Clinical Research Directory

Investigation of the Individual Fatigue Response During Blood Flow Restriction Training

The aim of the present pilot study is to investigate the feasibility of an exercise pressure response approach for assessing physiological strain during BFR training in a clinically supervised setting. Patients undergoing rehabilitation following total knee arthroplasty (TKA) will be included. The results are intended to contribute to an improved evaluation of load management during BFR training.

Ultrasound Guided Combined Adductor Canal, Superior Genicular Nerves and Anterior Femoral Cutaneous Nerves Blocks in Comparison With Periarticular Local Anesthesia Infiltration in Primary Total Knee Arthroplasty

Background: Pain management in total knee arthroplasty continues to evolve especially as an early postoperative analgesia is of paramount importance in achieving patient satisfaction and improving clinical outcomes. The goal of achieving an ideal analgesia modality which facilitates early rehabilitation, prevents knee stiffness, reduces hospital stay due to pain, and promotes good functional outcomes continues to be elusive. Multimodal analgesia has been devised to control postoperative pain and reduce opioid consumption including periarticular injection and peripheral nerve blocks. Rationale: Assess the efficacy of a triple block including Adductor canal block, superior lateral, superior medial genicular nerves block and anterior femoral cutaneous nerves block in comparison with Periarticular infiltration for pain management in patients undergoing a total knee arthroplasty. Methods: Prospective Randomized Control Trial

Efficacy of Genicular Block on Total Knee Arthroplasty Surgery

This prospective, randomized, double-blind, placebo-controlled trial evaluated the analgesic efficacy of preoperative ultrasound-guided genicular nerve block (GNB) in patients undergoing total knee arthroplasty. A total of 64 patients were randomly assigned to two groups (32 patients per group). The GNB group received 5 mL of 0.25% bupivacaine at each of three genicular nerve targets, whereas the placebo group received 5 mL of 0.9% normal saline at the same anatomical targets. All patients underwent standardized general anesthesia and received postoperative multimodal analgesia, including intravenous patient-controlled morphine analgesia. The primary outcome was movement-evoked pain intensity, assessed using the visual analog scale (VAS) at 24 hours postoperatively. Secondary outcomes included pain scores at other postoperative time points, opioid consumption, and knee range of motion. Participants and outcome assessors were blinded to group allocation.

Smart Knee Evaluation of Exparel and Zynrelef in TKA Recovery

This study looks at how three different numbing injections affect how quickly patients recover after knee replacement surgery (total knee arthroplasty, or TKA). Pain after knee replacement is common and can slow down how soon patients get moving again. Doctors often inject a numbing medication around the knee during surgery to help control this pain, but it is not clear which medication helps patients recover fastest in the first few days after surgery. The study compares three injections that are all FDA approved and already used as part of routine knee replacement care: Exparel (liposomal bupivacaine), Zynrelef (bupivacaine with meloxicam), and Marcaine (bupivacaine). Exparel and Zynrelef are the two groups being studied, and Marcaine is the comparison (control) group. Adults who are already planning to have a knee replacement may take part. People who join are placed into one of the three injection groups at random, so each person has a one in three chance of receiving each injection. Patients are not told which injection they received. Everything else about the surgery, anesthesia, and recovery care stays the same as usual. The main goal is to see which injection helps patients recover best in the first three days after surgery. To measure recovery, the study team collects information on pain, pain-medication use, knee motion, activity level, and function. Patients complete short questionnaires about their activity, pain, and quality of life at their regular visits (before surgery and at 3 days, 1 week, 2 weeks, 6 weeks, 3 months, 1 year, and 2 years). A smart knee implant also records information about knee movement and motion at 3 and 7 days after surgery. About 200 people will take part. The study is considered minimal risk, meaning the risks are similar to those of having a knee replacement outside of the study.

Impact of Chronic Venous Insufficiency on Outcomes After Total Knee Arthroplasty

Total knee arthroplasty (TKA) is an effective treatment for end-stage knee osteoarthritis; however, postoperative complications-particularly wound healing problems-remain a significant concern. Chronic venous insufficiency (CVI) is associated with venous hypertension, impaired microcirculation, and tissue hypoxia, which may negatively affect wound healing and increase complication rates. This prospective observational cohort study aims to evaluate the impact of preoperative CVI on postoperative outcomes following TKA. Patients will be assessed preoperatively using the CEAP classification and Doppler ultrasonography to identify and stratify venous insufficiency. Participants will be followed for 12 months postoperatively. The primary outcome will be wound healing complications in the early postoperative period. Secondary outcomes will include functional outcomes assessed by the Knee Society Score (KSS), patient-reported outcomes using the WOMAC score, and overall complication rates. The findings of this study are expected to clarify the role of venous insufficiency as a potential risk factor in TKA and may contribute to improved preoperative risk stratification and postoperative management strategies.

