Article

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/m(2)). 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 degrees ; 95% confidence
interval, -5.0 degrees to -0.21 degrees ; 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.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS