title: Preoperative preparation of a patient with grade II leg Lymphedema for his third hip replacement surgery.
abstract: BACKGROUND
  The treatment of lymphedema remains a challenge to modern medicine, due to the characteristics of the disease.
  
  
  METHODS
  Report on the case of a 75-year-old patient with lower limb lymphedema for treatment prior to surgery. At age 45, he made the first hip replacement surgery in the left leg. One year later he performed the same surgery on the right leg. At that time his legs had slight ankle edema mainly of the left leg and the entire left leg was affected by lymphedema. At 68 years old the patient returned to the surgeon, who indicated a third surgery to replace the left hip prosthesis. The patient was evaluated by bioimpedance, which measured the volumes of right and left legs at 5.52 and 7.24l, respectively. Five days of intensive treatment were proposed using Mechanical Lymphatic Therapy (RAGodoy®), Manual Lymphatic Therapy and compression therapy with a grosgrain stocking for 24h per day. On the fifth day, there was significant improvement in the volume (right leg 4.45l and left leg 5.57l).
  
  
  CONCLUSIONS
  In this case report intensive treatment was used to reduce the volume of leg edema prior to a surgery to replace a hip prosthesis in a patient with grade II leg lymphedema. Small positive and negative changes, which are common in the evolution of this type of case but the end result was a total reduction of the edema.
  
  
  CONCLUSIONS
  The patient underwent surgery to replace the prosthesis after total reduction of edema.
authors.affiliation: Medicine School of Sao Jose do Rio Preto (FAMERP) and Clinic Godoy, Sao Jose do Rio Preto, Brazil; Godoy Clinic, São Jose do Rio Preto, Brazil. Electronic address: mfggodoy@gmail.com.
authors.forename: Maria de Fátima
authors.initials: MF
authors.lastname: Guerreiro Godoy
authors.affiliation: Medicine School of Lusiadas-Santos-Brazil and Godoy Clinic, São Jose do Rio Preto, Brazil; Godoy Clinic, São Jose do Rio Preto, Brazil. Electronic address: godoylmp@gmail.com.
authors.forename: Livia Maria
authors.initials: LM
authors.lastname: Pereira de Godoy
authors.affiliation: Godoy Clinic, São Jose do Rio Preto, Brazil. Electronic address: renata_l_p@yahoo.com.br.
authors.forename: Renata
authors.initials: R
authors.lastname: Lopes Pinto
authors.affiliation: Medicine School of Sao Jose do Rio Preto (FAMERP) and Clinic Godoy, Sao Jose do Rio Preto, Brazil; Godoy Clinic, São Jose do Rio Preto, Brazil. Electronic address: godoyjmp@gmail.com.
authors.forename: Jose Maria
authors.initials: JM
authors.lastname: Pereira de Godoy
keywords: Joint prosthesis; Lymphedema; Treatment