Swelling assessment after total knee arthroplasty

Abstract

Background Total knee arthroplasty is a commonly performed elective orthopaedic surgery. Patients may endure substantial knee swelling following surgery, which are attributable to both effusion and edema. Studies have been aiming to identify an accurate and reliable method to quantify post-operative knee swelling to aid monitoring progress and treatment. The aim of this article was to review the means of clinically applicable measurements for knee swelling post TKA. Methods The medical literature was searched using PubMed to search for articles published using the terms knee edema, effusion, swelling, knee arthroplasty, knee replacement, total knee arthroplasty, total knee replacement, TKA, TKR. Year of publication was not restricted. Only English language publications were included. Only full-text published articles from peer-reviewed journals were eligible for inclusion. The knee swelling measurement methods used in post TKA were reviewed. Results Advancement in bioimpedance spectroscopy and handheld 3D scanning technology allows quick and precise quantification of knee swelling volume that the traditional clinical circumferential measurement and volumetric measurement lack. Handheld 3D scanning is also a potential tool to estimate the change of knee effusion volume and muscular volume after the surgery. Magnetic resonance imaging is accurate in effusion measurement but also the most time and resource demanding method. Conclusion Bioimpedance spectroscopy and 3D scanning technology can be the future tools for clinically measurement of knee swelling after total knee arthroplasty.

Efficacy of combining intravenous and topical dexamethasone against postoperative pain and function recovery after total knee arthroplasty: A prospective, double-blind, randomized controlled trial

“…4,5 In addition, postoperative lower limb swelling following TKA are one of the other important causes of dissatisfaction, and contribute to pain, inflammation, reduced range of motion, functional limitation and negative perception of enhanced recovery. [6][7][8][9][10] It is reported that the incidence of significant joint swelling after TKA is close to 20%. 8 Enhanced recovery after surgery (ERAS) has been introduced to arthroplasty in recent years and aims to reduce patients' stress response and postoperative complications, alleviate patients' pain, and shorten the length of hospital stays in TKA.…”

“…[6][7][8][9][10] It is reported that the incidence of significant joint swelling after TKA is close to 20%. 8 Enhanced recovery after surgery (ERAS) has been introduced to arthroplasty in recent years and aims to reduce patients' stress response and postoperative complications, alleviate patients' pain, and shorten the length of hospital stays in TKA. 11,12 Dexamethasone, a corticosteroid with powerful anti-inflammatory and antiemetic effects, has been frequently used in enhanced recovery protocol of TKA.…”

The Use of Biomarkers to Quantify Clinical Response to Total Knee Arthroplasty Interventions: A Systematic Review

“…Yet, such imaging techniques have been reported in the literature. Yau et al 38 argued that MRI is the most accurate noninvasive method for detecting knee effusion after TKA. However, the authors noted that MRI is typically reserved for assessing complications such as infection, joint loosening, wear, and malalignment.…”

Efficacy of Diosmin in Reducing Lower-Extremity Swelling and Pain After Total Knee Arthroplasty

“…The enhanced recovery after surgery pathway has emerged as one of the best strategies to improve the value and quality of surgical care 4,5 . Efforts to enhance recovery after TKA have identified postoperative lower-extremity swelling as one of the most frequent causes of patient dissatisfaction and pain, and such pain after surgery has been linked to inflammation, reduced range of motion, and the inhibition of quadricep function [6][7][8][9][10] . It has been reported that up to 20% of patients experience severe joint swelling following TKA 8 .…”

“…Qiuru Wang, MD 1 Qunhua Jin, MD 2 Lijun Cai, MM 1 Chengcheng Zhao, MM 1 Pengfei Feng, MD 2 Jie Jia, MD 3 Weihua Xu, MD 3 Qirong Qian, MD 4 Zheru Ding, MD 4 Jianzhong Xu, MD 5 Chenxi Gu, MD 5 Shoutao Zhang, MD 6 Hui Shi, MD 6 Hongbing Ma, MD 7 Ye Deng, MD 7 Tingjiu Zhang, MD 8 Yuan Song, MD 8 Qiang Wang, MD 9 Yinchang Zhang, MD 9 Xinshe Zhou, MD 10 Lijia Pei, MD 10 Yunkang Yang, MD 11 Jie Liang, MD 11 Tao Jiang, MD 12 Hao Li, MD 12 Huancai Liu, MD 13 Lizhong Wu, MD 13 Pengde Kang, MD, PHD 1…”