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Orthopaedic Application of Cryotherapy: A Comprehensive Review of the History, Basic Science, Methods, and Clinical Effectiveness

Kunkle BF, Kothandaraman V, Goodloe JB, Curry EJ, Curry EJ, Friedman RJ, Li X, Li X, Eichinger JK

JBJS reviews · 34 citas

Etiquetas de revisión

Financiación no declarada

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Cómo se estudió

Diseño
Revisión sistemática (clasificado por nuestro filtro de IA)
Estudiado en
Personas
Resultado principal
Marcadores de salud y funcionamiento

Quién lo pagó

Financiación
Financiación no declarada

Publicación

Publicado
2021-01-01 · JBJS Rev · vol. 9 · número 1 · pág. e20.00016
Editorial
Lippincott Williams & Wilkins
Citado
49 citas · más que el 89% de estudios similares · 2.3× el promedio de su campo
Referencias
105 trabajos
Acceso
De pago
Áreas de investigación
Exercise and Physiological Responses · Dermatological and COVID-19 studies · Thermal Regulation in Medicine
Palabras clave
Medicine, Cryotherapy, MEDLINE, Physical therapy, Physical medicine and rehabilitation, Surgery
MeSH
humans, range of motion, articular, treatment outcome, cryotherapy, orthopedics, postoperative pain

7 autores

  • Bryce F. Kunkle🇺🇸Medical University of South Carolina
  • Venkatraman Kothandaraman🇺🇸Medical University of South Carolina
  • Jonathan Brett Goodloe🇺🇸Medical University of South Carolina
  • Emily J. Curry🇺🇸Boston University
  • Richard Joel Friedman🇺🇸Medical University of South Carolina
  • Xinning Li🇺🇸Boston University
  • Josef Karl Eichinger🇺🇸Medical University of South Carolina

Resumen

El texto original del estudio, en el idioma en que se publicó.

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Cold therapy, also known as cryotherapy, includes the use of bagged ice, ice packs, compressive cryotherapy devices, or whole-body cryotherapy chambers. Cryotherapy is commonly used in postoperative care for both arthroscopic and open orthopaedic procedures.

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Cryotherapy is associated with an analgesic effect caused by microvasculature alterations that decrease the production of inflammatory mediators, decrease local edema, disrupt the overall inflammatory response, and reduce nerve conduction velocity.

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Postoperative cryotherapy using bagged ice, ice packs, or continuous cryotherapy devices reduced visual analog scale pain scores and analgesic consumption in approximately half of research studies in which these outcomes were compared with no cryotherapy (11 [44%] of 25 studies on pain and 11 [48%] of 23 studies on opioids). However, an effect was less frequently reported for increasing range of motion (3 [19%] of 16) or decreasing swelling (2 [22%] of 9).

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Continuous cryotherapy devices demonstrated the best outcome in orthopaedic patients after knee arthroscopy procedures, compared with all other procedures and body locations, in terms of showing a significant reduction in pain, swelling, and analgesic consumption and increase in range of motion, compared with bagged ice or ice packs.

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There is no consensus as to whether the use of continuous cryotherapy devices leads to superior outcomes when compared with treatment with bagged ice or ice packs. However, complications from cryotherapy, including skin irritation, frostbite, perniosis, and peripheral nerve injuries, can be avoided through patient education and reducing the duration of application.

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Future Level-I or II studies are needed to compare both the clinical and cost benefits of continuous cryotherapy devices to bagged ice or ice pack treatment before continuous cryotherapy devices can be recommended as a standard of care in orthopaedic surgery following injury or surgery.

Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial.

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