASURES Primary outcomes were pain , active and passive knee range of motion , swelling ( or circumference ) , quadriceps strength at postoperative day 7 , as well as complications , length of stay , and active and passive range of motion and function at 6 weeks . RESULTS Use of CPM increased active flexion and decreased swelling and the need for manipulations but did not significantly affect pain , active and passive extension , quadriceps strength , or length of hospital stay . At 6 weeks there were no differences between the two groups in either range of motion or function . In this series , use of CPM result ed in a net savings of $ 6764 over conventional rehabilitation in achieving these results . CONCLUSION For the average patient undergoing total knee arthroplasty , CPM is more effective in improving range of motion , decreasing swelling , and reducing the need for manipulation than is conventional therapy and lowers cost BACKGROUND AND PURPOSE The primary purpose of this r and omized controlled trial was to determine which method of mobilization - ( 1 ) st and ardized exercises ( SE ) and 
    Output:
    
There is not enough evidence from the available RCTs to conclude that CPM  reduces VTE after TKA .