Abstract
Total knee arthroplasty (TKA) is a widely accepted and successful procedure for end-stage
arthritis. Nevertheless, fast-track may be compromised by many factors, such as pain,
edema, and blood loss. Cryotherapy has been advocated as a safe and effective strategy
to improve the postoperative results, acting on pain, edema, and blood loss. This
study is a prospective randomized controlled study, involving 50 patients after primary
TKA. A power analysis was performed preoperatively. Twenty-four patients were addressed
to a postoperative treatment with a continuous cold flow device (Hilotherm, Hilotherm
GmbH, Germany). Twenty-six patients represented the control group, treated with crushed
ice packs. All the patients shared the same analgesic strategy and the same rehabilitation
protocol. Pain, analgesic consumption, active knee range of motion, drain output,
transfusion requirement, and total blood loss were evaluated at different follow-ups
(postoperative first, third, and seventh days). The two groups were homogenous for
preoperative and intraoperative features. The groups showed no statistically significant
differences in all the evaluated parameters. A modest reduction of knee volume was
evident after 7 days from surgery (trend). No differences in blood loss were noticed.
Continuous cold flow device in the acute postoperative setting after TKA did not show
superiority in reducing edema, pain, and blood loss, compared with traditional icing
regimen. Thus, due to the costs, it should be reserved to selected cases.
Keywords
continuous cold flow device - cryotherapy - total knee replacement - total knee arthroplasty
- randomized controlled trial
