Manual lymphatic drainage and Kinesio taping applications reduce early-stage lower extremity edema and pain following total knee arthroplasty

Combination of manual lymphatic drainage and Kinesio taping for treating pigmented villonodular synovitis: A case report

BACKGROUND

Pigmented villonodular synovitis (PVNS) is a benign proliferative disorder that affects the synovial joints, bursae, and tendon sheaths. To date, few studies have reported on the treatment of postoperative pain and edema in patients with PVNS. Herein, we present the case of a woman who developed pain and edema in the left lower limb 1 wk after synovectomy and arthroscopic partial meniscectomy and was unable to walk due to limited flexion and extension of the left knee.

CASE SUMMARY

A 32-year-old woman underwent synovectomy and arthroscopic partial meniscectomy successively and was treated with a combination of manual lymphatic drainage (MLD) and kinesio taping (KT) in our hospital to alleviate postoperative pain and edema. The following parameters were assessed at 2 wk post-treatment and 1 wk post-discharge follow up: suprapatellar circumference, infrapatellar circumference, visual analog scale score, knee range of motion, pittsburgh sleep quality index score, hamilton anxiety rating scale (HAMA) score, and hamilton depression rating scale (HAMD) score. After treatment, the postoperative pain and edema in the patient's left knee were effectively relieved, resulting in improved sleep quality and remarkably attenuated HAMA and HAMD scores.

CONCLUSION

Combined MLD and KT may be an effective approach for relieving postoperative pain and edema in patients with PVNS.

The effect of kinesio taping on edema, pain, and functionality after total knee arthroplasty: A randomised sham-controlled double blinded clinical study

BACKGROUND

There are current studies on kinesio taping (KT) application after total knee arthroplasty (TKA), but there is no definite consensus on its effectiveness and application method yet. This study aims to evaluates the effectiveness of KT applied added to the conservative postoperative physiotherapy program (CPPP) after TKA on postoperative edema, pain, range of motion, and functions on the early period.

MATERIALS AND METHODS

This prospective, randomized, controlled, double-blind study was conducted in with 187 patients undergoing TKA. The patients were divided into 3 groups as kinesio taping (KTG), sham taping (STG) and control group (CG). KT lymphedema technique and epidermis, dermis, fascia technique were applied on the 1st and 3rd days postoperatively. Extremity circumference and joint range of motion (ROM) were measured. Visual Analog Scale, Oxford Knee Scale filled. All patients were evaluated preoperatively, on the 1st day, 3rd day, and 10th day postoperatively.

RESULTS

There were 62 patients in CTG, 62 patients in STG, and 63 patients in CG. In all circumference measurements, the difference between post-op10th day (PO10D) diameter and preoperative diameter measurement was less in KTG than in CG and STG (p < 0.001). CG was higher than the STG in the ROM values measured at PO10D.There was no significant difference between the groups in terms of OKS values (P:0.648). CG was higher than STG in post-op 1st day VAS values (P:0.042).

CONCLUSION

Adding KT to CPP after TKA reduces edema in the acute phase, but has no additive effect on pain, functionality, and ROM.

Effect of Kinesio taping on edema and wrist functions in patients with distal radius fracture followed conservatively with a cast: A randomized controlled single-blinded study

BACKGROUND

Data in the literature on the results of Kinesio taping (KT) application after cast removal in patients with distal radius fracture (DRF) are quite limited.

PURPOSE

It was aimed to evaluate the effectiveness of KT applied immediately after cast removal in addition to the exercise program on edema, functionality, range of motion, and muscle strength in patients with conservatively followed DRF.

STUDY DESIGN

Randomized controlled single-blinded clinical study.

METHODS

This study was conducted with 64 patients with a diagnosis of DRF. The patients were randomized as Kinesio taping group (KTG) and control group. Both groups received a conventional home exercise program. KT was applied to patients in KTG for 10 days. Circumference and volume measurements were taken at baseline and day 10. Arm, Shoulder, and Hand Questionnaire for Disability, Visual Analog Scale, grip strength, and wrist joint range of motion measurements were taken at baseline, day 5, and day 10.

RESULTS

The circumference difference between the affected extremity and the healthy extremity was statistically greater in the control group on the fifth day at the wrist level (<0.001) and 6 cm proximal to the wrist (p = 0.001). The circumference difference between the affected extremity and the healthy extremity was statistically greater in the control group on the 10th day at the wrist level (p < 0.05) and 6 cm proximal to the wrist (p = 0.01). Wrist extension angle (<0.001), wrist flexion angle (p = 0.001), and supination angle (p = 0.001) were higher in KTG on the 10th day. On the 10th day, the grip strength (p < 0.05) was higher in the KTG, while the Visual Analog Scale value (p < 0.01), Arm, Shoulder, and Hand Questionnaire for Disability score (p < 0.01), and the percentage of strength loss in the healthy arm (p < 0.01) were lower in the KTG.

CONCLUSIONS

In patients with DRF who were treated conservatively with a cast, the inclusion of Kinesio taping (KT) in the rehabilitation program was found to be effective in reducing edema and pain, as well as improving functionality, strength, and range of motion.

