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Erschienen in: International Orthopaedics 6/2018

22.01.2018 | Original Paper

Impact of a new cryotherapy device on early rehabilitation after primary total knee arthroplasty (TKA): a prospective randomised controlled trial

verfasst von: Patrick Sadoghi, Sandro Hasenhütl, Gerald Gruber, Lukas Leitner, Andreas Leithner, Gudrun Rumpold-Seitlinger, Norbert Kastner, Rudolf W. Poolman, Mathias Glehr

Erschienen in: International Orthopaedics | Ausgabe 6/2018

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Abstract

Background

The aim of this prospective, randomised and single blinded study was to evaluate the efficiency and safety of a new cryotherapy device in patients undergoing unilateral, primary total knee arthroplasty (TKA). Our hypothesis was that patients administered to the new cryotherapy device would perform better than patients receiving a conventional standard cold therapy regimen.

Methods

Ninety-seven patients were randomised into two groups receiving either the cTreatment® (new cryotherapy device) or the standard cold therapy protocol (including cold pack application for six days after the surgical intervention). We evaluated the following endpoints consisting of range of motion (ROM), pain intensity, and knee girth on admission day and the second, fourth, and sixth post-operative day (POD).

Results

A statistically significant benefit of the new cryotherapy device was detected regarding the ROM on the sixth POD with an average gain of 7 degrees (p = 0.021). Pain in the numeric rating scale (NRS) score in motion was significantly lower in the cTreatment® group on the second POD (p = 0.034). There were no statistically significant differences between groups regarding the NRS in rest, patient controlled analgesia (PCA) consumption, and girth measurements. No adverse effects were observed in both study groups.

