This single-blinded RCT from Mayo Clinic is the first Level-I study comparing CPM to supervised physical therapy after arthroscopic elbow contracture release. 51 patients were randomized and followed for 1 year, with arc of motion and rate of recovery as primary outcomes. The study directly answers which rehabilitation protocol produces better motion — not just whether surgery works.
For decades, CPM and physical therapy were both used after elbow contracture release without Level-I evidence to guide the choice. Prior nonrandomized studies had contradictory results, leaving the decision to institutional habit and surgeon preference.
This trial changes that: when you have a patient with a moderate-to-severe contracture (especially one dominated by a flexion deficit), CPM should be your default. It doubles the chance of achieving functional flexion at 1 year (75% vs. 37%) and recovers 51% of lost motion vs. 36% with PT.
For mild contractures or patients without rapid-recovery demands, PT remains a reasonable option — the motion difference at 1 year may be less clinically meaningful in that group, and PROM scores are equivalent regardless.
One nuance worth knowing: this trial was performed at a single high-volume center by one surgeon with nearly 30 years of CPM experience. Reproducibility at centers less familiar with CPM protocols is an open question the authors themselves flag.
This single-blinded RCT from Mayo Clinic is the first Level-I study comparing CPM to supervised physical therapy after arthroscopic elbow contracture release. 51 patients were randomized and followed for 1 year, with arc of motion and rate of recovery as primary outcomes. The study directly answers which rehabilitation protocol produces better motion — not just whether surgery works.
For decades, CPM and physical therapy were both used after elbow contracture release without Level-I evidence to guide the choice. Prior nonrandomized studies had contradictory results, leaving the decision to institutional habit and surgeon preference.
This trial changes that: when you have a patient with a moderate-to-severe contracture (especially one dominated by a flexion deficit), CPM should be your default. It doubles the chance of achieving functional flexion at 1 year (75% vs. 37%) and recovers 51% of lost motion vs. 36% with PT.
For mild contractures or patients without rapid-recovery demands, PT remains a reasonable option — the motion difference at 1 year may be less clinically meaningful in that group, and PROM scores are equivalent regardless.
One nuance worth knowing: this trial was performed at a single high-volume center by one surgeon with nearly 30 years of CPM experience. Reproducibility at centers less familiar with CPM protocols is an open question the authors themselves flag.