Intervention with manual lymph drainage was not effective 10 days after surgery. Although the two-way analysis of variance indicated a statistically significant difference in the main effect between the groups for resting pain, we do not believe this is clinically meaningful. One reason is that there was no interaction between groups and measurement times. This in dicates that the rate of change was the same between groups, meaning that manual lymph drainage intervention was not effective. Another reason was that the data varied widely. A previous study of manual lymph drainage for knee arthroplasty patients reported results spanning up to 7 days postoperatively which related primarily to swelling and rang of motion . The postoperative inflammatory phase peaks from 7 to 10 days after a surgical procedure. Pain during the inflammatory phase occurs when a chemical mediator binds to a nociceptor. White blood cells and plasma components involved in the generation of chemical mediators are recoverable from the lymph duct at the end of the inflammatory phase 3-6 ) . Our study rationale was to address the importance of an intervention during this acute phase. Because patients’ quality of life during the postop- erative inflammatory phase following knee arthroplasty is largely contingent on pain intensity, we considered our investigation of high importance. Furthermore, acute pain can reportedly also contribute to chronic pain26). The novelty of this study pertains to our ability to evaluate the effects of manual lymph drainag interventions for up to 10 days after knee arthroplasty and to focus on pain intensity as the primary endpoint. dilates that the rate of change was the same between groups, meaning that manual lymph drainage intervention was not effective. Another reason was that the data varied widely. A previous study of manual lymph drainag for knee arthroplasty patients reported results spanning up to 7 days postoperatively which related primarily to swelling and ROM . The postoperative inflammatory phase peaks from 7 to 10 days after a surgical procedure. Pain during the inflammatory phase occurs when a chemical mediator binds to a nociceptor. White blood cells and plasma components involved in the generation of chemical mediators are recoverable from the lymph duct at the end of the inflammatory phase 3-6 ) . Our study rationale was to address the importance of an intervention during this acute phase. Because patients’ quality of life during the postoperative inflammatory phase following knee arthroplasty is largely contingent on pain intensity, we considered our investigation of high importance. Furthermore, acute pain can reportedly also contribute to chronic pain. The novelty of this study pertains to our ability to evaluate the effects of manual lymph drainage interventions for up to 10 days after knee arthroplasty and to focus on pain intensity as the primary endpoint.