KA2 Ankle CPM Guidelines Following Ankle Procedures:

Early passive motion is an intergral in part of postoperative rehabilitation. The most effective way to provide passive motion is with the Kinex Passive Motion device used in the patients home.

Chondroplaty/Autologous Chondrocyte Transplantation/Microfracture

• Set Up: Start CPM within 48 hours of procedure if possible (some surgical procedures require a later start time). Initial setting is 0-10 degrees dorsal-flexion and 0-10 degrees plantar-flexion in a pain free arc of motion.
• Wearing Schedule: The CPM device is used 6-12 hours a day, if possible. Range of motion is increased 2-5 degrees a day or as instructed by the physician.
• PROM Goals: The CPM is used 4-8 weeks in order to gain full range of motion and to allow cartilage healing. End range-of-motion goals are 40 degrees of plantar-flexion and 30 degrees of dorsal-flexion.

Soft Tissue Releases/Stiffness

• Set Up: CPM is initiated 24-48 postoperatively to have the most beneficial effects. CPM is started at the available post-operative arc of motion.
• Wearing Schedule: The Kinex device is used or 4-6 weeks. Day 1 CPM is used 6-24 hours. Week one CPM is used 6-12 hours a day. Week 2-6 and beyond CPM is used for 4-8 hours a day in 3-4 therapy sessions. CPM is used longer if post-operative scarring is aggressive.
• PROM Goals: The CPM is increased daily as tolerated. The end range-of-motion goals are 30 degrees of dorsal-flexion and 40 degrees of plantar-flexion.

Complex Regional Pain Syndrome-CRPS (Reflex Sympathetic Dystropy)

CPM can be very beneficial in patients suffering from CRPS in the ankle or knee by increasing range of motion and circulation which helps re-educate the normal nerve response. Early use as part of the rehabilitation program is important to reverse the abnormal nerve response.

• Set Up: CPM is set up in maximal pain free motion.
• Wearing Schedule: Begin with 20 minute intervals 3-4 times a day. Progress to 1-2 hour intervals 3-4 times a day. Use for 4-12 weeks.
• PROM Goals: Full plantar flexion, dorsi flexion, inversion and eversion.

ORIF Stable Calcaneal Fracture

• Set Up: The Kinex CPM is initiated 24-48 hours postoperatively. CPM motion is set at the available pain free range or as directed by the physician.
• Wearing Schedule: The Kinex device is used for 1 hour intervals, 3-4 sessions per day.
• PROM Goals: The CPM is increased 2-5 degrees or as tolerated per day. Expected maximum range-of-motion.