Evaluation of reduced ('Lite') compression versus brief bandaging to manage post-operative pain after total knee arthroplasty surgery; a single-centre randomised controlled trial

Matt Dawson; William Hage; Cristian Nita; Lucy Bell; Janice Gorman; Leon Jonker

doi:10.1016/j.ijotn.2024.101100

Evaluation of reduced ('Lite') compression versus brief bandaging to manage post-operative pain after total knee arthroplasty surgery; a single-centre randomised controlled trial

Int J Orthop Trauma Nurs. 2024 Apr 5:54:101100. doi: 10.1016/j.ijotn.2024.101100. Online ahead of print.

Authors

Matt Dawson¹, William Hage², Cristian Nita³, Lucy Bell⁴, Janice Gorman⁵, Leon Jonker⁶

Affiliations

¹ North Cumbria Integrated Care NHS Foundation Trust, Carlisle, CA2 7HY, UK. Electronic address: Matt@cumbriankneeclinic.co.uk.
² North Cumbria Integrated Care NHS Foundation Trust, Carlisle, CA2 7HY, UK. Electronic address: william.hage@ncic.nhs.uk.
³ North Cumbria Integrated Care NHS Foundation Trust, Carlisle, CA2 7HY, UK. Electronic address: cristian.nita@ncic.nhs.uk.
⁴ North Cumbria Integrated Care NHS Foundation Trust, Carlisle, CA2 7HY, UK. Electronic address: lucy.bell@ncic.nhs.uk.
⁵ North Cumbria Integrated Care NHS Foundation Trust, Carlisle, CA2 7HY, UK. Electronic address: Janice.gorman@ncic.nhs.uk.
⁶ North Cumbria Integrated Care NHS Foundation Trust, Carlisle, CA2 7HY, UK; University of Cumbria, Carlisle, CA1 2HH, UK. Electronic address: leon.jonker@ncic.nhs.

PMID: 38626558
DOI: 10.1016/j.ijotn.2024.101100

Abstract

Purpose: Investigate efficacy of reduced compression bandage for the control of pain after total knee arthroplasty.

Patients & methods: Prospective, single-centre, randomised controlled trial involving data for 56 out of 94 consented patients; 29 standard care versus 27 Andoflex TLC Calamine Lite. Comparison of standard care (non-compression bandage applied for up to one day) versus Andoflex TLC Calamine Lite (25-30 mmHg) two-layer compression bandage worn for five days. Outcomes measured with validated pain (McGill, 10-cm visual scale) and functionality (KOOS) tools.

Results: At day 5 post-surgery, the median pain level was 3.0 cm vs 4.0 cm (p-value 0.47, Mann-Whitney U test) respectively. Generic pain levels, pain types, and knee functionality did not differ between the interventions at days 3/5/12 and week 6 post-surgery. An exception was the degree of 'tender' pain at day 12, which was significantly lower in the Andoflex TLC Calamine Lite arm (p-value 0.041, Mann-Whitney U test). Binary logistic regression analysis showed that application of Andoflex TLC Calamine Lite, administration of oxycodone, and male sex were all significantly associated with less 'tender' pain.

Conclusion: Reduced compression bandaging does not affect overall pain levels post knee arthroplasty surgery, but may alleviate pain experienced as 'tender', highlighting the different types of pain that may be experienced. Patients' need for, and the use of, opioid medication (oxycodone) is a significant confounding variable when assessing adjuvant therapy to control pain. The applicability of reduced compression bandaging may therefore be limited and is less efficient than medical pain control.

Keywords: Compression bandaging; KOOS; Knee arthroplasty; Knee osteoarthritis; McGill questionnaire; Pain.