Compressive cryotherapy versus cryotherapy alone in patients undergoing knee surgery: a meta-analysis

Mingzhi Song, Xiaohong Sun, Xiliang Tian, Xianbin Zhang, Tieying Shi, Ran Sun, Wei Dai, Mingzhi Song, Xiaohong Sun, Xiliang Tian, Xianbin Zhang, Tieying Shi, Ran Sun, Wei Dai

Abstract

Aim: This study aims to conduct a meta-analysis to identify and compare the effectiveness of compressive cryotherapy and cryotherapy alone for patients undergoing knee surgery.

Background: Postoperative management is an important guarantee for the success of surgery. Cryotherapy and compression are two common nursing techniques after knee surgery, and are considered to be effective for postoperative clinical symptoms such as local pain and swelling. However, no previous meta-analyses have compared the effectiveness of compressive cryotherapy and cryotherapy alone in patients undergoing knee surgery.

Design: A meta-analysis of randomized controlled trials (RCTs).

Methods: We conducted a search in MEDLINE (via Pubmed, 1990-2014), EMBASE (via Elsevier, 1990-2014), Cochrane Central Register of Controlled Trials (The Cochrane Library, 1990-2014), CINAHL (1990-2014) and China National Knowledge Infrastructure (1990-2014) databases for RCTs published in English and Chinese. The primary outcome measure of interest was visual analog scale and girth measure. Finally, a meta-analysis was carried out using RevMan 5.3.

Results: Among the 593 RCTs, 10 RCTs were selected and included into this study. These studies included 522 patients who underwent knee surgery. Patients who underwent compressive cryotherapy tended to have less pain than patients who underwent cryotherapy alone at POD2 and POD3, while compressive cryotherapy had a strong tendency towards less swelling over cryotherapy alone at POD1 and POD2. However, there was no significant difference between compressive cryotherapy and cryotherapy alone at the intermediate stage of rehabilitation after knee surgery. All adverse reactions were recorded in all included RCTs.

Conclusion: Current evidence suggests that compressive cryotherapy is beneficial to patients undergoing knee surgery at the early rehabilitation stage. At the last stage, the effectiveness of compressive cryotherapy and cryotherapy alone were found to be similar.

Keywords: Anterior cruciate ligament reconstruction; Arthroscopy; Cryotherapy; Edema; Meta-analysis; Nursing; Pain; Pain relief; Postoperative care; Postoperative complications; Surgery; Total knee arthroplasty.

Figures

Fig. 1
Fig. 1
Study selection process
Fig. 2
Fig. 2
JADAD scale
Fig. 3
Fig. 3
Pooled data of VAS for compressive cryotherapy versus cryotherapy alone at the early rehabilitation stage: a–c stand for VAS at POD 1, 2 and 3, respectively
Fig. 4
Fig. 4
Pooled data of VAS for compressive cryotherapy versus cryotherapy alone at the chronic rehabilitation stage: a, b stand for VAS at POW 1 and 2, respectively
Fig. 5
Fig. 5
Pooled data of girth measure for compressive cryotherapy versus cryotherapy alone at the early rehabilitation stage: a–c stand for swelling at POD 1, 2 and 3, respectively

