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Compression therapy in orthopedics Harnessing synergies

Issue 02/2017

Dr. med. Lukas Weisskopf works hard to help injured athletes pursue their sport again. In doing so, the Swiss specialist in orthopedic surgery and sports medicine often relies on a combination of supports, orthoses, and medical compression stockings.

Dr. med. Lukas Weisskopf, Swiss specialist in orthopedic surgery and sports medicine.
Dr. med. Lukas Weisskopf, Swiss specialist in orthopedic surgery and sports medicine.

Dr. Lukas Weisskopf is a passionate sports physician and was even named “Sports Physician of the Year” by the German-Austrian-Swiss Society for Orthopedic Traumatologic Sports Medicine (GOTS) in 2015. The specialist , who is in his mid-forties, works at the Altius Swiss Sportmed Center in Rheinfelden, Switzerland, and his previous positions include serving as an Olympics physician for the Swiss team in Vancouver in 2010 and Sochi in 2014. He also looks after a number of individual athletes. The physician is fully aware that his patients’ main objective after suffering an injury is to be able to take up their beloved discipline as quickly as possible again. This is why he frequently combines orthopedic and phlebological aids, especially in his specialist areas of Achilles tendon injuries and cruciate ligament reconstructions.

Compression reduces rehabilitation time

After suffering an Achilles tendon rupture, Serbian-Swiss professional footballer Zdravko Kuzmanović was treated with an AchilloTrain Pro in combination with a VenoTrain micro knee-high stocking.
After suffering an Achilles tendon rupture, Serbian-Swiss professional footballer Zdravko Kuzmanović was treated with an AchilloTrain Pro in combination with a VenoTrain micro knee-high stocking.

“There are several benefits of using medical compression stockings in patients requiring knee or Achilles tendon operations,” explains the specialist in orthopedic surgery and sports medicine. “They even come in handy for reducing swelling before surgery. Hematomas and edemas are absorbed more quickly, speeding up the wound healing process. During surgery itself, we generally put a compression stocking on the non-injured leg to help prevent thrombosis. Then, after surgery, we recommend that patients wear medical compression stockings from morning to evening for a period of six weeks.”
According to Dr. Weisskopf, compression stockings boost venous return and stimulate the lymphatic system, which supports wound healing. He also finds that the compression knit improves proprioception and muscle coordination, which may reduce the rehabilitation time. Dr. Weisskopf mainly treats his patients using compression stockings in the compression class (Ccl) 2. “Depending on the case, I may also ask my patients to wear a stocking in Ccl 1 for three to four days after surgery until the wound dries.”

SecuTec Genu combined with VenoTrain micro

Following anterior cruciate ligament reconstruction surgery, for example, the Swiss specialist recommends patients wear a knee support (e.g. the GenuLoc stabilizing orthosis to immobilize the knee joint) at night for the first six weeks and, in most cases, the SecuTec Genu knee orthosis during the day. In combination with the support and orthosis, he also advises his patients to wear thigh-high stockings in Ccl 2 on both legs day and night. Besides helping to prevent thrombosis, the compression reduces swelling on the operated knee. “In some instances, an alternative option is to use a knee orthosis with an integrated compression support such as SofTec Genu. We also occasionally combine a GenuTrain with stockings,” states Dr. Weisskopf.

Very comfortable to wear

When treating his patients with compression stockings, he likes to use VenoTrain micro due to its good compressive effect and comfortable feel. “The athletes I treat want moisture-regulating stockings that do not cause them to sweat too much as their physiotherapy increases over the course of their treatment.” VenoTrain micro has a microfiber content of over 50 percent , making it particularly soft , gentle on the skin, and breathable.
The operated joint is mobilized and exposed to stress in line with a treatment program tailored to the patient , the intensity of which is stepped up slowly as the treatment progresses. “Most athletes are shocked at first when we tell them, for example, that they shouldn’t go jogging for the first three months after surgery. However, they soon come to realize that our treatment and training plan has them working hard enough,” says the Swiss physician with a twinkle in his eye.
He goes on to explain that by week seven, most patients can swap from SecuTec Genu to a GenuTrain. To ensure the surgery remains successful in the long term, he recommends that his patients continue wearing a compression stocking during everyday activities – especially when sitting or standing for a long time at work.

Knee-high stockings lend support following Achilles tendon ruptures

Swiss national handball player Lisa Frey wears SecuTec Genu and the VenoTrain micro thigh-high stocking.
Swiss national handball player Lisa Frey wears SecuTec Genu and the VenoTrain micro thigh-high stocking.

Dr. Weisskopf also likes combining treatments in his second area of specialism, Achilles tendon injuries. The tried-and-tested orthopedic aids he uses during the first six weeks following surgery to repair the Achilles tendon or after procedures such as rotationplasty include a postoperative plaster splint worn at night , a high Achilles tendon shoe with at least three wedges and, once he is confident that the wound is healing, an AchilloTrain Pro for compression alongside the Achilles tendon. He recommends that his patients wear anti-embolism stockings until the sutures are removed, followed by VenoTrain micro compression stockings (Ccl 2) on both legs day and night. While he uses thigh-high stockings (AG) in patients with cruciate ligament rupture, he believes that knee-high stockings (AD) are sufficient in cases of Achilles tendon ruptures.
In his opinion, steps towards removing the Achilles tendon shoe can generally begin in consultation with the surgeon from week seven. “The tongue should be removed first followed by the wedges over a period of two to four weeks,” says Dr. Weisskopf. He nevertheless advises that patients continue wearing VenoTrain micro in combination with AchilloTrain Pro. “The active support with its high-reaching friction pad provides important stabilization until week eleven, after which the treatment depends on the patient’s specific need for stabilization,” explains the sports physician from experience.
“Orthopedic and phlebological aids each have their own specific benefits. It’s great when these two types of treatment complement each other. We can harness these synergies to help athletes regain fitness more quickly,” summarizes Dr. Weisskopf.

 

Images: Remo Neuhaus (3), Dr. Lukas Weisskopf