Using a Smart Implantable Device to Compare Early Recovery in Two Different Knee Arthroplasty Approaches

This is a single-institution, prospective, randomized study comparing the medial parapatellar and subvastus approaches in primary total knee arthroplasty using continuous, implant-based gait monitoring. Patients receiving a Zimmer Persona IQ smart implant will be followed preoperatively and through the first 30 days post-operatively, with extended follow-up to 6 months. Preoperative activity is captured using iPhone Health step-count data, while post-operative recovery is assessed using continuous tibial implant data, including step count, range of motion, cadence, walking speed, stride length, and distance. These objective metrics are correlated with PROMs. The primary outcome is daily step count. Secondary outcomes include early functional milestones, pain, and patient-reported functional scores. This study is designed to characterize early recovery trajectories and determine whether meaningful differences exist between surgical approaches.

Early Cognitive Changes After General Versus Spinal Anesthesia in Older Adults Undergoing Total Knee Arthroplasty

This prospective observational study investigated early postoperative cognitive changes in older adults undergoing elective total knee arthroplasty under general or spinal anesthesia. Patients aged 65 years or older who were considered suitable for either anesthetic technique were prospectively enrolled. The anesthetic technique was determined according to patient preference, clinical characteristics, surgical considerations, and the attending anesthesiologist's judgment and was not assigned by the investigators. Cognitive function was assessed using the Mini-Mental State Examination (MMSE) preoperatively and 24 h after surgery. Serum S100B concentrations were measured preoperatively and at 6 and 24 h postoperatively. The primary objective was to compare changes in MMSE scores between the general and spinal anesthesia groups. Secondary objectives were to compare perioperative changes in serum S100B concentrations and to evaluate their association with postoperative changes in cognitive performance.

Liposomal Bupivacaine Versus Ropivacaine With Perineural Dexamethasone or Dexmedetomidine as Adjuncts for Adductor Canal Block Combined With IPACK Block in Total Knee Arthroplasty

Effective postoperative pain management remains a cornerstone of enhanced recovery protocols following total knee arthroplasty (TKA). Inadequate analgesia not only compromises patient satisfaction but also impedes early mobilization and rehabilitation, thereby increasing the risk of perioperative complications. Current multimodal analgesic strategies frequently incorporate regional techniques, with the adductor canal block (ACB) and infiltration between the popliteal artery and capsule of the knee (IPACK) block emerging as established modalities that provide motor-sparing analgesia. Despite their widespread adoption, the optimal local anesthetic regimen for these blocks remains undefined. While liposomal bupivacaine has garnered interest for its extended duration of action, its clinical efficacy relative to conventional local anesthetics combined with perineural adjuncts remains a subject of ongoing debate. Specifically, perineural dexamethasone and dexmedetomidine have each demonstrated the capacity to prolong the analgesic duration of ropivacaine; however, direct comparative data among these three distinct strategies-liposomal bupivacaine alone versus ropivacaine supplemented with either adjunct-are notably limited. Given the absence of head-to-head randomized trials evaluating these three clinically viable techniques, the optimal approach to maximize analgesic duration while minimizing opioid-related adverse effects remains unclear. This study therefore aims to compare the analgesic efficacy and safety profiles of liposomal bupivacaine, ropivacaine with perineural dexamethasone, and ropivacaine with perineural dexmedetomidine when administered via ACB and IPACK blocks in patients undergoing TKA.

Comparison of Ultrasound-Guided Lumbar ESPB and ACB for Knee Arthroplasty

Total knee arthroplasty (TKA) is a surgical procedure frequently associated with moderate-to-severe postoperative pain. While Adductor Canal Block (ACB) has demonstrated analgesic efficacy in TKA, the Erector Spinae Plane Block (ESPB) is also being utilized as part of multimodal analgesia for postoperative pain management in lower extremity surgeries. Currently, there is a gap in the literature as no studies have directly compared the efficacy of ACB and ESPB for pain management following TKA. The primary objective of this study is to compare the efficacy of these two analgesic methods in the context of postoperative analgesia management after total knee arthroplasty.

