Cryotherapy Treatment After Unicompartmental and Total Knee Arthroplasty: A Review

Chughtai, Morad; Sodhi, Nipun; Jawad, Michael; Newman, Jared M.; Khlopas, Anton; Bhave, Anil; Mont, Michael A.

doi:10.1016/j.arth.2017.07.016

Cited by 37 publications

(28 citation statements)

References 28 publications

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“…Moreover, all of these studies were confined to TKA with a limited number of studies included. Actually, for the patients suffering KA, no matter whether partial knee arthroplasty (PKA) or TKA are performed, the mechanisms of pain, stress and other reactions that caused by KA might be similar 30–32 . Consequently, the aim of this study is to systematically summarize the available scientific literatures on all kinds of KA to evaluate the efficacy and safety the addition of steroids addition to MCPI by conducting a quantitative meta-analysis including randomized controlled trials (RCTs).…”

Section: Introductionmentioning

confidence: 99%

The efficiency and safety of steroid addition to multimodal cocktail periarticular injection in knee joint arthroplasty: a meta-analysis of randomized controlled trials

Deng

Storm

et al. 2019

Sci Rep

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Steroids are frequently used for postoperative pain relief without definite evidence. This study was conducted to assess the pain management effect of the addition of steroids to a multimodal cocktail periarticular injection (MCPI) in patients undergoing knee arthroplasty and evaluate their safety. Pubmed, Embase, and Cochrane Library were searched through April, 2018. A total of 918 patients from ten randomized controlled trials (RCTs) were ultimately included. Compared with placebo groups, steroids application could effectively relieve pain on postoperative day (POD)1; decrease C-Reactive protein (CRP) level on POD3; improve range of motion (ROM) in postoperative 5 days; reduce morphine consumption, achieve earlier straight leg raising (SLR), and shorten the length of stay (LOS) in hospital. With regards to adverse effects, it did not increase the risk of postoperative infection, postoperative nausea and vomiting (PONV), or other complications. However, no significant difference in pain relief, ROM, or increased Knee Society Knee Function Scores were found during long-term follow up. Overall, this meta-analysis ensured the efficiency and safety of steroids with MCPI in knee arthroplasty patients during the early postoperative period.

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Section: Introductionmentioning

confidence: 99%

The efficiency and safety of steroid addition to multimodal cocktail periarticular injection in knee joint arthroplasty: a meta-analysis of randomized controlled trials

Deng

Storm

et al. 2019

Sci Rep

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“…A systematic review of RCTs identified insufficient primary studies to draw conclusions about the effectiveness of cryotherapy on pain and physical function on individuals with knee osteoarthritis [ 40 ]. However, a review of cryotherapy treatment after unicompartmental and total knee arthroplasty concluded that continuous circulating cold flow might be optimal for pain relief and minimization of pain medication use after knee arthroplasty [ 41 ]. These findings suggest that cold therapy may be especially helpful for OA patients during periods of increased inflammation (e.g., after surgery).…”

Section: Discussionmentioning

confidence: 99%

“…2). Supplemental searches were performed to expand on key topics identified in the original literature search, i.e., subchondral bone pathology [1], knee sleeves [2][3][4][5][19][20][21], bone marrow lesions [22][23][24][25][26], clinical risk factors for knee OA progression [27][28][29][30][31][32][33], OA phenotypes [34], nonpharmacological treatments for OA [35][36][37][38][39][40][41][42][43], and clinical practice guidelines for OA management [44].…”

Section: Literature Searchmentioning

confidence: 99%

Comparison of 8-year knee osteoarthritis progression in 2 siblings: a case-based review

Gourlay

2020

Clin Rheumatol

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Because the pathophysiology of knee osteoarthritis is poorly understood, optimal evidence-based clinical management is uncertain. Sibling comparison studies can help inform a clinical model to guide preventive care. We compared the 8-year clinical outcomes in 2 sisters with a family history of osteoarthritis, normal BMI, and absence of knee pain at baseline. Both patients had Kellgren–Lawrence grade 1 in the affected knee at the time of twisting knee injuries leading to osteoarthritis diagnoses at age 50 (patient 1) and 51 (patient 2). Patient 1 developed a chronic right knee effusion, and progressed to Kellgren–Lawrence grade 3 bilaterally by the time she had a right total knee replacement at age 58. Patient 2 had subchondral fractures of the right knee with transient effusion, which healed after 1 year of partial weight-bearing with crutches and subsequent daily use of knee sleeves. Patient 2 had Kellgren–Lawrence grade 0 bilaterally upon surveillance imaging at age 58. The terms “osteoarthritis and knee and diagnostic imaging and subchondral bone and pathophysiology” were searched in the PubMed database to identify original research articles to inform a clinical model consistent with the patients’ outcomes. A fluid model of osteoarthritis was the best explanatory model for the discordant clinical trajectories of the age-matched siblings. Patient recommendations are presented based on these findings.

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“…The advantage of these latter devices is controlled-temperature modulation with cooling at a speci c and continuous temperature for a prolonged time, introducing better effect of resolving pain and swelling than crushed ice pack [18] . Morad Chughtai et al [19] reviewed 16 studies where various types of cryotherapy were assessed and compared, concluding continuous temperature devices are the most effective. However, using the new-generation means the much higher cost than traditional cryotherapy, which is unaffordable for most patients.…”

Section: Discussionmentioning

confidence: 99%

Mirabilite with ice pack after Total Knee Arthroplasty: A Randomized Controlled Trial Study

Zhang

Zheng

et al. 2020

Preprint

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Background Total knee arthroplasty (TKA) is a well-established procedure for end-state arthritis of knee with complications such as swelling and pain. The aim of this study is to evaluate the effect of mirabilite with ice pack versus ice pack alone on relieving pain, reducing swelling, range of motion (ROM), and serum CRP level in patients after TKA. Methods Eighty patients undergoing primary unilateral TKA were randomly assigned to two groups (MIP group and WIP group). We used VAS to measure knee pain at 24 h, 48 h, and 72 h after the surgery respectively. Knee swelling degree was evaluated by measuring the girth of leg at the center of patella and 10 cm above and below it at the same frequency. The active ROM of the knee was measured by using a universal goniometer of plastic material at 72 h postoperatively. The serum CRP level was also measured at 72 h postoperatively. Results The MIP group showed statistically significant lower knee girth at 48 h (p༜0.05), 72 h (p < 0.05) postoperatively and VAS score at 72 h (P = 0.018) at postoperatively after TKA than WIP group. The ROM of MIP group were significantly wider than WIP group (P = 0.024). The CRP level (P = 0.036) and length of stay (LOS) (P = 0.037) of MIP group were significantly lower than WIP group. Conclusions Mirabilite with ice pack after TKA showed superiority in relieving pain, reducing swelling, and improving ROM than ice pack alone. Trial registration: Chinese Clinical Trial Registry (ChiCTR), ChiCTR-OCN-15006356. Registered 6 MAY 2015, http://www.chictr.org.cn/showproj.aspx?proj=10927

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Cryotherapy Treatment After Unicompartmental and Total Knee Arthroplasty: A Review

Cited by 37 publications

References 28 publications

The efficiency and safety of steroid addition to multimodal cocktail periarticular injection in knee joint arthroplasty: a meta-analysis of randomized controlled trials

The efficiency and safety of steroid addition to multimodal cocktail periarticular injection in knee joint arthroplasty: a meta-analysis of randomized controlled trials

Comparison of 8-year knee osteoarthritis progression in 2 siblings: a case-based review

Mirabilite with ice pack after Total Knee Arthroplasty: A Randomized Controlled Trial Study

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