The Use of Cold Compression Dressings After Total Knee Replacement: A Randomized Controlled Trial

Abstract

This prospective, controlled study compared cold compressive dressings with wool and crepe in the postoperative management of patients undergoing total knee replacement (TKR). Forty TKR patients were assessed for blood loss, pain, swelling, and range of motion. Patients in the cold compression group had less blood loss through suction drainage (982 ml versus 768 ml). A higher proportion of patients in the treatment group did not require blood transfusion postoperatively. Mean opiate requirements were lower in the cold compression group (0.57 versus 0.71 mg/kg/48 hours). The cold compression device appeared to reduce blood loss and pain following TKR.

Multimodal Analgesia for Total Joint Arthroplasty

“…The benefits of cryotherapy following TJA are conflicting. Whereas some studies showed improved pain levels, [77][78][79] reduced blood loss, [78][79][80][81] and increased range of motion, [79][80][81] other studies showed no differences in these parameters. 80,[82][83][84] A recent meta-analysis found that the potential benefits of cryotherapy may not be clinically significant to justify its use.…”

Alterations in deep tissue temperature around the knee after total knee arthroplasty: its association with knee motion recovery in the early phase

“…However, the clinical outcomes on ROM have been equivocal. Some studies have shown a benefit [4][5][6][7] , whereas others have demonstrated no difference [8][9][10][11] . One of the reasons for these controversial results may be different procedures of cryotherapy used in different studies.…”

Cryotherapy after total knee replacement: a survey of current practice

“…At others, treatment was applied on the basis of 'clinical need', with the majority of patients still receiving the treatment. The application of post-operative cryotherapy is a practice supported by Shelbourne and Wilkens (1990), Levy and Marmar (1993), Leutz and Harris (1995) and Webb et al (1998), who documented the benef its of cryotherapy following efficacy trials. However, Healy et al (1994) report no objective benef it in range of movement, swelling, blood loss or analgesia.…”

“…There are no standardized clinical guidelines relating to cryotherapy management in terms of the method of application, or on which postoperative day therapy is started, or the frequency with which it is applied. However, despite this apparent confusion, there is evidence in the literature that cryotherapy can be effective and present experience suggests that patients derive some objective and subjective benefits from it (Shelbourne and Wilkens, 1990;Webb et al, 1998;Leutz and Harris, 1995). Enloe et al (1996) investigated physiotherapists' methods of treating TKR and observed a multitude of different treatment programmes.…”

“…The application of cryotherapy after TKR has been described extensively in the literature; however, its benefits are unclear. Some authors reported reduced levels of blood loss, reduced analgesic requirement and improvements in range of motion (Walker et al, 1991;Levy and Marmar, 1993;Webb et al, 1998), but others do not demonstrate these findings (Healy et al, 1994;Leutz and Harris, 1995). Possible explanations for variation in trial results are differences in the clinical protocol or the type of cryotherapy application.…”