Does Advanced Cryotherapy Reduce Pain and Narcotic Consumption After Knee Arthroplasty?

Abstract

Level II, therapeutic study. See the Instructions for Authors for a complete description of levels of evidence.

Cryotherapy With Dynamic Intermittent Compression Improves Recovery From Revision Total Knee Arthroplasty

“…Patients feel less medicated and have a better postoperative course. Advanced cryotherapy was compared with icing only in the post operative course of TKA in a randomized controlled trial [4]. The authors concluded that there were no advantages in using advanced cryotherapy in daily practice, particularly because of the additional cost associated with these systems.…”

“…These side effects do not come into play when using CDIC. Thienpont et al [4] bring up the risk of frostbite in the area where CDIC is applied. This is an extremely serious complication that would require an additional major soft tissue procedure [23].…”

“…New devices that combine cryotherapy with dynamic inter mittent compression (CDIC) have recently been introduced. These devices provide a dry cold temperature and maintain a consistent temperature for an extended period of time [4,7]. Although the benefits of these systems were demonstrated in primary TKA [7] and anterior cruciate ligament reconstruction [8], we did not find any published studies evaluating the effect of CDIC in patients undergoing rTKA.…”

“…rTKA is a major orthopedic procedure that causes soft tissue damages that contribute to localized pain, which in turn reduces range of motion and causes persistent quadriceps atrophy [4]. Sig nificant blood loss after this procedure (up to 1.5 L) can lead to sys temic complications [3].…”

“…Sig nificant blood loss after this procedure (up to 1.5 L) can lead to sys temic complications [3]. Despite progress in multimodal analgesia and anesthetic methods, total knee arthroplasty (TKA) is a painful surgery [4]. Nonpharmacologic treatments can also play a role, most notably cryotherapy which decreases the local metabolism, thereby reducing blood loss and pain [5].…”