Assessment of the Nutritional Status of Patients Undergoing Prosthetic Orthopedic Surgery: An Exploratory Study

The aim of this study is to evaluate the impact of prosthetic orthopedic surgery on the nutritional status of patients undergoing total knee arthroplasty in adult patients scheduled. This study is based on the hypothesis that prosthetic orthopedic surgery may induce or worsen malnutrition, an issue that has not been investigated to date. Participants will perform an additionnal blood test, physical performance tests and questionnaires as part of this research.

Evaluation of Choose to Move Replacement Ready (CTM-RR)

Choose to Move (CTM) is a 3-month, choice-based health-promoting program for low active older adults being scaled-up across British Columbia (BC), Canada. Recently, the investigators adapted CTM for the \>14000 people in BC who are on surgical waitlists for total knee replacement or total hip replacement (TKR/THR) for osteoarthritis (OA). The primary goals of this observational study are to describe how the adapted program, Choose to Move Replacement Ready (CTM-RR), is implemented in BC and determine if the adapted program improves health outcomes in people with hip and/or knee osteoarthritis who are on surgical waitlists for TKR/THR. The investigators will also evaluate whether any health benefits achieved by CTM-RR participants are maintained three months after they finish the program and also during the remaining time that they wait for their TKR/THR surgery. The investigators will work with referral partners from hospitals and orthopaedic clinics in BC to recruit participants into CTM-RR. Participants who enrol in CTM-RR will answer online survey questions about the program and about their physical activity, mobility, pain, function, quality of life, willingness to undergo surgery, overall perception of their joint condition, psychosocial health, self-efficacy, social isolation, loneliness, and sedentary time. CTM-RR activity coaches will also answer online survey questions about the program. CTM-RR participants, activity coaches, and referral partners will also participate in interviews about the program.

COntralateral CorticoSTeroid Injection in Total Knee Arthroplasty

Through a triple-blinded randomized control trial, the primary purpose of this pilot study is to assess the efficacy of administering peri-operative contralateral corticosteroid injection in patients undergoing TKA. The secondary outcome was to assess the effect of contralateral corticosteroid injection on pain and functional outcomes of patients undergoing TKA.

"The Effect of AI-Assisted Mobilization Education on Kinesiophobia and Readiness for Hospital Discharge in Patients Undergoing Total Knee Arthroplasty''

The aim of this study is to investigate the effect of artificial intelligence-assisted mobilization education provided to patients undergoing total knee arthroplasty on their level of kinesiophobia and readiness for hospital discharge. The research questions are as follows: Does artificial intelligence-assisted mobilization education provided to patients undergoing total knee arthroplasty affect their level of kinesiophobia? Does artificial intelligence-assisted mobilization education provided to patients undergoing total knee arthroplasty affect their readiness for hospital discharge? Study Procedure In the control group, participants will receive the standard care routinely provided in the orthopedic clinic, without viewing the artificial intelligence-assisted mobilization education video. In the intervention group, participants will receive an artificial intelligence-assisted video-based mobilization education program developed to prepare them for their first postoperative mobilization. Intervention Group: After hospital admission, participants will complete a Personal Information Form. On postoperative day 1, before the first mobilization, the Tampa Scale for Kinesiophobia will be administered. Following completion of the baseline assessment, participants will receive the artificial intelligence-assisted video-based mobilization education delivered by a nurse. Immediately after the education, the Tampa Scale for Kinesiophobia will be administered again. Four hours before hospital discharge, participants will complete the Readiness for Hospital Discharge Scale-Patient Self-Assessment Form, and the nurse will complete the Readiness for Hospital Discharge Scale for Adult Patients-Nurse Assessment Short Form. Control Group: After hospital admission, participants will complete a Personal Information Form. On postoperative day 1, before the first mobilization, the Tampa Scale for Kinesiophobia will be administered. Following the baseline assessment, participants will receive the routine verbal mobilization education provided by the nurse. Immediately after the education, the Tampa Scale for Kinesiophobia will be administered again. Four hours before hospital discharge, participants will complete the Readiness for Hospital Discharge Scale-Patient Self-Assessment Form, and the nurse will complete the Readiness for Hospital Discharge Scale for Adult Patients-Nurse Assessment Short Form. At the final stage of the study, all preoperative and postoperative data collected from the participants will be compiled, recorded, and analyzed. Inclusion Criteria: Patients will be included in the study if they meet the following criteria: Age 18 years or older Undergoing total knee arthroplasty for the first time Able to read and write in Turkish No impairments that would prevent watching, hearing, or understanding the educational video No diagnosed psychiatric disorders and not using psychiatric medications that may affect the accuracy of responses No additional conditions affecting mobility other than knee arthroplasty No administration of narcotic analgesics within 30-60 minutes prior to mobilization Having access to a mobile phone capable of viewing the educational video during both the preoperative and postoperative periods. The population of the study will consist of all patients undergoing total knee arthroplasty in the Orthopedics Clinic of a state hospital. The sample will include patients who meet the study eligibility criteria and agree to participate in the study. A total of 72 patients will participate in the study, with 36 patients assigned to the control group and 36 patients assigned to the intervention group. Written and verbal informed consent will be obtained from all patients prior to participation in the study. Data will be analyzed using SPSS version 25.0 (Statistical Package for the Social Sciences).

