OBJECTIVE(S): To investigate the efficacy of manual lymphatic drainage (MLD) in the early post-operative period following total knee arthroplasty (TKA) to reduce edema and pain, and improve knee range of motion (ROM). DESIGN: Prospective randomized controlled trial. SETTING: Private hospital and functional rehabilitation clinic. PARTICIPANTS: A consecutive sample of 43 patients (53 knees) scheduled for TKA. INTERVENTION(S): MLD (versus no MLD) on days 2, 3 and 4 post-operatively. Both groups underwent conventional, concomitant physical therapy. MAIN OUTCOME MEASURES(S): Clinical assessment was undertaken pre-operatively and post-operatively prior to and after the designated post-operative MLD sessions (on days 2, 3 and 4), as well as 6-weeks post-surgery. This included active knee flexion and extension ROM, lower limb girths (ankle, mid-patella, thigh and calf), and knee pain using a Numerical Rating Scale (NRS) and the Knee Injury and Osteoarthritis Outcome Score (KOOS). RESULTS: A significant group effect was observed for active knee flexion, with post hoc tests demonstrating a significantly greater active knee flexion in the MLD group, when compared to the control (no MLD) group, at the final measure prior to hospital discharge (day 4 post-surgery) and at 6-weeks post-surgery. There were no further group effects observed for the remaining patient-reported and functional outcomes. CONCLUSION: MLD in the early post-operative stages following TKA appears to improve active knee flexion up to 6-weeks post-surgery, in addition to conventional care.

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