Evaluation of the effect of cooling strategies on recovery after surgical intervention

Abstract

Introduction Different cooling strategies exist for emergency treatments immediately after sports trauma or after surgery. The aim of this study was to investigate the effects of three cooling regimen during the immediate postoperative phase as well as in the rehabilitation phase. Methods 36 patients undergoing anterior cruciate ligament reconstruction received either no cooling (control-group, Con, N=12), were cooled with a menthol-containing cooling bandage (Mtl, N=12) or cooled with an ice containing cold pack (CP, N=12). During a 12-week physiotherapy treatment the cross section of the vastus medialis muscle was examined (day - 1; 30; 60; 90) and painkiller consumption was documented. Results A significant reduction in the cross section area 30 days after surgery was observed in CP and Con (Mtl: -3.2±1.7%, p=0.14, CP: -8.8±4.3%, p<0.01, Con: -7.2±8.1%, p<0.05). After 90 days of therapy, a significant increase in muscle cross section area was observed in Mtl (Mtl: 4.6%±6.1%, p<0.05, CP: 1.9%± 8.1%, p=0.29, Con: 3.3%±9.4%, p=0.31). The absolute painkiller consumption was lower for Mtl (25.5±3.7 tablets) than for CP (39.5±6.9 tablets) or Con (34.8±4.2 tablets). Conclusion We observed a beneficial effect of cooling by a menthol-containing bandage during the rehabilitation phase. Reduction of muscle cross section within 30 days after surgery was prevented which highly contributed to rehabilitation success after 90 days of therapy. Painkiller consumption was reduced with Mtl.