Cold Therapy Clinical Research Overview

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Wyatt 2023 | TKA

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Wyatt PB, Nelson CT, Cyrus JW, Goldman AH, Patel NK. The Role of Cryotherapy After Total Knee Arthroplasty: A Systematic Review. J Arthroplasty. 2023 May;38(5):950-956.

Design: Systematic Review

Methods: A strategic keyword search of Medline, Cochrane, Embase, and CINAHL retrieved randomized controlled trials examining cryotherapy following TKA published between February 1, 2017, and February 24, 2022.

Outcomes included: Pain ratings, knee/limb swelling, opioid use, and ROM.

Results

• Six studies were selected for inclusion in this review.

Key message: Cryotherapy's role after TKA appears to be in decreasing opioid consumption primarily in the first postoperative week.

• Opioid use was significantly decreased in cryotherapy groups compared to non-cryotherapy groups within the first postoperative week only (P < .05). • This effect may be augmented by the use of computer-assisted (temperature regulated) cryotherapy devices, compared to other modalities including ice packs.

• Pain ratings also decrease, but this decrease may not be clinically relevant.

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• Cryotherapy appears to confer no consistent benefit to ROM and swelling at any time point. • Computer-assisted cryotherapy may be associated with decreased opioid consumption after TKA compared to traditional ice packs.

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