Abstract
BackgroundPost-operative limb swelling may negatively affect the outcome of arthroscopic surgery and prolong rehabilitation. The aim of this pilot study was to evaluate the effect of compression stockings versus no compression on post-operative swelling and pain in the early post-operative phase.MethodsA single-centre, randomised controlled trial was performed. Patients who underwent minor knee arthroscopy were randomised to wear class II compression stockings (23-32 mmHg) (CS) or no compression stockings (NCS) immediately post-operatively for ten days. All patients received low molecular weight heparin (LMWH) at prophylactic dosage. The primary outcome variable was post-operative swelling of the limb, quantified by using an optical 3D measurement system (Bodytronic© 600). Pain was rated on a visual analogue scale (VAS). From a total of 76 patients assessed, 19 patients were eligible for final analysis. The trial followed the CONSORT criteria, was registered at clinicaltrial.gov and approved by the local ethics committee.ResultsThe circumference at the middle thigh (cF) was significantly different between groups at day 10 (p = 0.032; circumference − 1.35 ± 2.15% (CS) and + 0.79 ± 3.71% (NCS)). Significant differences were also noted around the knee (cD) at day 10 (p = 0.026) and a significant trend at cD and at the mid lower leg (cB1) at day 4. The volume of the thigh was also different with marked difference between days 1 and 4 between the two groups (p = 0.021; volume + 0.54 ± 2.03% (CS) and + 4.17 ± 4.67 (NCS)). Pain was lower in compression group (not statistically significant).ConclusionsPost-operative limb swelling can be reduced significantly by wearing compression stockings in the early post-operative phase when compared to not wearing stockings. This may improve the rehabilitation process after arthroscopic surgery. The optimal duration of compression therapy seems to be between three and ten days.Trial registrationclinicaltrials.gov (NCT02096562, date of registration 11.11.2013).
Highlights
Post-operative limb swelling may negatively affect the outcome of arthroscopic surgery and prolong rehabilitation
Few prospective clinical trials deal with the effects of compression therapy on post-operative leg swelling, after knee arthroscopy, despite its high prevalence [7]
Fourteen patients were randomised to undergo compression therapy (CS) after knee arthroscopy and 13 patients were randomised to be treated without compression
Summary
Post-operative limb swelling may negatively affect the outcome of arthroscopic surgery and prolong rehabilitation. The aim of this pilot study was to evaluate the effect of compression stockings versus no compression on post-operative swelling and pain in the early post-operative phase. Arthroscopy of the knee is a common orthopaedic surgical procedure in patients with traumatic and degenerative conditions and is widely performed in industrialised countries [1]. The advantages of this minimally invasive surgery are less pain and earlier restoration of function as well as less swelling compared to open surgery. Advances in 3D imaging technology, enable reliable measurements of the volume of the lower extremity to be made in less than one minute using optical methods, allowing valid and reliable investigation of post-operative limb swelling (Tischer T, Oye S, Feldhege F, Jacksteit R, Mittelmeier W, Rainer B, et al: Measuring lower limb circumference and volume – introduction of a novel optical 3D volumetric measurement system, submitted; [11, 12])
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