43 patients (53 knees) with a primary diagnosis of knee osteoarthritis and undergoing total knee arthroplasty were randomized to receive conventional postoperative rehabilitation with or without additional manual lymphatic drainage (MDL). Those who were randomized to the MDL group underwent 3 sessions to stimulate the superficial lymph nodes along the lymphatic pathways. The effects of MDL on range of motion, pain and lower limb girth were assessed up to 6 weeks postoperatively. The results indicated knee flexion was significantly greater in the manual lymphatic drainage group compared to the group of patients who did not receive additional treatment. All other measures including knee extension, lower limb girth, and pain were comparable between groups.