Should compression bandage be performed after total knee arthroplasty? A meta-analysis of randomized controlled trials

Pei Liu, Xiaohong Mu, Qidong Zhang, Zhaohui Liu, Weiguo Wang, Wanshou Guo, Pei Liu, Xiaohong Mu, Qidong Zhang, Zhaohui Liu, Weiguo Wang, Wanshou Guo

Abstract

Background: Compression bandage often is used after total knee arthroplasty (TKA) to alleviate pain, ameliorate swelling, and reduce bleeding. However, there is controversy about its application due to conflicting clinical outcomes and potential compression-related complications. This meta-analysis aimed to answer the question of if compression bandage should be implemented routinely after TKA.

Methods: Relevant randomized controlled trials (RCTs) on compression bandage were comprehensively retrieved utilizing search engines such as PubMed, EMBASE, Web of Science, and the Cochrane Library, up to September 2019. Studies included in the meta-analysis were those that compared post-operative pain score, swelling, total blood loss, pre- and post-operative hematocrit levels differences, range of motion (ROM), and complications, using Review Manager 5.3.0.

Results: Included were seven RCTs, which reported on 511 knees. The pooled results showed the compression bandage group was associated with a greater post-operative pain score during ambulation at 48 h (WMD = 0.70, 95% CI 0.07 to 1.34, P = 0.03), compared with the non-compression bandage group. No statistically significant differences were found between the groups in post-operative pain scores at the other times, swelling, blood loss, ROM, or other complications (P > 0.05).

Conclusions: The current evidence is unable to conclude that compression bandage is necessary after primary TKA. Surgeons routinely undertaking compression bandage should deliberate whether there is enough clinical evidence.

Keywords: Compression bandage; Meta-analysis; Total knee arthroplasty.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of study search and inclusion criteria
Fig. 2
Fig. 2
Risk-of-bias summary of included randomized controlled trials. +, no bias; −, bias,;? bias unknown
Fig. 3
Fig. 3
Forest plots of the included studies comparing post-operative pain
Fig. 4
Fig. 4
Forest plots of the included studies comparing post-operative swelling
Fig. 5
Fig. 5
Forest plots of the included studies comparing blood loss
Fig. 6
Fig. 6
Forest plots of the included studies comparing post-operative ROM
Fig. 7
Fig. 7
Forest plots of the included studies comparing complications

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