KNEE SWELLING AND ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION

Student thesis: Doctoral ThesisDoctor of Philosophy

Abstract

Swelling is universal after Anterior Cruciate Ligament Reconstruction (ACLR). Cooling compressive devices aim to treat swelling after surgery, but research has focussed more on pain than swelling.
The aims of this work were to measure knee swelling in ACLR with a perometer (an optoelectric volumeter) and to evaluate an intervention for knee swelling in ACLR which uses a cold compressive device.
The main outcome for the studies was knee volume measured using the perometer. Reliability was established and a randomised controlled trial was undertaken
The study aimed to compare the use of Cryocuff, and elevation, with standard treatment used post ACLR (compression bandage alone). Secondary outcomes were also measured to assess the correlates of knee swelling in ACLR.
The patients were randomised into a standard treatment group or into a Cryocuff and elevation group. Knee volume in both knees was measured pre-operatively and at two weeks post-operatively using the perometer. Secondary variables measured included: - range of movement, pain, knee laxity and function, medication use, tourniquet and discharge times, and operative factors.
There was with no significant difference between the groups (p=0.977). This study did not find Cryocuff and elevation to be more effective for minimising swelling at 2 weeks post-operatively, than a compression bandage alone. The perometer was reliable with Intra class correlation coefficient of 0.996.
Significant correlates of swelling post-ACLR were: blood pressure; knee joint laxity and extension loss, with daily elevation time and Intravenous fluid given intra operatively close to significance.
Further investigation outlined the level and profile of compression applied to the knee by the Cryocuff found that this device may have inherent features that could be provocative of swelling.
Date of Award2017
Original languageEnglish
Awarding Institution
  • King's College London
SupervisorMichael Thacker (Supervisor) & Matt Morrissey (Supervisor)

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