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Arch Phys Med Rehabil. 2013 Nov;94(11):2103-11. doi: 10.1016/j.apmr.2013.06.009. Epub 2013 Jun 26.

Randomized trial investigating the efficacy of manual lymphatic drainage to improve early outcome after total knee arthroplasty.

Author information

1
School of Sport Science, Exercise and Health, University of Western Australia, Crawley, Perth, WA, Australia; Hollywood Functional Rehabilitation Clinic, Nedlands, Perth, WA, Australia. Electronic address: jay.ebert@uwa.edu.au.

Abstract

OBJECTIVE:

To investigate the efficacy of manual lymphatic drainage (MLD) in the early postoperative period after total knee arthroplasty (TKA) to reduce edema and pain and improve knee range of motion.

DESIGN:

Prospective randomized controlled trial.

SETTING:

Private hospital and functional rehabilitation clinic.

PARTICIPANTS:

Consecutive sample of patients (N=43; 53 knees) scheduled for TKA.

INTERVENTION:

MLD (vs no MLD) on days 2, 3, and 4 postoperatively. Both groups underwent conventional, concomitant physical therapy.

MAIN OUTCOME MEASURES:

Clinical assessment was undertaken pre- and postoperatively prior to and after the designated postoperative MLD sessions (days 2, 3, and 4) and at 6 weeks postsurgery. This included active knee flexion and extension range of motion, lower limb girths (ankle, midpatella, thigh, and calf), and knee pain using a numeric rating scale and the Knee Injury and Osteoarthritis Outcome Score.

RESULTS:

A significant group effect was observed for active knee flexion, with post hoc tests demonstrating a significantly greater active knee flexion in the MLD group when compared with the control (no MLD) group at the final measure prior to hospital discharge (day 4 postsurgery) and at 6 weeks postsurgery. There were no further group effects observed for the remaining patient-reported and functional outcomes.

CONCLUSIONS:

MLD in the early postoperative stages after TKA appears to improve active knee flexion up to 6 weeks postsurgery, in addition to conventional care.

KEYWORDS:

ADL; Arthroplasty, replacement, knee; BMI; KOOS; Knee Injury and Osteoarthritis Outcome Score; MLD; Massage; NRS; OA; ROM; Rehabilitation; TKA; activities of daily living; body mass index; manual lymphatic drainage; numeric rating scale; osteoarthritis; range of motion; total knee arthroplasty

PMID:
23810354
DOI:
10.1016/j.apmr.2013.06.009
[Indexed for MEDLINE]

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