Abstract
Objective
To evaluate the effects of manual lymphatic drainage (MLD) on knee swelling and the
assumed consequences of swelling after total knee arthroplasty (TKA).
Design
Randomized controlled trial.
Setting
Primary care hospital.
Participants
Two groups of 30 patients were randomized before TKA surgery (N=60; 65% women [39];
mean age, 70.7±8.8y; weight, 77.8±11.3kg; size, 1.64±0.08m; body mass index, 29.9±4.1kg/m2).
Interventions
Participants received either 5 MLD treatments or a placebo, added to rehabilitation,
in between the second day and the seventh day after surgery.
Main Outcome Measures
Swelling was measured by blinded evaluators before surgery and at second day, seventh
day, and 3 months using bioimpedance spectroscopy and volume measurement. Secondary
outcomes were active and passive range of motion, pain, knee function, and gait parameters.
Results
At seventh day and 3 months, no outcome was significantly different between groups,
except for the knee passive flexion contracture at 3 months, which was lower and less
frequent in the MLD group (−2.6°; 95% confidence interval, −5.0° to −0.21°; P=.04; absolute risk reduction, 26.6%; 95% confidence interval, 0.9%–52.3%; number
needed to treat, 4). The mean pain level decreased between 5.8 and 8.2mm on the visual
analog scale immediately after MLD, which was significant after 4 of 5 MLD treatments.
Conclusions
MLD treatments applied immediately after TKA surgery did not reduce swelling. It reduced
pain immediately after the treatment. Further studies should investigate whether the
positive effect of MLD on knee extension is replicable.
Keywords
List of abbreviations:
BIS (bioimpedance spectroscopy), MLD (manual lymphatic drainage), RCT (randomized controlled trial), ROM (range of motion), TKA (total knee arthroplasty)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: January 29, 2016
Footnotes
Supported by the Swiss National Science Foundation (grant no. 120298).
Clinical Trial Registration No.: NCT00711711.
Disclosures: none.
Identification
Copyright
© 2016 The American Congress of Rehabilitation Medicine.
