Knee Arthroplasty, Total Clinical Trial
Official title:
Outcome of Manual Lymphatic Drainage Following Total Knee Arthroplasty Surgery
The purpose of this study is to evaluate the efficiency of manual lymphatic drainage to decrease the swelling of the knee after total knee replacement surgery
Background There is scientific evidence that rehabilitation has a positive influence on
patients'recovery after total knee arthroplasty (TKA). According to the literature,
conventional rehabilitation aims to improve knee range of motion, lower limb strength, gait,
activities and pain. Although swelling is a systematic consequence of TKA surgery, less focus
is put on swelling reduction. Patients develop swelling due to periarticular edema, hematoma
and joint effusion. Inflammation, pain, stiffness, alteration of gait pattern, quadriceps
contraction inhibition and slowing of rehabilitation are reported as consequences of
swelling. Accordingly, it is likely that a therapy that would promote resorption of swelling
would decrease the negative impact of swelling on patients'recovery. Manual lymph drainage
(MLD) could possibly accelerate edema resorption after TKA surgery. Several authors advise
MLD after TKA, and physiotherapists currently apply MLD to reduce postsurgical swelling. Its
positive effect on chronic lymphedema resorption is largely accepted. Results on pain and
range of motion seem interesting from an empirical point of view but, to our knowledge, no
scientifically driven studies have confirmed these positive effects after orthopaedic
surgery.
Aim This study aims to evaluate the effect of MLD on swelling, and parameters possibly
influenced by swelling (pain, knee range of motion, knee objective and subjective function
and gait pattern).
Methods This study is a randomized controlled clinical trial. Patients will be blinded from
goals of the treatments and evaluators will be blinded from the treatment delivered to the
patient. The effects of MLD (5 treatments of 30 minutes from the second to the eighth
postsurgical day) will be compared to those of a placebo (relaxation sessions). MLD or
placebo will be added to the conventional rehabilitation program of our Orthopaedic
Department. Assessments will be conducted one day before surgery, two days, 8 days and 3
months after surgery. Evolution and differences between groups will be statistically assessed
at each step.
Significance This project aims to improve knowledge on the efficiency of rehabilitation
treatments following TKA. It will contribute to effective evaluation of the effects of a
widely applied treatment. The results will help physiotherapists and medical doctors to take
clinical decisions based on documented evidence. This will make a contribution to better
quality of care and better allocation of resources to rehabilitation.
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