Total Knee Arthroplasty: Post-Surgical Swelling Assessment – a Feasibility Study utilising Bioimpedance Spectroscopy
Alicia Boyd1, Adrian Benson1, Alasdair Sutherland2, Stephen Gill3,41St John Of God Warrnambool Hospital, Warrnambool, Victoria, Australia2South West Healthcare, Warrnambool, Victoria, Australia3Deakin University, Geelong, Victoria, Australia4Barwon Health, Geelong, Victoria, Australia
Abstract
Background
Over 50,000 Australians undergo knee replacement surgery (TKA) annually; >50% experience at least one complication.
Swelling, a normal side effect following TKA, is often associated with pain, delayed wound healing, reduced joint range, delayed mobility and prolonged rehabilitation.
Traditional assessment by tape measure or visual inspection is: time consuming, unreliable, inaccurate.
Bioimpedance spectroscopy (BIS), measurement via electrical current is: fast, accurate,routinely used in lymphoedema management.
Aim
To investigate if swelling assessment, via BIS, within the clinical setting is feasible and how swelling changes over time following TKA?
Methods
This prospective, observational, feasibility study was conducted at SJGWH.
Participants / Sample size (n) / Methods
•Caregivers / n=12 (9 interviews, 3 paired) / Semi structured interviews; deductive content analysis.
•Patients / n=22 (n=23 knee operations) / BIS measurement. Visual inspection of swelling.
Results
Themes from caregiver interviews indicated:
•Caregivers were happy to continue assessing TKA patients via BIS.
•Rehabilitation findings more relevant: potential early identification of problem swelling
•Time implications: accessing machine, measuring, explaining results.
TKA Patient data revealed:
•Average BIS scores were lower when caregivers visually assessed swelling as ‘nil’ or ‘mild’, higher for ‘moderate’ swelling, highest for ‘severe’ swelling.
•Approximately one-third of post-operative leg BIS data was deemed unusable due to low scan quality.
Conclusion
There was evidence to indicate that BIS assessment is practically applicable within the clinical environment and acceptable to caregivers.
With projected growth in TKA surgery volume, further study is required to investigate interaction of outcome measures and intervention effectiveness to reduce identifiable, clinically significant, swelling.
Acknowledgements:
This study was supported by:
•Western Alliance emerging research grant.
•Research Mentor, Dr Louise Greenstock Western Alliance Research Translation Coordinator
•Biostatistician, Charlotte Molesworth, Western Alliance & Deakin University.
•In-kind support from associate investigators.
Biography
Alicia Boyd is a Senior Clinician Physiotherapist at St John of God Warrnambool Hospital (SJGWH).
Working primarily in the management of lymphoedema, as an Australasian Lymphology Association accredited practitioner, she leads the provision of lymphoedema services.
Alicia is passionate about delivering best practice care to her regional community, embracing new technologies, and achieving excellent patient outcomes.