The Effects of Mir Shakeel Teleintegrated Therapy Plan in Patients Undergoing Total Knee Arthroplasty

This randomized controlled trial aims to evaluate the effectiveness of a newly developed Modified Structured Telerehabilitation Intervention Protocol (MSTITP) compared with conventional in-person physical therapy in patients recovering from Total Knee Arthroplasty (TKA). The study also explores whether a hybrid rehabilitation approach may further optimize patient outcomes. A total of eligible participants aged 50-65 years who have undergone primary TKA will be randomly assigned to one of two groups: Group A (Intervention): Telerehabilitation-based structured exercise program (MSTITP) delivered through digital platforms with remote supervision. Group B (Control): Standard conventional face-to-face physiotherapy in a clinical setting. Both groups will receive rehabilitation programs of equal duration focusing on pain management, range of motion (ROM), muscle strengthening, gait training, and functional mobility. The primary objective is to compare the effectiveness of telerehabilitation and conventional therapy in improving pain, ROM, and gait performance. Secondary objectives include evaluation of exercise adherence, kinesiophobia, functional outcomes, quality of life, and patient satisfaction. Additionally, the study will explore whether integrating telerehabilitation with conventional rehabilitation could provide superior outcomes. Outcome assessments will be conducted using validated tools including pain scales (VAS), goniometric ROM measurements, gait analysis, functional performance tests, and standardized questionnaires for quality of life, exercise adherence, and fear of movement. This study addresses the increasing burden of osteoarthritis and the growing number of TKA procedures in Pakistan. Telerehabilitation may offer a cost-effective, accessible, and scalable rehabilitation model that ensures continuity of care and improved access to physiotherapy services, particularly in resource-limited settings. The findings of this trial are expected to provide evidence for developing standardized, technology-assisted rehabilitation protocols to improve post-TKA recovery outcomes and reduce healthcare burden.

Prospective, In-Vivo, Post-Market Safety and Efficacy Surveillance Registry of the MAXX Orthopedics, Freedom Total Knee® System

In an effort to satisfy regulatory requirements for post-market surveillance of product safety and efficacy, a representative sample of patients will be recruited for prospective monitoring.

IPACK vs Adductor Magnus Plane Block Added to Adductor Canal Block for Total Knee Arthroplasty

Total knee arthroplasty (TKA) is among the most frequently performed surgical procedures for degenerative joint diseases, including advanced knee osteoarthritis, rheumatoid arthritis, and post-traumatic arthritis. More than 700,000 TKA procedures are performed annually in the United States alone since 2012, with projections estimating a 143% increase by 2050. A significant proportion of patients experience moderate to severe postoperative pain following the procedure, adversely affecting early mobilization, adherence to rehabilitation programs, and ultimately functional recovery . Femoral nerve block (FNB) was historically the cornerstone of TKA analgesia; however, concerns about quadriceps weakness and associated fall risk led to its replacement by more motor-sparing alternatives . Adductor canal block (ACB) has since become the standard approach, providing analgesia equivalent to FNB while significantly preserving quadriceps strength . Nevertheless, ACB does not adequately cover the posterior capsule and popliteal plexus terminals; consequently, 60-80% of TKA patients report significant posterior knee pain that cannot be sufficiently managed by ACB alone . To address this limitation, several posterior knee analgesia techniques have been described. The IPACK (Interspace between Popliteal Artery and Capsule of the Knee) block targets genicular nerve branches and popliteal plexus terminals by injecting local anesthetic between the popliteal artery and the posterior knee capsule, largely sparing the main motor trunks and providing selective posterior analgesia . The adductor magnus muscle plane (AMM) block is a relatively novel interfascial plane block technique applicable in the supine position simultaneously with ACB. By injecting local anesthetic into the fascial plane along the posterior surface of the adductor magnus muscle, the AMM block aims to spread to the popliteal plexus and posterior capsular branches, potentially mimicking a sciatic nerve block effect . A key advantage of the AMM block is its applicability without patient repositioning during the same session as ACB. The primary objective of this prospective randomized trial was to compare the effects of IPACK and AMM blocks-both added to ACB-on postoperative opioid consumption in patients undergoing TKA. Secondary objectives included evaluating the impact of each technique on postoperative pain scores, mobilization time, functional recovery, and motor function

