Massage therapy after total knee arthroplasty: Techniques, evidence, and clinical implications – A narrative review
J. S. R. G. Saran, Srinivasa Somasundara, Natasha Varghese Isaac, Rakshith P. Uttam, R. Sandeep Reddy, S. M. AjoyAbstract
Background:
Total knee arthroplasty (TKA) effectively treats end-stage knee osteoarthritis; however, postoperative pain, edema, and stiffness may delay rehabilitation and functional recovery. Massage therapy is a low-cost adjunct increasingly explored to support early recovery, particularly in resource-constrained settings.
Materials and Methods:
A comprehensive narrative review searched PubMed, Scopus, Embase, the Cochrane Library and Google Scholar from inception to February 2026. Randomized controlled trials, systematic reviews, meta-analyses, and prospective studies evaluating massage therapy after primary TKA were included. Due to heterogeneity in techniques, timing, and outcomes, findings were synthesized narratively.
Results:
Across more than 20 randomized trials and meta-analyses involving over 1500 patients, massage therapy demonstrated moderate-quality evidence for short-term benefits, particularly during the first 1–3 postoperative weeks. Swedish massage and manual lymphatic drainage were most frequently studied and were associated with reduced pain and edema, improved early knee range of motion, and greater tolerance to physiotherapy. Adverse events were rare and self-limiting, with no increased thromboembolic or wound-related complications when therapy was initiated after incision healing.
Conclusions:
Massage therapy appears to be a safe, low-risk adjunct that may enhance early postoperative rehabilitation following TKA, based predominantly on small, unblinded trials. Standardized protocols and longer-term multicenter studies are needed before routine incorporation into rehabilitation guidelines.