Abstract

Purpose: The purpose of this research review is to investigate the efficacy of cryotherapy with dynamic intermittent compression (CDIC) compared to less advanced methods of cryotherapy, after total knee arthroplasty (TKA).

Background: The use of cryotherapy after surgery is a common and even standard of practice to help mitigate the side effects post-operatively. Some of these side effects include inflammation, pain, swelling, and stiffness; all of which, if not controlled, can influence recovery and have a detrimental effect on healing and returning to prior level of function. Currently there several different methods and treatment options when it comes to cryotherapy. There has been a steady increase in the number of TKAs each year. The push for patients to leave the hospital and return to work or sport faster is driving the development of better, more advanced modalities to speed up recovery. There are many therapeutic devices that claim to provide a better, faster recovery by delivering continuous cooling and intermittent pneumatic compression that mimics the body’s muscular pump. While the benefits of cryotherapy post-operatively have been demonstrated in research, the most effective cryotherapy method is still debated and there is currently limited research investigating the efficacy of more advanced commercial devices.

Case Description: The patient is a 68-year-old female presenting to the orthopedic outpatient clinic two days status post right TKA with pain, reduced range of motion, and increased swelling. She had a left TKA two years prior, and had a difficult time controlling her pain and swelling due to her limited tolerance of narcotics and ice, leading to a delayed return of range of motion and functional activities.

Methods: A literature review was conducted and numerous databases were searched to find research investigating the efficacy of CDIC devices compared less advanced cryotherapy methods.

Discussion: Upon literature review of current evidence, there is very limited high quality and consistent evidence that supports the use and the benefits of a CDIC device over standard ice and compression. With the inconsistency in results among current research and limited use of objective measures, it is difficult to draw a strict conclusion on whether the benefits outweigh the cost. Based on the research, CDIC devices are not seen to be superior to a standard ice bag with compression, and in some studies are seen to be less effective. Considering the cost of a CDIC device and its limited benefits, this method may not be appropriate for the majority of the patient population following TKA.

Language

English

Document Type

Capstone

Degree Name

Doctor of Physical Therapy (DPT)

Level of Degree

Doctoral

First Advisor

Tiffany Enache

Keywords

cryotherapy, dynamic intermittent compression, ice, total knee arthroplasty, modalities, postoperative recovery

COinS