Effect of Postoperative Kinesio Taping on Knee Edema, Pain, and Range of Motion After Total Knee Arthroplasty and Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis of Randomized Clinical Trials

BACKGROUND

Kinesio taping (KT) has been shown to be clinically effective in a wide range of musculoskeletal disorders. Despite evidence supporting KT, there still needs to be more certainty regarding its clinical worthiness in managing postoperative conditions. This study aims to assess the effect of postoperative KT on knee edema, pain, and range of motion (ROM) when added to routine physiotherapy after knee surgery.

METHODS

In this systematic review and meta-analysis, MEDLINE, Embase, Scopus, Web of Science, and CENTRAL databases were searched from their inception to July 2023. Randomized controlled trials (RCTs) comparing routine physiotherapy with and without KT were included. Random-effect models were used to calculate the standardized mean difference (SMD), confidence interval, and heterogeneity (I2).

RESULTS

Sixteen RCTs on 842 operated knees were included. KT reduced knee edema in first week (SMD, -0.59, p < 0.001), 14th postoperative day (POD) (SMD, -0.78, p < 0.001), and 28 to 42 days postop (SMD, -0.66, p < 0.001). The KT demonstrated significant pain improvement in second week (SMD, -0.87, p < 0.001) and the fourth week (SMD, -0.53, p < 0.001). The KT groups demonstrated ROM improvement within second week (SMD, 0.69, p = 0.010) and in the 28th POD (SMD, 0.89, p = 0.009). Subgroup analysis demonstrated minimal heterogeneity in anterior cruciate ligament reconstruction (ACLR) cases. However, it did not show significant superiority regarding ankle, calf, or thigh edema and Lysholm scale.

CONCLUSION

This study suggests that adding KT to routine postoperative physiotherapy reduces pain and knee edema after total knee arthroplasty or ACLR. Low to very low certainty of evidence for all outcomes and the limited number of studies emphasize the need for more high-quality primary studies to explore the optimal method of KT application and its effectiveness in specific knee surgeries.

LEVEL OF EVIDENCE

Level I. See Instructions for Authors for a complete description of levels of evidence.

Effects of manual lymphatic drainage on total knee replacement: a systematic review and meta-analysis of randomized controlled trials

BACKGROUND

Total knee joint replacement (TKR) is an effective method for the treatment of severe knee osteoarthritis. With an increasing number of surgeries, complications such as lower limb edema, pain, and limited mobility have caused a heavy burden. Manual lymphatic drainage (MLD) may be a solution to solve the problem. The study aims to evaluate the efficacy of MLD in reducing knee edema, pain, and improving range of motion (ROM) in patients after TKR.

METHODS

A search was conducted in PubMed, Embase, Cochrane Library, Web of Science, CNKI, VIPs, WanFang database, and Google Scholar from inception to June 2023. Only randomized controlled trials (RCTs) that compared the effects of MLD and non-MLD (or another physiotherapy) on improving knee edema, pain, and ROM after TKR were included. Stata 16.0 was used for meta-analysis. GRADE was used to assess the quality of evidence.

RESULTS

In total, 7 RCTs with 285 patients were identified. There were no significant differences found in the ROM of knee flexion (standardized mean difference (SMD) = 0.03, 95% confidence interval (CI): -0.22, 0.28, P = 0.812) and the ROM of knee extension (SMD= -0.30, 95%CI: -0.64, 0.04, P = 0.084). No differences were observed in the lower extremity circumference after TKR (SMD= -0.09, 95%CI: -0.27, 0.09, P = 0.324). For postoperative pain, there was no significant advantage between the MLD and non-MLD groups (SMD= -0.33, 95%CI: -0.71, 0.04, P = 0.083).

CONCLUSIONS

Based on the current evidence from RCTs, manual lymphatic drainage is not recommended for the rehabilitation of patients following total knee replacement.

Level I of evidence does not support manual lymphatic drainage for total knee arthroplasty: a meta-analysis

It is unclear whether manual lymphatic drainage (MLD) following primary total knee arthroplasty (TKA) is effective in reducing pain and swelling and improving knee function. The present study investigated the efficacy of MLD after TKA. The outcomes of interest are the range of motion (ROM), pain (visual analogue scale, VAS), and circumference of the lower leg. This meta-analysis was conducted according to the 2020 PRISMA statement. In November 2023, the following databases were accessed: PubMed, Web of Science, Google Scholar, and Embase, with no time constraint. Only level I evidence studies, according to the Oxford Centre of Evidence-Based Medicine, were considered. All the randomised controlled trials (RCTs) comparing patients who have received MLD versus a group of patients who did not undergo MLD following primary TKA were accessed. Data from four RCTs (197 TKAs) were retrieved. 67% (132 of 197 patients) were women. The mean length of follow-up was 7.0 ± 5.8 weeks. The mean age of the patients was 69.6 ± 2.7 years, and the mean BMI was 28.7 ± 0.9 kg/m2. At baseline, between-group comparability was evidenced in the male:female ratio, mean age, mean BMI, knee flexion, and VAS. No difference was found in flexion (P = 0.7) and VAS (P = 0.3). No difference was found in the circumference of the thigh (P = 0.8), knee (P = 0.4), calf (P = 0.4), and ankle (P = 0.3). The current level I of evidence does not support the use of MLD in primary TKA.