FRI0770-HPR A better way to decrease knee swelling in patients with knee osteoarthritis: intermittent pneumatic compression – a randomized controlled clinical trial
Authors: Z Sarı, O Aydoğdu, I Demirbüken, US Yurdalan, GM Polat
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> One of the most common symptoms of knee OA is swelling. Knee swelling negatively affects knee mechanics and muscle activity in patients with OA. Thus, knee swelling should be eliminated in the early period of rehabilitation. The utility of cold therapy for musculoskeletal injuries has been clearly established (1). It was shown that cold therapy may not be a statistically effective modality in improving range of motion and decreasing knee swelling (2). Intermittent pneumatic compression (IPC), which has been used to treat limb swelling, is a common option for patients with lymphedema and venous leg ulcers. Currently, IPC is primarily used in the prevention of deep venous thrombosis. It is also used for venous insufficiency, arterial occlusive disease, prevention of hematoma, etc (3). However, despite its widely accepted use, the literature on IPC in musculoskeletal injuries is limited. In particular, there is no report on whether IPC, which is known to have positive effects on circulatory problems, affects the knee swelling in OA. <h3>Objectives</h3> In this study, we hypothesized that IPC may have better outcomes on knee swelling. We also investigated whether IPC may contribute to better short-term patient outcomes in patients with knee OA rather than cold therapy. <h3>Methods</h3> This was a randomized, prospective, comparative clinical study. The study included 81 patients aged 18–65, who were admitted to the Or – Ahayim Balat Hospital. The patients were randomly divided into two groups. One group (n=36) received ultrasound, transcutaneous electrical nerve stimulation, electrical stimulation, exercise, and cold packs. The second group (n=45) received ultrasound, transcutaneous electrical nerve stimulation, electrical stimulation, exercise, and IPC. The primary outcome on pre- and post – treatment follow – up was knee swelling. Secondary outcome measures included range of motion, muscle strength, pain intensity and disability. <h3>Results</h3> Intermittent pneumatic compression significantly decreased knee swelling in patients with osteoarthritis (p&lt;0.001). A significant difference between the groups was found in knee swelling in favour of the intermittent pneumatic compression group (p=0.028). We also found significant improvements in range of motion, muscle strength, pain intensity and disability in both groups (p&lt;0.05). No significant differences in any of secondary outcome variables between the groups (p&gt;0.05). <h3>Conclusions</h3> The mechanism of our hypothesis was that in opposite of cold therapy which has local effects, IPC may affect circulatory of all lower extremity in patients with swollen knee. This randomized - controlled trial confirmed the hypothesized advantage of intermittent pneumatic compression over cold - pack on knee swelling in patients with knee osteoarthritis. <h3>References</h3> Rutherford DJ, Hubley-Kozey CL, Stanish WD: Knee effusion affects knee mechanics and muscle activity during gait in individuals with knee osteoarthritis. Osteoarthr. Cartil. 2012;20(9):974–81. Markert SE. The use of cryotherapy after a total knee replacement: a literature review. Orthopaedic Nursing. 2011:30(1):29–36. Chen AH, Frangos SG, Kilaru S, et al.: Intermittent pneumatic compression devices – Physiological mechanisms of action. Eur J Vasc Endovasc Surg. 2001;21(5):383–92. <h3>Disclosure of Interest</h3> None declared