Immediate inelastic compression garment for swelling management after total knee arthroplasty: a feasibility study
Background: Swelling after total knee arthroplasty (TKA) peaks between days 3 and 8. Peak swelling is associated with decreased strength and function.
Aim: The aim of the study was to investigate the feasibility and initial efficacy of an inelastic compression garment on attenuating peak swelling when applied immediately after TKA (immediate compression garment [ICG]).
Methods: The ICG group (n = 14) had the inelastic compression garment applied in the operating room after surgery and wore it for 12 h/day while awake for 21 days. The historical comparison group (n = 16) wore the same garment, which was donned 3 – 4 days after surgery (delayed compression garment). ICG feasibility outcomes at day 21 were safety, satisfaction, and adherence. Initial efficacy outcomes at days 4, 7, 14, 21, and 42 were swelling, quadriceps strength and activation, and pain. Hedges’ g effect sizes (ES) were calculated.
Results: One participant was removed from the study on day 7 due to deep vein thrombosis. Median satisfaction with ICG was 5/5, that is, very satisfied. On average, participants wore the garment for 11 h/day. ES favoring ICG were found for: (i) swelling at days 4 (ES = 0.26) and 14 (ES = 0.17) only; (ii) quadriceps activation at days 21 (ES = 0.77) and 42 (ES = 0.72); and (iii) pain at days 14 (ES = 0.43), 21 (ES = 0.57), and 42 (ES = 0.42).
Conclusion: The use of an ICG after TKA appears feasible, though its effect on peak swelling (days 4 and 7) is unclear. All ES should be interpreted with caution due to the small sample size.
Relevance for Patients: Donning the garment immediately in the operating room demonstrates promising trends toward improved quadriceps activation and pain.
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