Manual Lymph Drainage

Study Overview
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Brief Summary
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Manual Lymphatic Drainage (MLD) is a specialized massage technique utilized to decrease various forms of edema. This technique promotes reuptake of interstitial fluid along the pathways of the lymphatic system. This technique promotes healing, decrease swelling, and decrease pain.

Detailed Description
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Manual Lymphatic Drainage (MLD) is a specialized massage technique utilized to decrease various forms of edema. Edema can limit function, range of motion (ROM) and increase pain after surgery. Studies have shown that decreasing edema can increase knee strength and functional performance on various standardized measures. MLD has been shown to be effective in patients with hind foot operations and increases ROM post total knee replacement (TKR) surgery. The aim of this study is to determine whether MLD on a sample of patients with TKR will decrease edema, increase ROM and decrease pain as compared to TKR patients who do not receive MLD.

Official Title
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Manual Lymph Drainage for Patients With Acute Total Knee Replacement

Conditions
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Total Knee Arthroplasty, Post-operative Edema

Intervention / Treatment
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* Other: Manual Lymphatic Drainage
* Other: Physical Therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: s/p total knee replacement Primary diagnosis of osteoarthritis or degenerative joint disease Able to read and understand English to consent Acceptance of the study protocol procedure Exclusion Criteria: Active infection Tumor Metastatic or systemic malignancy Acute thrombus History of pulmonary embolism Major cardiac pathology such has angina Heart attack or uncompensated congestive heart failure (CHF) Body mass index (BMI) > 40 Pregnant or lactating women Renal dysfunction Joint revision Hospitalization length of stay less than or greater than 3 days Previous knee replacement Bilateral knee replacement

Ages Eligible for Study
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Minimum Age: 45 Years
Maximum Age: 90 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Control<br>Patients randomized to this arm will follow the current standard for post-operative care. | Other: Physical Therapy<br>* All patients will participate in joint physical therapy classes during their inpatient stay.<br>|
| Experimental: Experimental<br>Patients randomized to this arm will follow the current standard for post-operative care as well as 2 daily sessions of manual lymphatic drainage. | Other: Manual Lymphatic Drainage<br>* Manual Lymphatic Drainage (MLD) is a specialized massage technique utilized to decrease various forms of edema. This technique promotes reuptake of interstitial fluid along the pathways of the lymphatic system. This technique promotes healing, decrease swelling, and decrease pain.<br>* Other names: Manual Lymph Drainage;Other: Physical Therapy<br>* All patients will participate in joint physical therapy classes during their inpatient stay.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain Scores | Determine if performing MLD after TKR surgery decreases pain in the knee as compared to controls | 3 days | 
| Range of Motion | Determine if performing MLD after TKR surgery increases range of motion as compared to the standard of care | 3 days | 
| Girth | Determine if performing MLD after TKR surgery decreases girth and swelling in the knee as compared to the standar of care | 3 days |