Case report: Preoperative lower limb oedema
Patient: Patient is approximately 80-year-old woman, scheduled for total knee
arthroplasty of the right knee. Patient has referred herself to lymphatic
drainage due to swelling in the right lower limb. A prosthesis had been
implanted in the left knee some years earlier, and had to be repaired a few
times already. She had received physiotherapy and lymphatic drainage due to
this. Now the right ankle has been severely swollen, and the skin is raised in a
circular formation. There are fluids in the knee and shin as well. The tissue in
both legs is bumpy and loose, with a lot of connective tissue but poor muscular
strength. The patient has used crutches while walking short distances.
Methods: Lymphatic drainage therapy was started with manual treatment of the cervical
nodes, after which the stomach and the inguinal nodes were treated. The
patient was supine during the treatment, as turning sideways or in prone
position was difficult for her. The right lower limb was treated with the
LymphaTouch using continuous treatment mode. The pressure setting was
kept at 45 mmHg, as higher pressures of 60-70 mmHg caused the patient
painful sensations.
The mouthpiece was moved towards the inguinal nodes, focusing on the inner
side of the knee and thigh. Popliteal nodes were treated manually. Next the
shin and ankle were treated with the LymphaTouch, using the same pressures
in a pulsating mode. The foot was treated with pulsation, still using the same
pressure settings. The different sized mouthpieces were selected according to
the treated area. The treatment lasted 40 minutes.
Results: The swelling in the righ ankle was entirely gone after the treatment, and the
skinfolds had disappeared. The patient said the leg felt significantly lighter,
and walking due to improved mobility in the ankle was much easier.