References

    1. Adie S, Naylor JM, Harris IA. Cryotherapy after total knee arthroplasty a systematic review and meta-analysis of randomized controlled trials. J Arthroplasty. 2010;25:709–715. doi: 10.1016/j.arth.2009.07.010.
    1. Adie S, Kwan A, Naylor JM, Harris IA, Mittal R. Cryotherapy following total knee replacement. Cochrane Database Syst Rev. 2012;12:7911.
    1. Andersen LØ, Husted H, Otte KS, Kristensen BB, Kehlet H. A compression bandage improves local infiltration analgesia in total knee arthroplasty. Acta Orthop. 2008;79:806–811. doi: 10.1080/17453670810016894.
    1. Bleakley C, McDonough S, MacAuley D. The use of ice in the treatment of acute soft-tissue injury: a systematic review of randomized controlled trials. Am J Sports Med. 2004;32:251–261. doi: 10.1177/0363546503260757.
    1. Charalambides C, Beer M, Melhuish J, Williams RJ, Cobb AG. Bandaging technique after knee replacement. Acta Orthop. 2005;76:89–94. doi: 10.1080/00016470510030382.
    1. Cheung A, Lykostratis H, Holloway I. Compression bandaging improves mobility following total knee replacement in an enhanced recovery setting. J Perioper Pract. 2014;24:84–86.
    1. Cohn BT, Draeger RI, Jackson DW. The effects of cold therapy in the postoperative management of pain in patients undergoing anterior cruciate ligament reconstruction. Am J Sports Med. 1989;17:344–349. doi: 10.1177/036354658901700306.
    1. 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;55:229–240. doi: 10.1016/j.rehab.2012.03.004.
    1. Higgins JPT, Green S (2011) Cochrane handbook for systematic reviews of interventions. The Cochrane collaboration. Version 5.0.2
    1. Jadad AR, Moore RA, Caroll D, Jenkinson C, Reynolds DJM, Gavaghan DJ, McQuay HJ. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials. 1996;17:1–12. doi: 10.1016/0197-2456(95)00134-4.
    1. Khoshnevis S, Craik NK, Diller KR. Cold-induced vasoconstriction may persist long after cooling ends: an evaluation of multiple cryotherapy units. Knee Surg Sports Traumatol Arthrosc. 2015;23:2475–2483. doi: 10.1007/s00167-014-2911-y.
    1. Kraeutler MJ, Reynolds KA, Long C, McCarty EC. Compressive cryotherapy versus ice-a prospective, randomized study on postoperative pain in patients undergoing arthroscopic rotator cuff repair or subacromial decompression. J Shoulder Elbow Surg. 2015;24:854–859. doi: 10.1016/j.jse.2015.02.004.
    1. Lakhan SE, Ford CT, Tepper D. Zingiberaceae extracts for pain: a systematic review and meta-analysis. Nutr J. 2015;14:50. doi: 10.1186/s12937-015-0038-8.
    1. Lee B, Benyajati S, Woods JA, Jan YK. Effect of local cooling on pro-inflammatory cytokines and blood flow of the skin under surface pressure in rats: feasibility study. J Tissue Viability. 2014;23:69–77. doi: 10.1016/j.jtv.2014.01.002.
    1. Lessard LA, Scudds RA, Amendola A, Vaz MD. The efficacy of cryotherapy following arthroscopic knee surgery. J Orthop Sports Phys Ther. 1997;26:14–22. doi: 10.2519/jospt.1997.26.1.14.
    1. Li LL, Ning N, Hou XL, Zhu H, Chen JL, Chen ZL, Liao DB, Yang H. Clinical research on the Cryo/cuff system in controlling pain of postoperative knee arthroscopy patients. Mod Prev Med. 2010;37:2587–2589.
    1. Li LL, Ning N, Hou XL, Zhu H, Chen JL, Chen ZL. Cryo/Cuff system controls swelling following postoperative knee arthroscopy patients. J Clin Rehabil Tissue Eng Res. 2010;14:7286–7389.
    1. Markert SE. The use of cryotherapy after a total knee replacement: a literature review. Orthop Nurs. 2011;30:29–36. doi: 10.1097/NOR.0b013e318205749a.
    1. Martimbianco AL, Gomes da Silva BN, de Carvalho AP, Silva V, Torloni MR, Peccin MS. Effectiveness and safety of cryotherapy after arthroscopic anterior cruciate ligament reconstruction. A systematic review of the literature. Phys Ther Sport. 2014;15:261–268. doi: 10.1016/j.ptsp.2014.02.008.
    1. Mejia N, Dedow K, Nguy L, Sullivan P, Khoshnevis S, Diller KR. An On-Site Thermoelectric Cooling Device for Cryotherapy and Control of Skin Blood Flow. J Med Device. 2015;9:445021–445026. doi: 10.1115/1.4029508.
