What is the average duration of diffuse leg swelling following a total knee arthroplasty (TKA)?

From the Guidelines

The average length of time for diffuse leg swelling following a total knee arthroplasty (TKA) is typically around 14 days, as indicated by the time it takes for the wound to show evidence of healing and for sutures/staples to be removed. This timeframe is based on the guidelines for the perioperative management of antirheumatic medication in patients with rheumatic diseases undergoing elective total hip or total knee arthroplasty 1. Management of swelling includes elevation of the affected limb above heart level for 30 minutes several times daily, application of cold therapy for 15-20 minutes every 2-3 hours during the first few weeks, compression with elastic stockings or compression bandages, and gentle ankle pumping exercises to promote circulation. Some key points to consider in the management of diffuse leg swelling after TKA include:

• Elevation of the affected limb to reduce fluid accumulation
• Cold therapy to reduce inflammation
• Compression to prevent further fluid buildup
• Gentle exercises to promote circulation and lymphatic drainage It's also important to note that while the provided evidence does not directly address the duration of diffuse leg swelling after TKA, the information on wound healing and management can be applied to understand the typical timeframe for swelling resolution. Patients should be monitored for signs of complications such as infection or deep vein thrombosis, and should contact their surgeon if they experience severe pain, redness, warmth, fever, or sudden worsening of swelling.

From the Research

Average Length of Time of Diffuse Leg Swelling Following a TKA

• The average length of time of diffuse leg swelling following a Total Knee Arthroplasty (TKA) is not directly stated in the provided studies.
• However, study 2 mentions that 70% of the swelling had occurred before application of the stocking the day after surgery, and knee, calf and ankle swelling measured on days 2,7,14 and 30 showed no significant difference between the two groups.
• Study 3 found that clinically relevant differences in edema reduction between the two groups were found in the early postoperative period and at the six weeks follow up.
• Study 4 compared compression stockings and non-compressive sleeves embedded with semiconductor elements (Incrediwear) on post-TKA measures, and found that Incrediwear subjects had lower levels of effusion than controls at week 3.
• Study 5 compared above-knee versus below-knee stockings in total knee arthroplasty, and found no statistical difference between the groups and no difference in wound complication rates.
• Study 6 identified pre-operative predictors of lower extremity swelling following total knee arthroplasty in patients with venous insufficiency and osteoarthritis, including pre-operative great saphenous diameter, GSV reflux, deep only VI, CEAP C4-6, and hypothyroidism.

Time Frame for Diffuse Leg Swelling

• Study 3 measured edema reduction at six weeks follow up, suggesting that diffuse leg swelling may persist for at least six weeks after TKA.
• Study 4 measured effusion at week 3, suggesting that diffuse leg swelling may be reduced by this time point.
• Study 6 measured leg circumference at one and three months post-operatively, suggesting that diffuse leg swelling may persist for several months after TKA.

Factors Affecting Diffuse Leg Swelling

• Study 2 found that the use of medical elastic compression stockings did not have a significant effect on knee, calf and ankle swelling.
• Study 3 found that multi-layer compression therapy (MLCT) could be an alternative treatment to reduce postoperative edema in patients after total knee arthroplasty.
• Study 4 found that non-compressive sleeves embedded with semiconductor elements (Incrediwear) appeared to reduce effusion and improve knee flexion better than traditional compression stockings.
• Study 6 identified pre-operative predictors of lower extremity swelling, including pre-operative great saphenous diameter, GSV reflux, deep only VI, CEAP C4-6, and hypothyroidism, suggesting that these factors may affect the duration and severity of diffuse leg swelling after TKA.