Cryotherapy compared with Robert Jones bandage after total knee replacement: A prospective randomized trial

Abstract

Sixty patients undergoing total knee replacement were randomized to receive either a cold compression dressing (Cryo/Cuff, Aircast, UK) or a modified Robert Jones bandage immediately after surgery. The cold compression dressing was used for a minimum of 6 h per day throughout the hospital stay, and the modified Robert Jones bandage remained in place for 48 h from the time of operation. The 2 groups of patients were compared during their hospital stay for blood loss, range of movement, pain scores and need for analgesia. No difference was found between the 2 groups except for less blood loss in the surgical drains in the cold compression group (P<0.05). Postoperative complications were seen in both groups, but no complication was associated with either the cold compression dressing or the modified Robert Jones bandage. Résumé Etude randomisée de 60 patients qui, immédia-tement après une arthroplastie totale du genou ont eu soit un pansement compressif froid de type "Cryocuff" soit un pansement compressif de type Robert Jones. Le pansement froid a été utilisé 6 heures par jour pendant la durée de l'hospitalisation tandis que le pansement compressif de type Robert Jones a été laisse en place pendant 48 heures après l'opération. Aucune différence statistiquement significative n'a pu être mise en évidence entre les deux groupes, à l'exception des pertes sanguines dans le drainage, moins importantes dans le premier groupe de patients. Nous avons eu des complications post opératoires dans les deux groupes mais aucune corrélation n'a pu être établie entre ces complications et le type de bandage appliqué.

The Role of Drainage After Total Knee Arthroplasty

“…Though some studies have shown that drainage after TKA is not necessary (Adalberth et al 1998;Niskanen et al 2000;Esler et al 2003;Parker et al 2004;Jones et al 2007), it is still widely used by orthopedic surgeons (Canty et al 2003). Surgeons who routinely drain total knee replacements may also use adjunctive measures such as autologous blood transfusion, use of fibrin tissue adhesive, compression bandaging and local ice packing (Gibbons et al 2001;Kullenberg et al 2006;Radkowski et al 2007) to reduce the excessive blood loss from the drain. Recently, drain clamping has received increasing attention.…”

Can A Modified Robert Jones Bandage After Knee Arthroplasty Reduce Blood Loss? A Prospective Randomized Controlled Trial

“…Various surgical techniques [9,11,16,17,19], medications [5,15,22], and postoperative protocols [2,4,8,12] to reduce bleeding have been proposed. Various postoperative approaches including cold compresses [6], elastic bandage support [7], and compressive dressings [1] also have been reported for reduction of bleeding, soft tissue edema, and hemarthroses.…”

“…The compression was between 40 to 50 mm Hg pressure at application; pressure decreased to 2 to 10 mm Hg within 48 hours. The reported advantages of the Robert Jones bandage are reduced pain and swelling after surgery [2,6,21]. In an animal model, application of a compression bandage reduced postfracture swelling in the tissue [13].…”

Tranexamic Acid Reduces Blood Loss and Blood Transfusion after TKA: A Prospective Randomized Controlled Trial

“…transfusions include autologous blood transfusion [10,34,37], postoperative blood salvage [1,9,16,20,21,34,52], use of a femoral intramedullary plug [43], hypotensive anesthesia [30], cryotherapy and Jones bandage [18], use of fibrin tissue adhesive [33,58], drain clamping [41,42,45,46,48,51,54,59], and administration of tranexamic acid [6-8, 19, 23, 24, 27, 28, 35, 39, 53, 55].…”