J Knee Surg 2005; 18(2): 123-129
DOI: 10.1055/s-0030-1248169
Original Article

© 2005 Thieme Medical Publishers

Cryotherapy After ACL Reconstruction – A Meta-analysis

Mathew C. Raynor1 , Ricardo Pietrobon2, 4 , Ulrich Guller2, 3 , Laurence D. Higgins
  • 1The School of Medicine, University of North Carolina at Chapel Hill, Duke University Medical Center, Durham, North Carolina
  • 2The Center for Excellence in Surgical Outcomes, Duke University Medical Center, Durham, North Carolina
  • 3The University of Basel, Department of Surgery, Divisions of General Surgery and Surgical Research, 4031 Basel, Switzerland
  • 4The Division of Orthopedic Surgery, Duke University Medical Center, Durham, North Carolina
Further Information

Publication History

Publication Date:
27 January 2010 (online)


Cryotherapy is a common treatment modality after orthopedic surgery procedures. Single institutional randomized clinical trials have evaluated the efficacy of cryotherapy after arthroscopically-as-sisted anterior cruciate ligament (ACL) reconstruction. Most of these studies were, however, underpowered to detect clinically relevant outcomes differences. This meta-analysis assessed the combined scientific evidence of studies evaluating the effectiveness of cryotherapy after arthroscopically-assisted ACL reconstruction. Electronic databases and bibliographic references of relevant articles were used to identify all relevant randomized clinical trials comparing cryotherapy to a placebo group after ACL reconstruction. Outcomes under investigation were postoperative drainage, range of motion, and pain. Random-effects models were used to combine the findings of the randomized controlled trials. Seven randomized clinical trials were included in the meta-analysis. Postoperative drainage (P =.23) and range of motion (P =.25) were not significantly different between cryotherapy and control group. However, cryotherapy was associated with significantly lower postoperative pain (P =.02).

This meta-analysis showed that cryotherapy has a statistically significant benefit in postoperative pain control, while no improvement in postoperative range of motion or drainage was found. As the cryotherapy apparatus is fairly inexpensive, easy to use, has a high level of patient satisfaction, and is rarely associated with adverse events, we believe that cryotherapy is justified in the postoperative management of knee surgery.