The Post-operative Effect on Formation of Oedema After Total Knee Arthroplasty With or Without the Use of a Nerve Stimulator (the gekoTM Device)

Postoperative Oedema Management Following Neuromuscular Electro- Stimulation of the Peroneal Nerve Using the gekoTM Device After Total Knee Arthroplasty

This study will investigate whether the recovery of muscle function of total knee arthroplasty is accelerated with the use of the gekoTM device along with its effect on reducing symptoms such as oedema and inhibition of the muscle function.

This study will investigate total knee arthroplasty patients:

• One group gets standard of care (i.e. performing exercises & guidance by a physiotherapist via a CE-marked mobile application, called moveUP)
• Second group gets standard of care + GekoTM device (i.e. non-invasive neuromuscular electrostimulation applied at the peroneal nerve for 10 days after the operation date.)

The primary objective of the study is to assess the post-operative effect of gekoTM on formation of oedema (measured by perometer).

The effect of the gekoTM device on the muscle function & the overall recovery will be also investigated.

To collect parameters, the patient will be asked to complete questionnaires, including the following patient reported outcomes (PROMs): Knee Injury and Osteoarthritis Outcome Score (KOOS), Knee Society Score (KSS), Euroqol Health questionnaire EQ5D, Forgotten Joint Score (FJS), Oxford Knee Score (OKS).

The collection of the PROMs will give an indication on outcome and overal recovery in the 2 groups.

Inclusion Criteria:

• Primary TKA planned for degenerative OA
• Subjects must be discharged to home environment and be able to independently perform the activities of daily life
• Obtain a written informed consent

Exclusion Criteria:

• TED stockings, Dauerbinde, other compressive bandages
• Mechanical foot pump
• Cooling device type 'Game Ready'
• Posttraumatic OA of the knee
• History of DVT / Flebitis / Pulmonary embolism
• Surgical treatment of venous insufficiency <1y prior to TKA surgery
• Neurological deficit of lower limbs
• Current sciatic irradiating pain in lower limbs
• History of lumbar fusion
• Knee Arthroscopy of the involved limb <6m prior to TKA surgery
• Any per-operative complication related to the TKA procedure (bleeding, fracture, vascular injury, cardiac complication, pulmonary complication)
• In case of a release during the TKA procedure
• Any per-operative (e.g. epidural catheter, urethral catheter, intra articular catheter) or post-operative procedure that might interfere with the rehabilitation during and after hospitalization
• Any scheduled surgery in the 3 months following the reference surgery;
• Any significant medical condition (e.g. Parkinson's disease, multiple sclerosis, cerebral vascular accident) that might interfere with the rehabilitation
• Any significant psychiatric disorders, active alcohol/drug abuse
• Subject is either pregnant or interested in becoming pregnant during the duration of the study
• Subjects who are currently involved in any investigational drug or device study or have been enrolled in such study within the last 3 months