Programmed Intermittent Epidural Bolus Versus Continuous Epidural Infusion for Postoperative Analgesia After Total Knee Arthroplasty

The goal of this clinical trial is to compare two different epidural analgesia delivery methods for pain control after total knee arthroplasty in adults undergoing elective surgery. The study will evaluate whether programmed intermittent epidural bolus (PIEB) provides better postoperative analgesia and recovery outcomes than continuous epidural infusion (CEI). The main questions it aims to answer are: Does PIEB reduce total epidural local anesthetic consumption during the first 24 postoperative hours compared with CEI? Does PIEB improve postoperative pain control and quality of recovery? Are there differences between the two methods regarding motor block, rescue analgesic requirement, patient-controlled epidural analgesia use, and adverse effects? Researchers will compare PIEB plus patient-controlled epidural analgesia (PCEA) with CEI plus PCEA in patients undergoing total knee arthroplasty. Participants will: Receive combined spinal-epidural anesthesia during surgery Receive postoperative epidural analgesia using either PIEB or CEI Be evaluated for pain scores, motor block, recovery quality, epidural local anesthetic consumption, rescue analgesic requirement, and adverse events during the first 24 postoperative hours

Proximal Spread in Adductor Canal Block(ACB)

This prospective, randomized clinical study is designed to evaluate the effects of two different injection levels of adductor canal block (ACB) on the proximal spread of local anesthetic and clinical outcomes in patients undergoing total knee arthroplasty. The study will be conducted at Ankara Etlik City Hospital and will include a total of 68 patients. All cases are limited to unilateral elective knee replacement surgeries performed under spinal anesthesia. In this study, the comparison will be based on the application of adductor canal block at two distinct injection levels. In both groups, blocks will be performed under ultrasound (USG) guidance using the same technical principles and standardized conditions; in the first group, the block will be administered at the level where the vasto-adductor membrane is first visualized, while in the second group, it will be performed at the level where the adductor longus ends. The type, concentration, and volume of local anesthetic used in both groups will be standardized as 20 mL of 0.25% bupivacaine. The groups will be compared in terms of the proximal spread of the local anesthetic based on the injection level, the area of spread at the apex of the iliopectineal fossa, the involvement of the femoral nerve, the incidence of postoperative falls, and analgesic consumption.

Recovery Trajectories After Total Knee Arthroplasty

This prospective cohort study aimed to compare recovery trajectories following cruciate-retaining (CR) and posterior-stabilized (PS) total knee arthroplasty (TKA) using rehabilitation-centered patient-reported outcome measures (PROMs). Forty patients undergoing primary unilateral TKA were evaluated preoperatively and at 3 and 6 months postoperatively. Outcomes included pain intensity, functional status, kinesiophobia, health-related quality of life, and joint awareness assessed using validated PROMs including the Visual Analog Scale (VAS), WOMAC, Tampa Scale for Kinesiophobia (TSK), SF-36, and Forgotten Joint Score-12 (FJS-12). The study investigated whether posterior cruciate ligament management influences early postoperative recovery trajectories after TKA.

Effect of Combined Adductor Canal and AFCN Block on Postoperative Inflammation

The aim of this thesis is to evaluate the effects of adding an anterior femoral cutaneous nerve (AFCN) block to the adductor canal block used for postoperative analgesia after total knee arthroplasty on the postoperative inflammatory response, as assessed by inflammatory biomarkers including NLR, PLR, AISI, and CAR.

