Page 34 - JCTR-10-5

Journal of Clinical and Translational Research 2024; 10(5): 296-306

Journal of Clinical and Translational Research

Journal homepage: http://www.jctres.com/en/home

ORIGINAL ARTICLE

Immediate inelastic compression garment for swelling management

after total knee arthroplasty: a feasibility study

Andrea Marshall , Roseann Johnson , Jason Jennings , Douglas Dennis 2,3,4,5 , Jennifer Stevens-Lapsley ,
1,6
2
1
2,3
Michael Bade *
1,6
1 Department of Physical Medicine and Rehabilitation, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado,
United States of America, Colorado Joint Replacement, AdventHealth Porter, Denver, Colorado, United States of America, Department of
2
3
Mechanical and Materials Engineering, Ritchie School of Engineering and Computer Science, University of Denver, Denver, Colorado, United
States of America, Department of Orthopedics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, United States
4
of America, Department of Biomedical Engineering, School of Engineering, University of Tennessee, Knoxville, Tennessee, United States of
5
America, Eastern Colorado Veteran Affairs Geriatric Research Education and Clinical Center, Aurora, Colorado, United States of America
6
ARTICLE INFO ABSTRACT
Article history: Background: Swelling after total knee arthroplasty (TKA) peaks between days 3 and 8. Peak
Received: June 6, 2024 swelling is associated with decreased strength and function.
Accepted: October 14, 2024 Aim: The aim of the study was to investigate the feasibility and initial efficacy of an inelastic
Published Online: November 6, 2024 compression garment on attenuating peak swelling when applied immediately after TKA
(immediate compression garment [ICG]).
Keywords: Methods: The ICG group (n = 14) had the inelastic compression garment applied in the operating
Feasibility room after surgery and wore it for 12 h/day while awake for 21 days. The historical comparison
Inelastic compression garment group (n = 16) wore the same garment, which was donned 3 – 4 days after surgery (delayed
Swelling compression garment). ICG feasibility outcomes at day 21 were safety, satisfaction, and adherence.
Total knee arthroplasty 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.
*Corresponding author: Results: One participant was removed from the study on day 7 due to deep vein thrombosis.
Michael Bade Median satisfaction with ICG was 5/5, that is, very satisfied. On average, participants wore the
Department of Physical Medicine and garment for 11 h/day. ES favoring ICG were found for: (i) swelling at days 4 (ES = 0.26) and 14
Rehabilitation, School of Medicine, University (ES = 0.17) only; (ii) quadriceps activation at days 21 (ES = 0.77) and 42 (ES = 0.72); and (iii) pain
of Colorado Anschutz Medical Campus, at days 14 (ES = 0.43), 21 (ES = 0.57), and 42 (ES = 0.42).
Aurora, Colorado, United States of America; Conclusion: The use of an ICG after TKA appears feasible, though its effect on peak swelling
Eastern Colorado Veteran Affairs Geriatric (days 4 and 7) is unclear. All ES should be interpreted with caution due to the small sample size.
Research Education and Clinical Center, Relevance for Patients: Donning the garment immediately in the operating room demonstrates
Aurora, Colorado, United States of America. promising trends toward improved quadriceps activation and pain.
Email: michael.bade@cuanschutz.edu

© 2024 Author(s). This is an Open-Access
article distributed under the terms of the 1. Introduction
Creative Commons Attribution-Noncommercial
License, permitting all non-commercial use, Patients experience significant swelling after total knee arthroplasty (TKA). Swelling
distribution, and reproduction in any medium, increases 10%/day, on average, for the first 3 days after surgery and then peaks at 25 – 47%
provided the original work is properly cited.
between post-operative days 3 – 8 [1,2]. Even 90 days after surgery, swelling remains 11%
higher than pre-operative values [1]. Swelling after TKA is associated with lower patient
satisfaction [3] and is one of the most frequent reasons for emergency department visits
shortly after surgery [4,5]. In addition, swelling after TKA is associated with decreased
quadriceps strength and functional performance, such as reduced gait speed [1,6,7]. It is
thought that the relationship between swelling and functional performance is mediated
by quadriceps strength [1,6].
DOI: http://doi.org/10.36922/jctr.24.00026