title: Cryocompression therapy after elective arthroplasty of the hip.
abstract: Pneumatic compression and cryotherapy have been successfully being employed in the management of acute tissue damage. The Game Ready System (GRS) combines cyclic compression and cryotherapy. No randomised controlled trial has been performed on the effects of combined cyclic compression and cryotherapy in total hip arthroplasty (THA). We observed postoperative pain, morphine usage, blood loss, wound discharge, patient and medical staff satisfaction, together with the feasibility of a cryocompression machine, total hospital admission time, infection rate, deep vein thrombosis, and short-term prosthesis related problems in this context. Thirty patients, mean age 68 yrs (range 31-83 yrs) undergoing elective hip arthroplasty for end-stage osteoarthritis were included. Control patients (n = 15) received a tricot compression bandage alone, and patients studied received a tricot compression bandage plus intermittent cryocompression therapy 15 times for 30 minutes. Haemoglobin levels on postoperative day (POD) 1 dropped 2.34 mmol/L in the control group and 1,87 mmol/L in the intervention group (p = 0,027). At POD 3 haemoglobin levels were reduced by 2,63 and 2,16 respectively (p = 0,646). A trend occurred towards lower morphine usage, shorter hospital admission time and less wound discharge in the study group. No difference was found in postoperative pain scores. One event of deep venous thrombosis occurred in the control group. Intermittent cryocompression therefore appears to reduce postoperative blood loss. A trend towards less analgesic use, shorter hospital stay, less wound discharge and less pain at 6 weeks postoperatively was also observed.
authors.affiliation: Department of Orthopaedic Surgery, