Effectiveness and methods of cryotherapy in reducing swelling after total knee arthroplasty: A systematic review on randomized controlled trials

Lee, Yoonyoung; Shin, Yong Soon; Kim, Hyun Jung; An, Jiwon

doi:10.1002/nop2.1906

Cited by 3 publications

(4 citation statements)

References 43 publications

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“…Total knee arthroplasty (TKA) is now widely accepted as the preferred treatment for end-stage knee osteoarthritis [1][2][3]. For several years, the number of TKA procedures done in Europe and the United States (US) has been steadily increasing, with the annual volume of primary TKA procedures reaching 480,980 in 2019 in the US [4].…”

Section: Introductionmentioning

confidence: 99%

“…Despite the excellent functional outcomes in the short and medium term, better quality of life [1,2,6], and a high level of satisfaction, the postoperative period following TKA is key. In fact, during the early postoperative period, patients often have limited joint range of motion (ROM), altered muscle function and edema, with or without joint effusion [1][2][3]. These can considerably limit function, which can delay rehabilitation and increase the length of hospital stay [1,3,6,7].…”

Section: Introductionmentioning

confidence: 99%

“…In fact, during the early postoperative period, patients often have limited joint range of motion (ROM), altered muscle function and edema, with or without joint effusion [1][2][3]. These can considerably limit function, which can delay rehabilitation and increase the length of hospital stay [1,3,6,7]. Despite the widespread use of enhanced recovery after surgery protocols [3,8] (multimodal pain management, early rehabilitation, improved anesthesia and surgical techniques), management of the postoperative phase following TKA continues to be a challenge for the care team and patients.…”

Section: Introductionmentioning

confidence: 99%

“…In fact, the international literature recommends incorporating early and routine functional rehabilitation following TKA, with the aims of restoring knee ROM, preventing trophic skin and vascular changes, reducing pain and improving the patient's independence [1,3,9]. Cryotherapy is a nonpharmacological intervention that is recommended and widely used after orthopedic surgery procedure, including TKA [1,10].…”

Section: Introductionmentioning

confidence: 99%

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Randomized controlled trial of compressive cryotherapy versus standard cryotherapy after total knee arthroplasty: pain, swelling, range of motion and functional recovery

Quesnot,

Mouchel,

Salah

et al. 2024

BMC Musculoskelet Disord

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Background After total knee arthroplasty (TKA), patients have limited knee range of motion (ROM), trophic changes and pain. Cryotherapy and compression are recommended in the literature, but no study has shown that cryotherapy and compression combined leads to better results than cryotherapy alone. The primary objective was to compare knee ROM after 21 days of rehabilitation post-TKA between patients who underwent rehabilitation with compressive cryotherapy with those who had cryotherapy alone. The secondary objectives were to compare other trophic, pain and functional outcomes. Methods Forty patients were randomized into two groups: Standard Cryotherapy (SC = 20, median age 77 years), which applied cold packs along with their rehabilitation; and Compressive Cryotherapy (CC = 20, median age 76 years), which received cold compression. Knee joint’s passive and active ROM (primary outcome) were measured with a goniometer. Knee’s circumference, fluctuation test, pain at rest and during activity, 6-minute walking test (6MWT) and KOOS questionnaire were secondary outcomes. The groups were compared on D1 (baseline) and D21 of rehabilitation. A survival analysis has compared the groups on D1, D8, D15, D21. Results All subjects had a significant improvement in all the parameters on D21 relative to D1 (p < .05), except for pain at rest (p = .065 for CC and p = .052 for SC). On D21, the CC group had a significantly larger improvement in the joint effusion (p = .002), pain during activity (p = .005), 6MWT (p = .018) and KOOS (p = .004) than the SC group. Based on the survival analysis, the CC group had significantly faster improvement in the joint ROM (p = .011 for flexion and p = .038 for extension) and knee circumference (p = .013) than the SC group. Conclusions Both cryotherapy methods improved joint ROM, trophic changes, pain and function. Adding dynamic compression to a cryotherapy protocol provided further benefits: a significantly faster improvement in passive knee flexion ROM, a greater reduction of swelling, and pain during activity. Similarly, walking distance and KOOS questionnaire were significantly better for CC. Trials registration The study was registered in the ClinicalTrials.gov database on 14/09/2023 (identifier: NCT06037824).

