Investigation of the efficacy of manual lymphatic drainage applied after total knee arthroplasty on pain, edema, functionality, kinesiophobia and blood lactate level

In this study, the efficacy of the manual lymph drainage (MLD) technique applied in addition to the postoperative rehabilitation protocol in patients undergoing total knee arthroplasty (TKA) surgery, on pain, edema, functionality, kinesiophobia, and blood lactate level was investigated in the acute and subacute postoperative period. Patients were randomly divided into 2 groups stratified according to activity pain, body mass index and age criteria. Rehabilitation protocol was applied to both groups from the first postoperative day. MLD was applied to one of the group. The groups were followed up with a home program for 6 weeks after discharge. Pain level, pain threshold, edema, knee flexion angle, functionality, kinesiophobia, walking distance, quality of life, lactate dehydrogenase (LDH) level was evaluated. The patients were evaluated preoperatively, in the acute postoperative period and at 6th week. The improvement in pain parameters, pain threshold, knee flexion and kinesiophobia in the MLD group, which started in the postoperative acute period and continued at the 6th week was higher (p<0.05). While the decrease in the amount of edema was not significant between the groups (p>0.05), functionality and quality of life values were better in the MLD group at 6th week (p<0.05). LDH levels were lower in the MLD group (p<0.05). As a result, it was seen that adding the MLD application to the standard protocol contributed more to the healing process than the standard protocol in the same time period. We think that adding this special technique to the rehabilitation program will contribute positively to the improvement in clinical symptoms.