Abstract
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.
DOI: http://doi.org/10.36922/jctr.24.00026
Author affiliation
1Department of Physical Medicine and Rehabilitation, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado,
United States of America
2Colorado Joint Replacement, AdventHealth Porter, Denver, Colorado, United States of America
3Department of
Mechanical and Materials Engineering, Ritchie School of Engineering and Computer Science, University of Denver, Denver, Colorado, United
States of America
4Department of Orthopedics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, United States
of America
5Department of Biomedical Engineering, School of Engineering, University of Tennessee, Knoxville, Tennessee, United States of
America
6Eastern Colorado Veteran Affairs Geriatric Research Education and Clinical Center, Aurora, Colorado, United States of America
*Corresponding author:
Michael Bade
Department of Physical Medicine and
Rehabilitation, School of Medicine, University
of Colorado Anschutz Medical Campus,
Aurora, Colorado, United States of America;
Eastern Colorado Veteran Affairs Geriatric
Research Education and Clinical Center,
Aurora, Colorado, United States of America
Email: michael.bade@cuanschutz.edu
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