AI Article Synopsis
- The study aimed to assess the effectiveness of cryotherapy in enhancing early rehabilitation for patients who underwent total knee arthroplasty (TKA) and compare the results of continuous cold flow devices versus cold packs.
- A systematic review included 31 randomized controlled trials (RCTs), showing that cryotherapy significantly reduced pain levels (measured by visual analogue scale) and other related factors like opioid consumption and blood loss, especially in the first three postoperative days.
- While cryotherapy proved beneficial for pain relief and rehabilitation, the continuous cold flow device did not show superior results compared to traditional cold packs.
Article Abstract
Objective: Despite being well-studied and widely utilized, the efficacy of cryotherapy after total knee arthroplasty (TKA) in enhancing early rehabilitation lacks consensus. The aim of this systematic review and meta-analysis was to investigate (1) whether cryotherapy is able to promote the rehabilitation of patients undergoing TKA and (2) whether continuous cold flow device has superior results than cold pack in cryotherapy.
Methods: A comprehensive trial searching was performed in the PubMed, Embase, Cochrane Library, and Google Scholar electronic databases in May, 2024. Randomized controlled trials (RCTs) comparing cryotherapy with no cryotherapy or comparing continuous cold flow device with cold pack after TKA were included. The primary outcome was visual analogue scale (VAS) of pain, and secondary outcomes included opioid consumption, blood loss (hemoglobin decrease and drainage), range of motion (ROM), swelling, length of stay (LOS), and adverse event.
Results: A total of 31 RCTs were included in this meta-analysis with 18 trials comparing cryotherapy with no cryotherapy and 13 trials comparing continuous cold flow device with cold pack. Pooled results showed cryotherapy group had significantly lower VAS scores than no cryotherapy group on postoperative day (POD) 1 (MD, -0.59 [95% CI, -1.14 to -0.04]; p = 0.04), POD 2 (MD, -0.84 [95% CI, -1.65 to -0.03]; p = 0.04), and POD 3 (MD, -0.86 [95% CI, -1.65 to -0.07]; p = 0.03). Cryotherapy group also showed reduced opioid consumption, reduced hemoglobin loss, decreased drainage, and improved ROM after TKA. Continuous cold flow device group had comparable VAS, opioid consumption, blood loss, ROM, knee swelling, and LOS with cold pack group.
Conclusion: Cryotherapy can effectively alleviate postoperative pain, reduce blood loss, improve ROM, and thus promote the postoperative rehabilitation for TKA patients, but the continuous cold flow device did not show better efficacy than cold packs. These findings support the routine use of cryotherapy for the rapid rehabilitation of TKA patients, and the traditional cold pack is still recommended.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11608804 | PMC |
| http://dx.doi.org/10.1111/os.14266 | DOI Listing |
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