{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T09:27:17Z","timestamp":1780046837242,"version":"3.53.1"},"reference-count":36,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[1987,3,1]],"date-time":"1987-03-01T00:00:00Z","timestamp":541555200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Sports Med"],"published-print":{"date-parts":[[1987,3]]},"abstract":"<jats:p>The hypothesis proposed in this study was that the initiation of active and passive knee motion within 48 hours of major intraarticular knee ligament surgery would not have the deleterious effects of increasing knee effusion, hemarthrosis, periarticular soft tissue edema, and swelling.<\/jats:p>\n                  <jats:p>We conducted a prospective study with randomized assignment of 18 patients into two groups: 9 patients in the \"motion\" group began 10 hours of daily continu ous passive motion (CPM) on the 2nd postoperative day, while the remaining 9 in the \"delayed motion\" group used a soft hinged knee brace with knee hinges locked at 10\u00b0 of flexion and entered into the motion program on the 7th postoperative day. All knees were allowed full 0\u00b0 to 90\u00b0 of motion except for a total of seven knees with concomitant mensicus repairs and extraar ticular reconstructions where 20\u00b0 to 90\u00b0 of motion was allowed, limiting the last 20\u00b0 of knee extension for the first 4 postoperative weeks to protect the repair. In all other respects, the rehabilitation program after surgery was the same for the two groups, including postoper ative compression dressings, exercises, and weight- bearing status.<\/jats:p>\n                  <jats:p>Ten of the eighteen patients had acute ACL disrup tions and 8 had chronic ACL insufficiencies. There was an even distribution of acute and chronic knee cases and of open and arthroscopic ligament procedures in the early and delayed motion groups. Associated sur gery included four meniscus repairs, three medial col lateral ligament repairs, and one lateral collateral liga ment repair. Special suturing and fixation techniques were used at surgery to maintain the integrity of liga ment and meniscus structures, allowing the surgeon to feel safe in subjecting the joint to early postoperative motion. The objective parameters measured were KT- 1000 arthrometer measurements, Cybex isokinetic testing, girth measurements at four lower limb loca tions, range of motion goniometer measurements, post operative pain medications, and days of hospitalization. Starting intermittent passive motion on the 2nd post operative day did not increase joint effusion, hemar throsis, or soft tissue swelling. In both motion groups, postoperative joint effusions were absent after the 14th postoperative day. There was no statistically significant difference in knee extension or flexion limits, pain med ication used, or hospital stay in comparing the two knee motion programs.<\/jats:p>\n                  <jats:p>An important finding of this study was the significant decreases in thigh circumference that occurred within the first few weeks of surgery, which progressed de spite a closely supervised inpatient and outpatient re habilitation program. The decreased thigh girth was related to the type of operative procedure. Arthroscopic reconstructions had only 25% to 38% of the loss of thigh girth found in open operative procedures. By the 7th postoperative day, the average circumference loss for the open reconstruction group (motion at 7th post operative day) was nearly 4 cm, compared with the arthroscopic group's average of 1 cm. By the 21 st postoperative day, all patients who underwent open procedures sustained an average of 6.5 cm thigh cir cumference decrease compared with a 2 to 3.5 cm loss in the arthroscopic group. We concluded that traditional rehabilitation protocols are often ineffective in prevent ing the significant quadriceps muscle atrophy that may occur within the first few days of surgery.<\/jats:p>\n                  <jats:p>Of importance was the finding that initiating early knee motion did not stretch out ligamentous recon structions. We strongly recommend an early motion program to decrease the morbidity of major intraarti cular ligamentous procedures. The program is initiated within the hospital setting immediately after knee sur gery.<\/jats:p>","DOI":"10.1177\/036354658701500210","type":"journal-article","created":{"date-parts":[[2007,6,21]],"date-time":"2007-06-21T20:46:52Z","timestamp":1182458812000},"page":"149-160","source":"Crossref","is-referenced-by-count":282,"title":["Early knee motion after open and arthroscopic anterior cruciate ligament reconstruction"],"prefix":"10.1177","volume":"15","author":[{"given":"Frank R.","family":"Noyes","sequence":"first","affiliation":[{"name":"Cincinnati Sportsmedicine Center, and the Deaconess Hospital Sportsmedicine and Cardiovascular Fitness Center, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert E.","family":"Mangine","sequence":"additional","affiliation":[{"name":"Cincinnati Sportsmedicine Center, and the Deaconess Hospital Sportsmedicine and Cardiovascular Fitness Center, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sue","family":"Barber","sequence":"additional","affiliation":[{"name":"Cincinnati Sportsmedicine Center, and the Deaconess Hospital Sportsmedicine and Cardiovascular Fitness Center, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[1987,3,1]]},"reference":[{"key":"atypb1","doi-asserted-by":"publisher","DOI":"10.1016\/S0030-5898(20)31181-0"},{"key":"atypb2","doi-asserted-by":"crossref","unstructured":"Blockey NJ An observation concerning the flexor muscles during recovery of function after dislocation of the elbow J Bone Joint Surg 36A 833-840, 1954","DOI":"10.2106\/00004623-195436040-00015"},{"key":"atypb3","doi-asserted-by":"publisher","DOI":"10.1177\/036354658401200414"},{"key":"atypb4","unstructured":"Butler DL, Noyes FR, Grood ES, et al The effects of