Ask an answerable question (PICO)：
Based on the five steps of evidence-based nursing, a PICO question is formed: "Can continuous passive motion increase the angle of joint motion after knee arthroplasty?", set the keywords as: P：knee arthroplasty、I：continuous passive motion、C：Routine、O：knee joint motion angle.
The Method and Analysis of Literature Review：
This article uses a systematic literature review method to search for domestic and foreign articles related to the use of continuous passive articulation devices to increase the angle of joint motion after knee arthroplasty. The search databases include The Cochrane Library, PubMed, Embase, CINAHL Plus with Full Text, AiritiLibrary Huayi online library and other databases, the keywords used are post-knee replacement surgery, continuous passive joint mover, joint motion angle, and the scope of literature search only includes systematic review (SR) and integration meta-analysis , Clinical randomized controlled trial (RCT). Data search strategy, following Boolean logic, first connect keywords with OR, and then use AND among P, I, O to intersect; there are full texts for reviewing Chinese and English documents; using the limit search function, The publication period is from March 2017 to March 2022. The keywords of the search scope need to appear in the serach field tags:Title/Abstract to establish the search scope. A total of fourteen related literatures were obtained. Subjects, and excluding duplicate literature and the use of multiple interventional measures, etc., a literature Preoperative range of motion and applications of continuous passive motion predict outcomes after knee arthroplasty in patients with arthritis was selected for review.
Critical Appraisal：
The search results deducted replication and non-RCT, SR studies, and study design methods did not conform to the PICO literature.Finally, one article that fits the theme is selected for systematic literature review. According to the Oxford Centre for Evidence Based Medicine, the evidence scale is Level one , and CASP is used as the evaluation tool.
Clinical Application of Evidence：
Use the seven steps of empirical knowledge translation to improve.During the study period April 5 to May 31, 2022.The intervention consisted of daily use of ontinuous passive motion. The daily angle is increased by ten degrees, the time is one hour, and the application is four times a day.The interval needs to be more than 2 hours and the duration is four days. Evaluation Results Using the angle ruler to measure the range of Knee joint motion angle before and after knee arthroplasty. If the knee flexion angle is > 90 degrees, then perform active exercise training instead.
Evaluation of Effectiveness：
There is no harm to the patient during the implementation.For hospitals, although there are machine purchase costs and maintenance costs, it can benefit many postoperative patients.Evaluating interventions shows that the benefits outweigh the risks.The evaluation of the angle of motion of the knee arthroplasty is consistent with the references in the literature.Conclusion The continuous passive joint can increase the angle of motion of the knee arthroplasty.And in the added value, it was found that the postoperative pain index decreased from 8 points to 4-5 points.
Conclusions and Recommendations：
After the PICO was formed through empirical evidence, relevant literatures were searched and screened using evidence-based medicine strategies. After a rigorous analysis of one literature.The evaluation intervention method showed that the advantages outweighed the disadvantages. Learn about continuous passive articulations that can increase the angle of motion in knee replacements. In terms of clinical application, although only 5 patients were accepted, it has been proved by empirical application that the Continuous passive motion can increase the joint movement angle of knee joint replacement.It is suggested that the continuous passive motion device intervention measures can be included in the routine standardization of knee Continuous passive motion arthroplasty in clinical application, so as to increase the angle of motion of the knee arthroplasty.Continuous passive motion can also be included in preoperative education, and quantifiable scales (such as visual analog scales) can be added to perform postoperative pain index measurement to increase patient participation.
