Impact of postoperative compression dressing using polyethylene foam pad on the multimodal protocol for swelling control following total knee arthroplasty: a randomized controlled trial

BACKGROUND The multimodal approach is commonly applied to improve knee swelling after total knee arthroplasty. Although the use of a knee compression pad may improve knee swelling, its impact in the multimodal protocol remains unclear. METHODS A total of 57 knees were randomly assigned to one of 2 groups receiving treatment with either a compression dressing using a polyethylene foam pad designed to effectively compress the postoperative knee combined with an elastic bandage or a compression dressing with use of an elastic bandage only. All patients were treated with the multimodal approach, including an external cooling system, intravenous tranexamic acid, no pneumonic tourniquet, and periarticular multidrug injection. RESULTS In intention-to-treat analysis, the circumferences of the thigh measured on postoperative days 1 and 7 were not significantly different between the 2 groups. In addition, there were no differences between the 2 groups in knee flexion angle, perioperative total blood loss, or complication rate. CONCLUSIONS The polyethylene foam pad had no significant beneficial effect on knee swelling in patients undergoing total knee arthroplasty using the multimodal approach.