Cryotherapy in joint arthroplasty rehabilitation: Effects on pain, analgesic consumption, blood loss, and range of motion

BACKGROUND: Effectiveness of cryotherapy in the rehabilitation of joint arthroplasty remains controversial. Our systematic review was to evaluate application of cryotherapy following total joint arthroplasty on outcome measures related to rehabilitation exercise. METHODS: PubMed, Web of Science, Cochrane Library, Embase, and CIHAHL, Grey literature, and other relevant databases for randomized controlled trials were searched. A meta-analysis was performed using Revman5.3, and we used Cochrane risk-of-bias 2.0 (RoB2.0) tool to evaluated the quality of included literature. We also use GRADEprofiler 3.6 software for evidence quality assessment. RESULTS: A systematic review of 21 studies, with a pooled analysis of 1462 patients (1177 total knee arthroplasty [TKA] and 285 total hip arthroplasty [THA]), was conducted. All assessed studies were deemed eligible for inclusion. Compared to non-cryotherapy group, meta-analysis revealed that cryotherapy following TKA significantly alleviated postoperative pain on the 2nd day and reduced analgesic consumption (P.05). The GRADE assessment determined that the quality of evidence for these outcomes ranged from very low to moderate. CONCLUSION: Cryotherapy has the potential to aid in joint rehabilitation following total joint arthroplasty. However, it is essential to consider the specific type of joint replacement surgery the patient has undergone, as the rehabilitative effects of cryotherapy differ between TKA and THA. The variability in the quality of the studies included, along with limited sample sizes and generally low quality evidence, necessitates further validation of these findings through rigorously designed, large-scale, multicenter randomized controlled trials.