Above-knee versus below-knee stockings in total knee arthroplasty.

Background: Graduated compression stockings are frequently used following arthroplasty surgery for deep vein thrombosis (DVT) prophylaxis. There are often strongly held beliefs regarding whether below-knee or above-knee stockings should be used in total knee joint replacement. Many surgeons argue that below-knee stockings are more likely to induce wound complications because of increased swelling above the stocking and the elastic causing localised pressure on the wound.

Methods: This study is a prospective comparison of above and below-knee stockings in patients undergoing total knee joint replacement. A total of 50 patients were recruited and studied - 23 patients in the above-knee stocking group and 24 in the below-knee group. Swelling around the knee was measured over the course of an in-patient stay, together with wound complication rates and patients' preference.

Results: No statistical difference was found between the groups and no difference in wound complication rates was determined.

Conclusions: Below-knee stockings are safe following total knee replacement and are preferred by patients.