Tourniquet Vs. No-Tourniquet Technique in Total Knee Arthroplasty at the University Hospital of the West Indies

The goal of this clinical trial is to determine whether performing total knee replacement surgery (total knee arthroplasty, TKA) without a tourniquet is clinically equivalent to performing the procedure with a tourniquet in adults with symptomatic knee osteoarthritis. A tourniquet is commonly used during surgery to reduce bleeding and improve the surgeon's view. However, some studies suggest it may be associated with certain complications. It is currently unclear whether using a tourniquet meaningfully changes outcomes compared to not using one. This study aims to assess whether both approaches result in similar outcomes within a clinically acceptable range. The main question this study aims to answer is: Is total blood loss during surgery equivalent between TKA performed with a tourniquet and TKA performed without a tourniquet, within a predefined margin of ±100 mL? Additional questions include: Are surgical field quality, postoperative pain, functional recovery, and complication rates comparable between the two techniques? Researchers will compare: TKA performed with a pneumatic tourniquet TKA performed without a tourniquet to determine whether outcomes between the two approaches are equivalent rather than whether one is superior to the other. Participants will: Be randomly assigned to one of the two surgical groups using a computer-generated process Undergo standard total knee replacement surgery and routine perioperative care Have blood loss assessed during and after surgery Be monitored for pain, recovery of function, wound healing, and complications during hospital stay and follow-up visits This study is designed as a randomized controlled equivalence trial to determine whether both surgical approaches produce comparable outcomes within clinically acceptable limits, in a standardized local setting.

Knee Flexionater to Avoid Motion Restoring Surgery

The goal of this clinical trial is to learn whether adding a stretching device to standard physical therapy can help people regain knee bending after total knee replacement surgery. Some people have difficulty bending their knee during recovery. When this happens, doctors may recommend another procedure called motion-restoring surgery to improve knee movement. This study aims to answer two main questions. First, does adding a hydraulic high-intensity stretching device to physical therapy help people regain knee bending after surgery? Second, does using the device affect recovery, daily activities, or the chance of needing another procedure? Researchers will compare two treatment approaches. One group will receive standard physical therapy alone. The other group will receive standard physical therapy and will also use a hydraulic high-intensity stretching device called the Ermi Knee Flexionater at home. Participants who receive the device will use it at home each day in addition to attending their physical therapy sessions. Researchers will measure how well participants can bend their knee and will ask questions about pain, daily function, and activity level. Participants will also complete simple walking and mobility tests. Study visits will occur about four weeks after surgery when participants enroll, and again at about eight weeks, twelve weeks, six months, one year, and two years after surgery. Researchers will compare results between the two groups to see whether the stretching device improves recovery after knee replacement.

Monocentric Randomised Controlled Trial Assessing Cryocompression Following Total Knee Replacement

Immediately following surgery, icepacks are commonly used to decrease inflammation and reduce pain and have demonstrated to decrease post-operative opioid consumption. New cryocompression devices have been introduced as a non-invasive and non-pharmacological modality used to manage acute inflammation and pain, demonstrating benefits in the post- operative setting promoting vasoconstriction, reducing blood flow and inflammation. The addition of compression may further decrease inflammation and pain, revealed in studies on anterior cruciate ligament reconstruction, total hip replacement, and lumbar fusion. Recently, an RCT was published by Marinova et al. that compared cryocompression to icepacks following TKR in terms of pain on VAS, range of motion (ROM), knee circumference, and opioid consumption, but only found significant differences in extension ROM at day 1 and at 2 weeks. Due to the small sample size of Marinova et al. and high rates of losses to follow-up due to COVID-19, there remains doubt on the efficacy of cryocompression for TKR. Furthermore, cryocompression require additional investment in terms of cost to acquire the devices, and in time to train the hospital staff, and the devices may not be available for every patient. Finally, the authors are unsure how cryocompression affects wound healing in the short- and long-term. The hypothesis was that both cryocompression and regular icepacks would grant equivalent pain on numeric rating scale at 48 hours postoperatively.

Drain Removal Before Versus After CPM in Primary Total Knee Arthroplasty

The aim of this prospective randomized controlled study was to determine whether the timing of drain removal in relation to continuous passive motion (CPM) application influences postoperative residual hematoma formation following primary total knee arthroplasty (TKA). Our primary hypothesis was that removing the drain after initiating CPM would result in less residual hematoma, as CPM-induced intra-articular fluid and blood mobilization would be evacuated through the drain before its removal, thereby reducing postoperative fluid accumulation.