vascularity on the mechanical properties of primate antenor cruciate ligament replacements Transactions of the Orthopaedic Research Society 8 93, 29th annual meeting, Anaheim, CA, 1983"},{"key":"atypb5","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-198163080-00008"},{"key":"atypb6","doi-asserted-by":"crossref","unstructured":"Cooper R. Alterations during immobilization and regeneration of skeletal muscle in rats J Bone Joint Surg 54A. 919-953, 1972","DOI":"10.2106\/00004623-197254050-00001"},{"key":"atypb7","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/20.4.211"},{"key":"atypb8","unstructured":"Coutts R., Rothe C., Kaita J. The role of continuous passive motion in the rehabilitation of the total knee patient Clin Orthop 159 126-132, 1981"},{"key":"atypb9","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-196547020-00008"},{"key":"atypb10","unstructured":"Dehne E., Tory R. Treatment of joint injuries by immediate mobilization\u2014 based upon the spinal adaptation concept Clin Orthop 77 218-232, 1971"},{"key":"atypb11","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-197254050-00003"},{"key":"atypb12","doi-asserted-by":"publisher","DOI":"10.1055\/s-2008-1034575"},{"key":"atypb13","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-196042050-00001"},{"key":"atypb14","doi-asserted-by":"crossref","unstructured":"Gerber C., Matter P. Biomechanical analysis of the knee after rupture of the antenor cruciate ligament and its pnmary repair- An instant-centre analysis of function J Bone Joint Surg 65B 391-399, 1983","DOI":"10.1302\/0301-620X.65B4.6874709"},{"key":"atypb15","doi-asserted-by":"publisher","DOI":"10.1177\/036354657900700111"},{"key":"atypb16","unstructured":"Hunter J.: Huntenan Reminiscences London, Sherwood, Gilbert and Piper, 1833"},{"key":"atypb17","doi-asserted-by":"crossref","unstructured":"Knegshauser L., Bryan R.: Early motion with cast-brace after modified Coventry high tibial osteotomy Clin Orthop 195. 168-172, 1985","DOI":"10.1097\/00003086-198505000-00016"},{"key":"atypb18","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-197456070-00009"},{"key":"atypb19","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-198466030-00005"},{"key":"atypb20","doi-asserted-by":"publisher","DOI":"10.1016\/S0030-5898(20)30467-3"},{"key":"atypb21","doi-asserted-by":"crossref","unstructured":"O'Driscoll SW, Kumar A., Salter RB: The effect of continuous passive motion on the clearance of a hemarthrosis from a synovial joint: An experimental investigation in the rabbit. Clin Orthop 176: 305-311, 1983","DOI":"10.1097\/00003086-198306000-00044"},{"key":"atypb22","doi-asserted-by":"publisher","DOI":"10.1177\/036354658100900303"},{"key":"atypb23","doi-asserted-by":"crossref","unstructured":"Perkins G.: Rest and motion. J Bone Joint Surg 35B: 521-539, 1954","DOI":"10.1302\/0301-620X.35B4.521"},{"key":"atypb24","unstructured":"Richardson W., Garrett W.: Clinical uses of continuous passive motion . Contemp Orthop 10. 75-79, 1985"},{"key":"atypb25","unstructured":"Salter RB: The prevention of arthritis through preservation of cartilage. Can Assoc Radiol 32. 5-7, 1981"},{"key":"atypb26","unstructured":"Salter RB, Bell RS The effect of continuous passive motion on the healing of partial thickness lacerations of the patellar tendon in the rabbit. Orthop Trans 5: 209, 1981"},{"key":"atypb27","doi-asserted-by":"crossref","unstructured":"Salter RB, Bell RS, Keeley F.: The protective effect of continuous passive motion on living articular cartilage in acute septic arthritis: An expenmental investigation in the rabbit Clin Orthop 159: 223-247, 1981","DOI":"10.1097\/00003086-198109000-00031"},{"key":"atypb28","unstructured":"Salter RB, Minster RR: The effect of continuous passive motion on a semitendinosus tenodesis in the rabbit knee. Orthop Trans 6. 292, 1982"},{"key":"atypb29","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-198062080-00002"},{"key":"atypb30","doi-asserted-by":"publisher","DOI":"10.1002\/jor.1100010313"},{"key":"atypb31","unstructured":"Sokoloff L. , Jay GE Jr: Natural history of degenerative joint disease in small laboratory animals 4 Degenerative joint disease in the laboratory rat Arch Pathol 62: 140-142, 1956"},{"key":"atypb32","doi-asserted-by":"publisher","DOI":"10.1177\/036354658501300609"},{"key":"atypb33","doi-asserted-by":"crossref","unstructured":"Swearington RL, Dehne E. A study of pathological muscle function following injury to a joint, in Proceedings of the American Academy of Orthopaedic Surgeons. J Bone Joint Surg 46A: 1361-1381, 1964","DOI":"10.2106\/00004623-196446060-00027"},{"key":"atypb34","unstructured":"Willems C. Treatment of purulent arthntis by wide arthrotomy followed by immediate active mobilization. J Gynecol Obstet 28: 546, 1919"},{"key":"atypb35","unstructured":"Willems C. Immediate active mobilization in the treatment of gunshot wounds of joints Med Rec 95: 953, 1919"},{"key":"atypb36","unstructured":"Wojtys EM, Noyes FR Patella Infera Syndrome. Presented at the fifty-third annual meeting of the American Academy of Orthopaedic Surgeons , New Orleans, Louisiana, February 1986"}],"container-title":["The American Journal of Sports Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/036354658701500210","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/036354658701500210","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T09:38:24Z","timestamp":1777369104000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/036354658701500210"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1987,3]]},"references-count":36,"journal-issue":{"issue":"2","published-print":{"date-parts":[[1987,3]]}},"alternative-id":["10.1177\/036354658701500210"],"URL":"https:\/\/doi.org\/10.1177\/036354658701500210","relation":{},"ISSN":["0363-5465","1552-3365"],"issn-type":[{"value":"0363-5465","type":"print"},{"value":"1552-3365","type":"electronic"}],"subject":[],"published":{"date-parts":[[1987,3]]}}}