Cryotherapy following total knee arthroplasty: What is the evidence?

Abstract

Background: Total knee arthroplasty (TKA) is an important option in the management of severe osteoarthritis. Despite excellent long-term results following TKA, the immediate postoperative period is often associated with pain, bleeding, edema, and reduced range of movement. Cryotherapy has been shown to provide some benefit in addressing these factors but results are largely controversial. This study aims at reviewing the current existing literature on the effects of cryotherapy following TKA. Methods: A comprehensive review of the current literature on the use of cryotherapy in knee arthroplasty was performed. The literature search was performed using PubMed, Cochrane Library, Google Scholar, and cross references using the search words “cryotherapy” AND “knee arthroplasty” for articles published between January 1990 and November 2016. Results: A total of 51 articles were analyzed and 24 of them were selected based on clinical relevance. Conclusion: Immediate and early postoperative management following TKA remains challenging. Cryotherapy has been shown to have some benefits but the severe lack of level 1 studies supporting its use make it difficult to reach a suitable conclusion. Further multicenter randomized controlled trials with representative populations and fair comparison of devices are needed.