Cold Therapy Clinical Research Overview

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Demoulin 2012

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Demoulin C, Brouwers M, Darot S, Gillet P, Crielaard JM, Vanderthommen M. Comparison of gaseous cryotherapy with more traditional forms of cryotherapy following total knee arthroplasty. Ann Phys Rehabil Med. 2012 May;55(4):229-40. English, French.

Design: Randomised Study

Subjects: 66 patients undergoing primary unilateral TKA

Methods: On preoperative day 1, patients were randomized into three groups;

• Gaseous cryotherapy (GC),

• Cold pack (CP),

• Cryo/Cuff.

All patients received cold therapy starting from postoperative day (POD) 2 and the therapy continued until the last hospitalization day. Outcomes included: knee pain intensity, mobility and girth measurements on preoperative day 1 and POD 7. Skin temp was measured on POD7 pre and post cold application.

Key message: Although skin temperature was significantly lower with gaseous cryotherapy, it was not more beneficial than routinely used strategies (Cryo/Cuff and gel packs) for pain intensity or knee ROM.

Results:

• Although skin temperature dropped to 14°C following GC versus 22 to 24°C for the other two applications (P<0.05), the three groups did not differ at POD7 regarding the three primary outcomes. • Following surgery, range of motion of the operated knee further decreased (P < 0.05) in all groups. There was no significant difference between groups. • The between-group comparisons at baseline revealed no significant difference with regard to pain intensity. • Following surgery, pain increased significantly in the CP (P < 0.05) and GC groups (P < 0.01) whereas it remained stable in the Cryo/Cuff group.

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