Conclusion

The new computer-controlled cooling therapy device provides benefits in terms of early post-operative remobilisation with respect to ROM and pain, which might be attributed to a reduced inflammatory response, as well as reduced secretion and bleeding. The cTreatment® system appears to be a safe and efficient procedure.
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Literatur
1.
Zurück zum Zitat Bourne RB, McCalden RW, MacDonald SJ, Mokete L, Guerin J (2007) Influence of patient factors on TKA outcomes at 5 to 11 years followup. Clin Orthop Relat Res 464:27–31PubMed Bourne RB, McCalden RW, MacDonald SJ, Mokete L, Guerin J (2007) Influence of patient factors on TKA outcomes at 5 to 11 years followup. Clin Orthop Relat Res 464:27–31PubMed
2.
Zurück zum Zitat Sorrells RB, Voorhorst PE, Murphy JA, Bauschka MP, Greenwald AS (2004) Uncemented rotating-platform total knee replacement: a five to twelve-year follow-up study. J Bone Joint Surg Am 86-A(10):2156–2162CrossRefPubMed Sorrells RB, Voorhorst PE, Murphy JA, Bauschka MP, Greenwald AS (2004) Uncemented rotating-platform total knee replacement: a five to twelve-year follow-up study. J Bone Joint Surg Am 86-A(10):2156–2162CrossRefPubMed
3.
Zurück zum Zitat Hawker G, Wright J, Coyte P, Paul J, Dittus R, Croxford R et al (1998) Health-related quality of life after knee replacement. J Bone Joint Surg Am 80(2):163–173CrossRefPubMed Hawker G, Wright J, Coyte P, Paul J, Dittus R, Croxford R et al (1998) Health-related quality of life after knee replacement. J Bone Joint Surg Am 80(2):163–173CrossRefPubMed
4.
Zurück zum Zitat Demoulin C, Brouwers M, Darot S, Gillet P, Crielaard JM, Vanderthommen M (2012) Comparison of gaseous cryotherapy with more traditional forms of cryotherapy following total knee arthroplasty. Ann Phys Rehabil Med 55(4):229–240CrossRefPubMed Demoulin C, Brouwers M, Darot S, Gillet P, Crielaard JM, Vanderthommen M (2012) Comparison of gaseous cryotherapy with more traditional forms of cryotherapy following total knee arthroplasty. Ann Phys Rehabil Med 55(4):229–240CrossRefPubMed
5.
Zurück zum Zitat Holm B, Husted H, Kehlet H, Bandholm T (2012) Effect of knee joint icing on knee extension strength and knee pain early after total knee arthroplasty: a randomized cross-over study. Clin Rehabil 26(8):716–723CrossRefPubMed Holm B, Husted H, Kehlet H, Bandholm T (2012) Effect of knee joint icing on knee extension strength and knee pain early after total knee arthroplasty: a randomized cross-over study. Clin Rehabil 26(8):716–723CrossRefPubMed
6.
Zurück zum Zitat Su EP, Perna M, Boettner F, Mayman DJ, Gerlinger T, Barsoum W et al (2012) A prospective, multi-center, randomised trial to evaluate the efficacy of a cryopneumatic device on total knee arthroplasty recovery. J Bone Joint Surg Br 94(11 Suppl A):153–156CrossRefPubMed Su EP, Perna M, Boettner F, Mayman DJ, Gerlinger T, Barsoum W et al (2012) A prospective, multi-center, randomised trial to evaluate the efficacy of a cryopneumatic device on total knee arthroplasty recovery. J Bone Joint Surg Br 94(11 Suppl A):153–156CrossRefPubMed
7.
Zurück zum Zitat Radkowski CA, Pietrobon R, Vail TP, Nunley JA 2nd, Jain NB, Easley ME (2007) Cryotherapy temperature differences after total knee arthroplasty: a prospective randomized trial. J Surg Orthop Adv 16(2):67–72PubMed Radkowski CA, Pietrobon R, Vail TP, Nunley JA 2nd, Jain NB, Easley ME (2007) Cryotherapy temperature differences after total knee arthroplasty: a prospective randomized trial. J Surg Orthop Adv 16(2):67–72PubMed
8.
Zurück zum Zitat Kullenberg B, Ylipaa S, Soderlund K, Resch S (2006) Postoperative cryotherapy after total knee arthroplasty: a prospective study of 86 patients. J Arthroplast 21(8):1175–1179CrossRef Kullenberg B, Ylipaa S, Soderlund K, Resch S (2006) Postoperative cryotherapy after total knee arthroplasty: a prospective study of 86 patients. J Arthroplast 21(8):1175–1179CrossRef
9.
Zurück zum Zitat Scarcella JB, Cohn BT (1995) The effect of cold therapy on the postoperative course of total hip and knee arthroplasty patients. Am J Orthop (Belle Mead NJ) 24(11):847–852 Scarcella JB, Cohn BT (1995) The effect of cold therapy on the postoperative course of total hip and knee arthroplasty patients. Am J Orthop (Belle Mead NJ) 24(11):847–852
10.
Zurück zum Zitat Leutz DW, Harris H (1995) Continuous cold therapy in total knee arthroplasty. Am J Knee Surg 8(4):121–123PubMed Leutz DW, Harris H (1995) Continuous cold therapy in total knee arthroplasty. Am J Knee Surg 8(4):121–123PubMed
11.
Zurück zum Zitat Morsi E (2002) Continuous-flow cold therapy after total knee arthroplasty. J Arthroplast 17(6):718–722CrossRef Morsi E (2002) Continuous-flow cold therapy after total knee arthroplasty. J Arthroplast 17(6):718–722CrossRef
12.
Zurück zum Zitat Martin SS, Spindler KP, Tarter JW, Detwiler KB (2002) Does cryotherapy affect intraarticular temperature after knee arthroscopy? Clin Orthop Relat Res (400):184–189 Martin SS, Spindler KP, Tarter JW, Detwiler KB (2002) Does cryotherapy affect intraarticular temperature after knee arthroscopy? Clin Orthop Relat Res (400):184–189
13.
Zurück zum Zitat Demoulin C, Vanderthommen M (2012) Cryotherapy in rheumatic diseases. Joint Bone Spine 79(2):117–118CrossRefPubMed Demoulin C, Vanderthommen M (2012) Cryotherapy in rheumatic diseases. Joint Bone Spine 79(2):117–118CrossRefPubMed
14.
Zurück zum Zitat Abramson DI, Chu LS, Tuck S Jr, Lee SW, Richardson G, Levin M (1966) Effect of tissue temperatures and blood flow on motor nerve conduction velocity. JAMA 198(10):1082–1088CrossRefPubMed Abramson DI, Chu LS, Tuck S Jr, Lee SW, Richardson G, Levin M (1966) Effect of tissue temperatures and blood flow on motor nerve conduction velocity. JAMA 198(10):1082–1088CrossRefPubMed