    1. Meyer-Marcotty M, Jungling O, Vaske B, Vogt PM, Knobloch K. Standardized combined cryotherapy and compression using Cryo/Cuff after wrist arthroscopy. Knee Surg Sports Traumatol Arthrosc. 2011;19:314–319. doi: 10.1007/s00167-010-1280-4.
    1. Munk S, Jensen NJ, Andersen I, Kehlet H, Hansen TB. Effect of compression therapy on knee swelling and pain after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2013;21:388–392. doi: 10.1007/s00167-012-1963-0.
    1. Nadler SF, Weingand K, Kruse RJ. Cryotherapy and thermotherapy for the pain practitioner. Pain Physician. 2004;7:395–399.
    1. Ni SH, Jiang WT, Guo L, Jin YH, Jiang TL, Zhao Y, Zhao J. Cryotherapy on postoperative rehabilitation of joint arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2015;23:3354–3361. doi: 10.1007/s00167-014-3135-x.
    1. Pinsornsak P, Chumchuen S. Can a modified Robert Jones bandage after knee arthroplasty reduce blood loss? A prospective randomized controlled trial. Clin Orthop Relat Res. 2013;471:1677–1681. doi: 10.1007/s11999-013-2786-0.
    1. Raynor MC, Pietrobon R, Guller U, Higgins LD. Cryotherapy after ACL reconstruction: a meta-analysis. J Knee Surg. 2005;18:123–129. doi: 10.1055/s-0030-1248169.
    1. Schaser KD, Disch AC, Stover JF, Lauffer A, Bail HJ, Mittlmeier T. Prolonged superficial local cryotherapy attenuates microcirculatory impairment, regional inflammation, and muscle necrosis after closed soft tissue injury in rats. Am J Sports Med. 2007;35:93–102. doi: 10.1177/0363546506294569.
    1. Schröder D, Pässler HH. Combination of cold and compression after knee surgery: A prospective randomized study. Knee Surg Sports Traumatol Arthrosc. 1994;2:158–165. doi: 10.1007/BF01467918.
    1. Smith J, Stevens J, Taylor M, Tibbey J. A randomized, controlled trial comparing compression bandaging and cold therapy in postoperative total knee replacement surgery. Orthop Nurs. 2002;21:61–66. doi: 10.1097/00006416-200203000-00009.
    1. Tian RX, Hao YF, Guo H. Comparison of Cryo/Cuff system with ice compress in postoperative care of knee arthroscopy patients. J Nurs (China) 2013;20:10–13.
    1. Trobec R, Sterk M, AlMawed S, Veselko M. Computer simulation of topical knee cooling. Comput Biol Med. 2008;38:1076–1083. doi: 10.1016/j.compbiomed.2008.08.004.
    1. van Grinsven S, van Cingel RE, Holla CJ, van Loon CJ. Evidence-based rehabilitation following anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. 2010;18:1128–1144. doi: 10.1007/s00167-009-1027-2.
    1. Wang FF, Li Q, Wei YL. The effectiveness evaluation of cycling compressive cryotherapy system after arthroscopic cruciate ligament reconstruction surgery. China Health Care Nutr. 2014;24:3722–3723.
    1. Warren TA, McCarty EC, Richardson AL, Michener T, Spindler KP. Intra-articular knee temperature changes: ice versus cryotherapy device. Am J Sports Med. 2004;32:441–445. doi: 10.1177/0363546503258864.
    1. Waterman B, Walker JJ, Swaims C, Shortt M, Todd MS, Machen SM, Owens BD. The Efficacy of Combined Cryotherapy and Compression Compared with Cryotherapy Alone Following Anterior Cruciate Ligament Reconstruction. J Knee Surg. 2012;25:155–160. doi: 10.1055/s-0031-1299650.
    1. Xie Q, Huang HY, Duan JF, Chen YR, Zheng XF, Zuo D, Wang YQ, Zhang Y, Xia H. The effect of continuous compression cryotherapy for postoperative pain and swelling after anterior cruciate ligament reconstruction. China J Rehabil. 2013;28:190–191.
    1. Xie Q, Liu H, Huang HY, Wang YQ, Li PY, Zheng XF, Yin QS. The early effect of continuous compression cryotherapy for postoperative patients undergoing knee arthroscopic operation. Guangdong Med J. 2014;35:3–5.
    1. Xu XH, Li XF, Xiong YF. Comparison of Cryo/cuff Systems and intermittent cold compress with hypertonic saline following total knee arthroplasty. China J Tissue Eng Res. 2013;17:8325–8330.
    1. Yabroudi MA, Irrgang JJ. Rehabilitation and return to play after anatomic anterior cruciate ligament reconstruction. Clin Sports Med. 2013;32:165–175. doi: 10.1016/j.csm.2012.08.016.

Source: PubMed

Sponsorer og samarbeidspartnere

Medisinsk tilstand

Legemiddelintervensjoner

3
Abonnere