The effects of immediate programmed cryotherapy and continuous passive motion in patients after computer-assisted total knee arthroplasty: a prospective, randomized controlled trial

Abstract

Background: The postoperative nursing intervention with immediate cryotherapy and continuous passive motion (CPM) remains elusive regarding the postoperative pain and range of motion (ROM) for patients undergoing computer-assisted total knee arthroplasty (CAS-TKA). Methods: A prospective, randomized controlled trial with a purposive sampling method was utilized. Sixty patients scheduled for a unilateral CAS-TKA at a medical center were randomly assigned to the intervention group (n = 30) and control group (n = 30). The intervention group applied programed cryotherapy and CPM within 1 h while returning to the ward on the day of surgery, while the control group did not. Data were analyzed using mixed models to compare the numeric rating scale (NRS) for pain, ROM, and swelling at postoperative day (POD) 4. Results: There was no significant difference in the NRS score between the groups (p = 0.168). The intervention group had significantly higher ROM than the control group (98°vs. 91°, p = 0.004) at POD 4. Although no significant difference in joint swelling was found between groups (p = 0.157), the intervention group had lower mean joint swelling (32.2 cm) than the control group (33.9 cm). Conclusions: Immediate programmed cryotherapy and continuous passive motion could help to improve ROM quickly after CAS-TKA. It should be incorporated into the daily nursing plan for patients undergoing CAS-TKA.

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

“…The effects of cryotherapy were not significantly different in six studies (Brouwers et al, 2022; Chen et al, 2020; Hecht et al, 1983; Holmström & Härdin, 2005; Thijs et al, 2019; Webb et al, 1998). However, in one, the swelling decreased in the cryotherapy group compared to the control group after 24 and 48 h (Wang, 2017).…”

“…The application time per session was 10 min in Stocker et al (2018). It was 20 min for Chen et al (2020) and Hecht et al (1983), 2–6 h for Brouwers et al (2022), 6 h for Thijs et al (2019), 48 h for Holmström and Härdin (2005) and Wang (2017). One study did not provide the application time per session (Webb et al, 1998).…”

“…Regarding the start time of cryotherapy after TKA, three studies (Holmström & Härdin, 2005; Thijs et al, 2019; Wang, 2017) started the application on the operation day, and three (Brouwers et al, 2022; Chen et al, 2020; Stocker et al, 2018) on the first postoperative day. Two studies did not provide the start time (Hecht et al, 1983; Webb et al, 1998).…”

“…TA B L E 1 Descriptive summary of the included studies. Wang, 2017;Webb et al, 1998); ice pack was used in the remaining three studies (Chen et al, 2020;Hecht et al, 1983;Stocker et al, 2018).…”

Is There an Optimal Timing of Adductor Canal Block for Total Knee Arthroplasty?—A Retrospective Cohort Study

“…Continuous passive motion (CPM) is an adjunct therapy for the initiation of early mobilization of the operated knee in patients that underwent TKA [ 30 , 31 ]. Adequate postoperative pain management encourages patients to participate in the CPM rehabilitation program [ 32 ] and facilitates a faster recovery to normal activities [ 33 ]. In addition, our study found that more patients in Group A quit their first CPM training because of intolerable pain after the first few cycles of passive motion training; these patients also had higher VAS scores than patients with ACB.…”