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Randomized controlled trial of compressive cryotherapy versus standard cryotherapy after total knee arthroplasty: pain, swelling, range of motion and functional recovery

Quesnot,

Mouchel,

Salah

et al. 2024

BMC Musculoskelet Disord

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Effectiveness and methods of cryotherapy in reducing swelling after total knee arthroplasty: A systematic review on randomized controlled trials

et al. 2023

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AimThis study aims to investigate the effect and methods of cryotherapy in reducing swelling after total knee arthroplasty.DesignSystematic review.MethodsWe searched PubMed, Embase, CINAHL, Cochrane Library, KoreaMed, KERIS and National Science Digital Library for randomized controlled trials on 19 August 2021. This systematic review was conducted according to the PRISMA 2009 checklist.ResultsA total of eight randomized controlled trials were systematically reviewed to determine the effect and methods of cryotherapy on reducing postoperative swelling. The effects were not significantly different in six studies. Application time per cryotherapy session was 10–20 min when using an ice pack and up to 48 h when using an automated device. The duration ranged from 2 days to 1 week or until discharge, and the frequency varied from 2 to 72 times per day.

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Cryotherapy for Rehabilitation After Total Knee Arthroplasty: A Comprehensive Systematic Review and Meta‐Analysis

Liang,

Ding,

Wang

et al. 2024

Orthopaedic Surgery

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ObjectiveDespite being well‐studied and widely utilized, the efficacy of cryotherapy after total knee arthroplasty (TKA) in enhancing early rehabilitation lacks consensus. The aim of this systematic review and meta‐analysis was to investigate (1) whether cryotherapy is able to promote the rehabilitation of patients undergoing TKA and (2) whether continuous cold flow device has superior results than cold pack in cryotherapy.MethodsA comprehensive trial searching was performed in the PubMed, Embase, Cochrane Library, and Google Scholar electronic databases in May, 2024. Randomized controlled trials (RCTs) comparing cryotherapy with no cryotherapy or comparing continuous cold flow device with cold pack after TKA were included. The primary outcome was visual analogue scale (VAS) of pain, and secondary outcomes included opioid consumption, blood loss (hemoglobin decrease and drainage), range of motion (ROM), swelling, length of stay (LOS), and adverse event.ResultsA total of 31 RCTs were included in this meta‐analysis with 18 trials comparing cryotherapy with no cryotherapy and 13 trials comparing continuous cold flow device with cold pack. Pooled results showed cryotherapy group had significantly lower VAS scores than no cryotherapy group on postoperative day (POD) 1 (MD, −0.59 [95% CI, −1.14 to −0.04]; p = 0.04), POD 2 (MD, −0.84 [95% CI, −1.65 to −0.03]; p = 0.04), and POD 3 (MD, −0.86 [95% CI, −1.65 to −0.07]; p = 0.03). Cryotherapy group also showed reduced opioid consumption, reduced hemoglobin loss, decreased drainage, and improved ROM after TKA. Continuous cold flow device group had comparable VAS, opioid consumption, blood loss, ROM, knee swelling, and LOS with cold pack group.ConclusionCryotherapy can effectively alleviate postoperative pain, reduce blood loss, improve ROM, and thus promote the postoperative rehabilitation for TKA patients, but the continuous cold flow device did not show better efficacy than cold packs. These findings support the routine use of cryotherapy for the rapid rehabilitation of TKA patients, and the traditional cold pack is still recommended.

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Effectiveness and methods of cryotherapy in reducing swelling after total knee arthroplasty: A systematic review on randomized controlled trials

Cited by 3 publications

References 43 publications

Randomized controlled trial of compressive cryotherapy versus standard cryotherapy after total knee arthroplasty: pain, swelling, range of motion and functional recovery

Randomized controlled trial of compressive cryotherapy versus standard cryotherapy after total knee arthroplasty: pain, swelling, range of motion and functional recovery

Effectiveness and methods of cryotherapy in reducing swelling after total knee arthroplasty: A systematic review on randomized controlled trials

Cryotherapy for Rehabilitation After Total Knee Arthroplasty: A Comprehensive Systematic Review and Meta‐Analysis

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