Cryotherapy following total knee replacement

Device or Ice: The Effect of Consistent Cooling Using a Device Compared with Intermittent Cooling Using an Ice Bag after Total Knee Arthroplasty

“…This finding is consistent with those of previous studies with respect to the lack of significant influence of cryotherapy on pain post-TKR. 16,26 Similarly, we found no between-group difference in PROM, nausea or vomiting, or blood loss, which suggests that consistent and intermittent cooling were equally as effective in managing these common consequences of TKA. These findings concur with those reported by Adie and colleagues; 16 however, although the four trials included in their meta-analysis compared several different methods of cooling (cold vs. compression, cold compression vs. nothing, and cold compression vs. compression), none included a comparison between ice and a cooling device.…”

“…These findings concur with those reported by Adie and colleagues; 16 however, although the four trials included in their meta-analysis compared several different methods of cooling (cold vs. compression, cold compression vs. nothing, and cold compression vs. compression), none included a comparison between ice and a cooling device. 16 Our study addresses this gap in the literature. Our findings are particularly intriguing because although the intervention group had much longer and more consistent cooling periods, and thus the magnitude of a therapeutic effect could theoretically have favoured this group, it did not.…”

“…14 Although compression used for at least 48 hours can provide effective control of intra-articular bleeding, 15 cryotherapy has only a small effect on intra-articular bleeding. 16 Although applying a bag of ice is a common method of postoperative cryotherapy, 17 the frequency, intensity, and duration of application vary, which may contribute to suboptimal care for patients. 17 Moreover, this method of cooling carries a risk of precipitating skin and nerve damage.…”

“…[22][23][24][25] Similarly, Markert 26 reported inconsistent findings in a review of 11 studies on the use of cryotherapy post-TKA. A Cochrane review by Adie and colleagues 16 reported that cryotherapy had a small but perhaps not clinically significant beneficial effect on blood loss, pain, and ROM. Variation in the application of cryotherapy (type, frequency, duration) in the literature makes it difficult to ascertain definitive direction for clinical practice.…”

“…Variation in the application of cryotherapy (type, frequency, duration) in the literature makes it difficult to ascertain definitive direction for clinical practice. Moreover, none of the trials reviewed by Adie and colleagues 16 included a measure of function, and there was no analysis comparing the relative effectiveness of intermittent cooling with an ice bag versus consistent cooling with a device. The purpose of our study, therefore, was to compare the effects on pain and several secondary outcomes of consistent cooling (using a motorized icing device) with those of intermittent cooling (using an ice bag) for 48 hours post-TKA.…”