Cryotherapy-Induced Common Peroneal Nerve Palsy

Moeller, James L.; Monroe, Jeffrey; McKeag, Douglas B.

doi:10.1097/00042752-199707000-00011

Cited by 33 publications

(18 citation statements)

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“…45 As with any intervention, the potential exists for complications of cryotherapy, including frostbite leading to skin compromise or, more rarely, injury to the peroneal nerve has been reported. [46][47][48] There is a paucity of literature looking at the efficacy of compressive therapy and elevation. One study did not find a significant benefit of postoperative use of medical compression stockings on postoperative knee pain and swelling.…”

Section: Postoperative Pain Management Cryotherapy Elevation Comprementioning

confidence: 99%

Evidence-Based Approach of Treatment Options for Postoperative Knee Pain

Farr¹,

Jaggers

Lewis

et al. 2014

The Physician and Sportsmedicine

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Optimal pain management is critical after knee surgery to avoid adverse events and to improve surgical outcomes. Pain may affect surgical outcomes by contributing to limitations in range of motion, strength, and functional recovery. The causes of postoperative pain are multifactorial; therefore, an appropriate pain management strategy must take into account preoperative, intraoperative, and postoperative factors to create a comprehensive and individualized plan for the patient. Preoperative assessment includes management of patient expectations, recognition of conditions and early counseling for high-risk patients (ie, opioid dependence, psychiatric comorbidities), and use of preemptive analgesia techniques (ie, preoperative IV medications, peripheral nerve blocks, incisional field blocks). Intraoperative strategies include meticulous surgical technique, limiting the use of tourniquets (ie, duration and pressure), and using preventive analgesia methods (ie, postoperative field block, continuous nerve catheters, intra-articular injection). Postoperative analgesia may be facilitated by cryotherapy, early mobilization, bracing, and rehabilitation. Certain modalities (ie, continuous passive motion devices, transcutaneous electrical nerve stimulation units, iontophoresis) may be important adjuncts in the perioperative period as well. There may be an evolving role for alternative medicine strategies. Early recognition and treatment of exaggerated postoperative pain responses may mitigate the effects of complex regional pain syndrome or the development of chronic pain.

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Section: Postoperative Pain Management Cryotherapy Elevation Comprementioning

confidence: 99%

Evidence-Based Approach of Treatment Options for Postoperative Knee Pain

Farr¹,

Jaggers

Lewis

et al. 2014

The Physician and Sportsmedicine

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“…Several instances of ice burn and even amputation are reported in the literature following prolonged or inappropriate cooling . Other adverse events associated with excessive cooling include: nerve damage (Høiness et al, 1998;Moeller et al, 1997), cold urticaria (Dover et al, 2004), and compartment syndrome (Khajavi et al, 2004).…”

Section: Overviewmentioning

confidence: 99%

The use of thermal imaging in assessing skin temperature following cryotherapy: a review

Costello¹,

McInerney²,

Bleakley³

et al. 2012

Journal of Thermal Biology

108

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a b s t r a c tBackground: Cryotherapy is used in various clinical and sporting settings to reduce odema, decrease nerve conduction velocity, decrease tissue metabolism and to facilitate recovery after exercise induced muscle damage. The basic premise of cryotherapy is to cool tissue temperature and various modalities of cryotherapy such as whole body cryotherapy, cold spray, cryotherapy cuffs, frozen peas, cold water immersion, ice, and cold packs are currently being used to achieve this. However, despite its widespread use, little is known regarding the effectiveness of different cryotherapy modalities to reduce skin temperature. Objectives: To provide a synopsis of the use of thermal imaging as a method of assessing skin temperature following cryotherapy and to report the magnitude of skin temperature reductions associated with various modalities of cooling. Design: Structured narrative review. Methods: Three electronic databases were searched using keywords and MESH headings related to the use of thermal imaging in the assessment of skin temperature following cryotherapy. A hand-search of reference lists and relevant journals and text books complemented the electronic search. Summary: Nineteen studies met the inclusion criteria. A skin temperature reduction of 5-15 1C, in accordance with the recent PRICE (Protection, Rest, Ice, Compression and Elevation) guidelines, were achieved using cold air, ice massage, crushed ice, cryotherapy cuffs, ice pack, and cold water immersion. There is evidence supporting the use and effectiveness of thermal imaging in order to access skin temperature following the application of cryotherapy. Conclusions: Thermal imaging is a safe and non-invasive method of collecting skin temperature. Although further research is required, in terms of structuring specific guidelines and protocols, thermal imaging appears to be an accurate and reliable method of collecting skin temperature data following cryotherapy. Currently there is ambiguity regarding the optimal skin temperature reductions in a medical or sporting setting. However, this review highlights the ability of several different modalities of cryotherapy to reduce skin temperature.

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“…While cryotherapy treatment yields many therapeutic benefits, it is often associated with a number of side effects including, tissue necrosis, and neuropathy (1, 4, 6, 26, 29). These conditions are likely the result of profound reductions in local tissue temperature and the subsequent pronounced tissue ischemia during the period of cryotherapy.…”

Section: Introductionmentioning

confidence: 99%

Sustained cutaneous vasoconstriction during and following cyrotherapy treatment: Role of oxidative stress and Rho kinase

Christmas

Patik

Khoshnevis

et al. 2016

Microvascular Research

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Cryotherapy is a therapeutic technique using ice or cold water applied to the skin to reduce bleeding, inflammation, pain, and swelling following soft tissue trauma and injury. While beneficial, there are some side effects such as pronounced vasoconstriction and tissue ischemia that are sustained for hours post-treatment. This study tested the hypothesis that this vasoconstriction is mediated by 1) the Rho-kinase pathway and/or 2) elevated oxidative stress. 9 subjects were fitted with a commercially available cryotherapy unit with a water perfused bladder on the lateral portion of the right calf. Participants were instrumented with three microdialysis probes underneath the bladder. One site received lactated ringers (control site), one received the Rho-Kinase inhibitor Fasudil, and one received Ascorbic Acid. Skin temperature (Tskin) and cutaneous vascular conductance (CVC) was measured at each site. Subjects had 1 °C water perfused through the bladder for 30 min, followed by passive rewarming for 90 min. Tskin fell from ~ 34 °C to ~ 18.0 °C during active cooling across all sites and this response was similar for all sites (P>0.05 for all comparisons). During passive rewarming Tskin rose to a similar degree in all sites (P>0.05 relative to the end of cooling). %CVC was reduced during active cooling in all sites; however, the magnitude of this response was blunted in the Fasudil site relative to control (P<0.001 for all comparisons) and min 25 and 30 of cooling in the Ascorbic Acid site (P<0.05). During passive rewarming %CVC at the control and Ascorbic Acid sites did not change such that values were similar to the end of cooling (P>0.05 for each comparison). %CVC at the Fasudil site remained elevated during passive rewarming such that values were higher compared to the control Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. HHS Public Access

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Cryotherapy-Induced Common Peroneal Nerve Palsy

Cited by 33 publications

References 0 publications

Evidence-Based Approach of Treatment Options for Postoperative Knee Pain

Evidence-Based Approach of Treatment Options for Postoperative Knee Pain

The use of thermal imaging in assessing skin temperature following cryotherapy: a review

Sustained cutaneous vasoconstriction during and following cyrotherapy treatment: Role of oxidative stress and Rho kinase

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