title: Cryotherapy after ACL reconstruction: a meta-analysis.
abstract: Cryotherapy is a common treatment modality after orthopedic surgery procedures. Single institutional randomized clinical trials have evaluated the efficacy of cryotherapy after arthroscopically-assisted anterior cruciate ligament (ACL) reconstruction. Most of these studies were, however, underpowered to detect clinically relevant outcomes differences. This meta-analysis assessed the combined scientific evidence of studies evaluating the effectiveness of cryotherapy after arthroscopically-assisted ACL reconstruction. Electronic databases and bibliographic references of relevant articles were used to identify all relevant randomized clinical trials comparing cryotherapy to a placebo group after ACL reconstruction. Outcomes under investigation were postoperative drainage, range of motion, and pain. Random-effects models were used to combine the findings of the randomized controlled trials. Seven randomized clinical trials were included in the meta-analysis. Postoperative drainage (P=.23) and range of motion (P=.25) were not significantly different between cryotherapy and control group. However, cryotherapy was associated with significantly lower postoperative pain (P=.02). This meta-analysis showed that cryotherapy has a statistically significant benefit in postoperative pain control, while no improvement in postoperative range of motion or drainage was found. As the cryotherapy apparatus is fairly inexpensive, easy to use, has a high level of patient satisfaction, and is rarely associated with adverse events, we believe that cryotherapy is justified in the postoperative management of knee surgery.
authors.affiliation: School of Medicine, University of North Carolina at Chapel Hill, Duke University Medical Center, Durham, North Carolina 27710, USA.
authors.forename: Mathew C
authors.initials: MC
authors.lastname: Raynor
authors.forename: Ricardo
authors.initials: R
authors.lastname: Pietrobon
authors.forename: Ulrich
authors.initials: U
authors.lastname: Guller
authors.forename: Laurence D
authors.initials: LD
authors.lastname: Higgins
mesh_terms: D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D001182:Arthroscopy; D017679:Cryotherapy; D004322:Drainage; D006801:Humans; D007718:Knee Injuries / Q000628:therapy*; D010147:Pain Measurement; D011182:Postoperative Care; D016032:Randomized Controlled Trials as Topic; D016059:Range of Motion, Articular