Intraoperative Arthroscopic Cold Irrigation Solution Does Not Affect Postoperative Pain and Swelling

Abstract

OBJECTIVE: To determine what effect using a cold irrigating solution during arthroscopic knee surgery would have on postoperative pain intensity, pain-medicine consumption, and knee joint swelling. DESIGN AND SETTING: We employed a randomized, controlled trial design. Subjects were randomly assigned to either the cold (4 degrees C) irrigating saline group or room-temperature (18 degrees C) irrigating saline (control) group. Subjects were blinded to group assignment. All surgeries were performed at the same hospital by the same surgeon. SUBJECTS: The sample was 93 physically active patients (32 women, 61 men, mean age = 47.4 +/- 15.1 years) who had knee injuries requiring surgery. Those with cold sensitivities or contraindications to the use of cold were excluded. MEASUREMENTS: A 10-cm horizontal visual analog scale was used to measure postoperative pain intensity. Postoperative pain-medicine consumption was recorded using a daily log. Knee joint swelling (girth) was measured at midpatella and 2 in (5.08 cm) above midpatella. Pain and swelling measures were collected before and after surgery. RESULTS: No statistical or clinical differences were found between the cold-saline and control groups for pain, pain-medicine consumption, and postoperative swelling across the first 4 postoperative days. CONCLUSIONS: Our results suggest that using intra-articular cold saline to irrigate the knee joint during arthroscopic surgery had no statistically or clinically significant effect on postoperative pain, medication usage, or swelling in the first 4 postoperative days.

Figures

Pain (visual analog scale) ratings by treatment group across the postoperative interval showed no significant differences between groups (bars represent standard errors).