15.
Zurück zum Zitat Ciolek JJ (1985) Cryotherapy. Review of physiological effects and clinical application. Cleve Clin Q 52(2):193–201CrossRefPubMed Ciolek JJ (1985) Cryotherapy. Review of physiological effects and clinical application. Cleve Clin Q 52(2):193–201CrossRefPubMed
16.
Zurück zum Zitat Stalman A, Berglund L, Dungnerc E, Arner P, Felländer-Tsai L (2011) Temperature-sensitive release of prostaglandin E2 and diminished energy requirements in synovial tissue with postoperative cryotherapy: a prospective randomized study after knee arthroscopy. J Bone Joint Surg Am 93(21):1961–1968CrossRefPubMed Stalman A, Berglund L, Dungnerc E, Arner P, Felländer-Tsai L (2011) Temperature-sensitive release of prostaglandin E2 and diminished energy requirements in synovial tissue with postoperative cryotherapy: a prospective randomized study after knee arthroscopy. J Bone Joint Surg Am 93(21):1961–1968CrossRefPubMed
17.
Zurück zum Zitat Jastrzabek R, Straburzynska-Lupa A, Rutkowski R, Romanowski W (2013) Effects of different local cryotherapies on systemic levels of TNF-alpha, IL-6, and clinical parameters in active rheumatoid arthritis. Rheumatol Int 33(8):2053–2060CrossRefPubMed Jastrzabek R, Straburzynska-Lupa A, Rutkowski R, Romanowski W (2013) Effects of different local cryotherapies on systemic levels of TNF-alpha, IL-6, and clinical parameters in active rheumatoid arthritis. Rheumatol Int 33(8):2053–2060CrossRefPubMed
18.
Zurück zum Zitat Adie S, Kwan A, Naylor JM, Harris IA, Mittal R (2012) Cryotherapy following total knee replacement. Cochrane Database Syst Rev 9:CD007911 Adie S, Kwan A, Naylor JM, Harris IA, Mittal R (2012) Cryotherapy following total knee replacement. Cochrane Database Syst Rev 9:CD007911
19.
Zurück zum Zitat Adie S, Naylor JM, Harris IA (2010) Cryotherapy after total knee arthroplasty a systematic review and meta-analysis of randomized controlled trials. J Arthroplast 25(5):709–715CrossRef Adie S, Naylor JM, Harris IA (2010) Cryotherapy after total knee arthroplasty a systematic review and meta-analysis of randomized controlled trials. J Arthroplast 25(5):709–715CrossRef
20.
Zurück zum Zitat Raynor MC, Pietrobon R, Guller U, Higgins LD (2005) Cryotherapy after ACL reconstruction: a meta-analysis. J Knee Surg 18(2):123–129CrossRefPubMed Raynor MC, Pietrobon R, Guller U, Higgins LD (2005) Cryotherapy after ACL reconstruction: a meta-analysis. J Knee Surg 18(2):123–129CrossRefPubMed
21.
Zurück zum Zitat Sehat KR, Evans RL, Newman JH (2004) Hidden blood loss following hip and knee arthroplasty. Correct management of blood loss should take hidden loss into account. J Bone Joint Surg Br 86(4):561–565CrossRefPubMed Sehat KR, Evans RL, Newman JH (2004) Hidden blood loss following hip and knee arthroplasty. Correct management of blood loss should take hidden loss into account. J Bone Joint Surg Br 86(4):561–565CrossRefPubMed
22.
Zurück zum Zitat Barry S, Wallace L, Lamb S (2003) Cryotherapy after total knee replacement: a survey of current practice. Physiother Res Int 8(3):111–120CrossRefPubMed Barry S, Wallace L, Lamb S (2003) Cryotherapy after total knee replacement: a survey of current practice. Physiother Res Int 8(3):111–120CrossRefPubMed
24.
25.
Zurück zum Zitat Ruffilli A, Castagnini F, Traina F, Corneti I, Fenga D, Giannini S, Faldini C (2017) Temperature-controlled continuous cold flow device after total knee arthroplasty: a randomized controlled trial study. J Knee Surg 30(7):675–681CrossRefPubMed Ruffilli A, Castagnini F, Traina F, Corneti I, Fenga D, Giannini S, Faldini C (2017) Temperature-controlled continuous cold flow device after total knee arthroplasty: a randomized controlled trial study. J Knee Surg 30(7):675–681CrossRefPubMed
27.
Zurück zum Zitat Bech M, Moorhen J, Cho M, Lavergne MR, Stothers K, Hoens AM (2015) Device or ice: the effect of consistent cooling using a device compared with intermittent cooling using an ice bag after total knee arthroplasty. Physiother Can 67:48e55CrossRef Bech M, Moorhen J, Cho M, Lavergne MR, Stothers K, Hoens AM (2015) Device or ice: the effect of consistent cooling using a device compared with intermittent cooling using an ice bag after total knee arthroplasty. Physiother Can 67:48e55CrossRef
28.
Zurück zum Zitat Schinsky MF, McCune C, Bonomi J (2016) Multifaceted comparison of two cryotherapy devices used after total knee arthroplasty: cryotherapy device comparison. Orthop Nurs 35:309e16CrossRef Schinsky MF, McCune C, Bonomi J (2016) Multifaceted comparison of two cryotherapy devices used after total knee arthroplasty: cryotherapy device comparison. Orthop Nurs 35:309e16CrossRef
29.
Zurück zum Zitat Smith J, Stevens J, Taylor M, Tibbey J (2002) A randomized, controlled trial comparing compression bandaging and cold therapy in postoperative total knee replacement surgery. Orthop Nurs 21(2):61–66CrossRefPubMed Smith J, Stevens J, Taylor M, Tibbey J (2002) A randomized, controlled trial comparing compression bandaging and cold therapy in postoperative total knee replacement surgery. Orthop Nurs 21(2):61–66CrossRefPubMed
Metadaten
Titel
Impact of a new cryotherapy device on early rehabilitation after primary total knee arthroplasty (TKA): a prospective randomised controlled trial
verfasst von
Patrick Sadoghi
Sandro Hasenhütl
Gerald Gruber
Lukas Leitner
Andreas Leithner
Gudrun Rumpold-Seitlinger
Norbert Kastner
Rudolf W. Poolman
Mathias Glehr
Publikationsdatum
22.01.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
International Orthopaedics / Ausgabe 6/2018
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-018-3766-5

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