Effectiveness and methods of cryotherapy in reducing swelling after total knee arthroplasty: A systematic review on randomized controlled trials.
Yoonyoung Lee, Yong Soon Shin, Hyun Jung Kim and 1 others
PMID 37334865WHAT IT FOUND
Cryotherapy after total knee replacement did not reliably reduce swelling.
Six of eight studies found no clear difference, while two found less swelling. Temperature, timing and dose varied, so a standard method cannot be recommended.
Key findings
01Six of eight included studies found no clear difference in swelling after cryotherapy.
02Two studies reported less swelling: one at 24 and 48 hours, and one at the third and sixth postoperative day and at six weeks.
03The review concluded that the effect and methods of cryotherapy on swelling after total knee arthroplasty could not be confirmed.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only eight trials and 490 patients were available, and study sizes ranged from 16 to 106. Only four trials were judged low risk of bias. The cryotherapy devices, temperatures, sites, session lengths, start times and durations differed across studies, so the review could not identify one best method. The two studies that found less swelling combined cryotherapy with compression or continuous passive motion, or compared it with another active treatment, so the effect of cold alone cannot be isolated. Several studies did not report temperature, site, session time, frequency or duration.
Declared interests
The review was funded by a basic research project from the Government of Korea through the Korea Research Foundation, and the authors declared no conflicts of interest.
The easy way to misread this
Do not read the two studies that found less swelling as proof that cryotherapy alone reduces swelling. They used different comparisons, including continuous passive motion and compression therapy, and the overall review found the effect could not be confirmed.