The Role of Cryotherapy After Total Knee Arthroplasty: A Systematic Review

Wyatt, Phillip; Nelson, Chase T.; Cyrus, John; Goldman, Ashton H.; Patel, Nirav K.

doi:10.1016/j.arth.2022.12.004

Cited by 9 publications

(8 citation statements)

References 22 publications

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“…Individuals with a greater skinfold thickness have been shown to require cryotherapy treatment durations of up to six times longer than those with a lower skinfold thickness in order to achieve similar reductions in tissue temperature [ 34 ]. This is evidence to suggest that cold therapy protocols should be bespoke and prescribed on a user-to-user basis, and that this could be an explanation for existing controversy in the literature with regard to post-operative clinical outcomes following cryocompression [ 3 , 20 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

A randomised crossover trial of five cryocompression devices’ ability to reduce skin temperature of the knee

Belsey,

Reid,

Paine

et al. 2024

PLoS ONE

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Background The application of cold and pressure to the knee is a common part of post-operative rehabilitation. Skin temperature should be reduced to within 10–15 °C to optimise the therapeutic benefits of cryocompression. The purpose of this study was to investigate the ability of five different cryocompression devices to reduce skin temperature to within this therapeutic range. Materials and methods 32 healthy adult participants (mean (SD): age 26.3 (7.9) years; BMI 24.8 (2.7) kg/m2; 20 males) were recruited for this randomised crossover study. Skin temperature was measured 20 mm distal to the patella using a k-type thermocouple every five minutes during a 30-minute treatment with one of five different cryocompression devices (Physiolab S1, GameReady, Cryo/Cuff, VPulse, and a Gel Wrap). Changes in skin temperature over time were compared to baseline within and between conditions. A subjective rating of comfort was also recorded for each device. Results The Physiolab S1 and GameReady devices caused significantly lower skin temperatures compared to the VPulse, Gel Wrap, and Cryo/Cuff after 30 minutes (p<0.05). 87–96% reported a positive comfort rating for the Physiolab S1, VPulse, Cryo/Cuff and Gel Wrap, whereas 53% of participants reported a positive comfort rating for the GameReady. Conclusions Only the Physiolab S1 and GameReady devices reduced skin temperature of the knee to within the target range of 10–15 °C. The Physiolab S1 was reportedly more comfortable than the GameReady. Clinicians should be aware of the performance differences of different cryocompression devices to understand which is most likely to provide an effective dose of cold therapy to a joint.

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Section: Discussionmentioning

confidence: 99%

A randomised crossover trial of five cryocompression devices’ ability to reduce skin temperature of the knee

Belsey,

Reid,

Paine

et al. 2024

PLoS ONE

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“…A separate RCT comparing vitamin D 3 supplementation before TKA with placebo did not demonstrate significant improvements in function, the TUG test, or complications up to 6 weeks after the surgical procedure 21 . The role of cryotherapy after TKA was evaluated in a systematic review of RCTs, which showed a significant decrease in opioid consumption during the first postoperative week in cryotherapy groups; however, swelling and knee range of motion did not appear to improve with this treatment modality 22 . In an award-winning study, Shaw et al evaluated the use of oral dexamethasone compared with placebo capsules up to 4 days after TKA and found a significant decrease in postoperative VAS pain when using oral dexamethasone but no significant differences with regard to opioid use, nausea, vomiting, 90-day complications, ability to walk with or without assistance, or early patient-reported outcome measures 23 .…”

Section: Primary Tka Perioperative Carementioning

confidence: 99%

What’s New in Adult Reconstructive Knee Surgery

Villa,

Hosseinzadeh,

Higuera-Rueda

2023

Journal of Bone and Joint Surgery

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In the current Guest Editorial, we evaluate and summarize the most relevant findings from recent, meaningful, peer-reviewed publications in different research areas. Articles at various Levels of Evidence were included, but increased attention was paid to Level-I and award-winning reports. EconomicsConsiderable debate continues with regard to the economics of reconstructive knee surgery. An updated Medicare projection revealed that, by 2040, the annual number of revision total knee arthroplasties (TKAs) performed would be 115,147, whereas, by 2060, it would be 286,740. These values are important for understanding the future health-care resource utilization involving revision TKA, which is only expected to increase 1 . A secondary analysis of a randomized clinical trial (RCT) evaluating health-care resource utilization up to 12 months after primary TKA, among dissatisfied and satisfied patients, showed that patients dissatisfied with their return to function incurred a mean cost of $19,007.70, compared with $13,523.83 for satisfied patients (p = 0.07). Although the cost difference was not significant, its magnitude deserves attention 2 . Data from the New Zealand Joint Registry indicated that patients undergoing TKA have a mortality rate 8% higher than that of the general population 3 . Assessing mortality after primary TKA is relevant for future economic analyses.

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“…One clinical example is total knee arthroplasty (TKA) which is often accompanied with high postoperative pain ratings. A study conducted by Wyatt et al (85) demonstrated that cryotherapy decreases opioid consumption in the first postoperative week when they are used the most extensively. Nevertheless, ultra-low temperature effects on pain, range of motion, and swelling are still being debated and heterogeneous protocols make comparisons challenging.…”

Section: Cryotherapymentioning

confidence: 99%

Cryogenic Media in Biomedical Applications: Current Advances, Challenges, and Future Perspectives

MOKBEL,

KODRESKO,

GHAZAL

et al. 2023

In Vivo

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This paper explores the crucial role of cryogenic mediums in driving breakthroughs within the biomedical sector. The objective was to investigate, critically discuss, and present the current knowledge and state-of-the-art practices, along with the challenges and perspectives of the most common applications. Through an extensive literature review, this work aims to supplement existing research, offering a comprehensive and up-to-date understanding of the subject. Biomedical research involving cryogenic mediums is advancing on multiple fronts, including the development of advanced medical technologies, clinical treatments for life-threatening conditions, high-quality biospecimen preservation, and antimicrobial interventions in industrial food processing. These advances open new horizons and present cutting-edge opportunities for research and the medical community. While the current body of evidence showcases the impressive impact of cryogenic mediums, such as nitrogen, helium, argon, and oxygen, on

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The Role of Cryotherapy After Total Knee Arthroplasty: A Systematic Review

Cited by 9 publications

References 22 publications

A randomised crossover trial of five cryocompression devices’ ability to reduce skin temperature of the knee

A randomised crossover trial of five cryocompression devices’ ability to reduce skin temperature of the knee

What’s New in Adult Reconstructive Knee Surgery

Cryogenic Media in Biomedical Applications: Current Advances, Challenges, and Future Perspectives

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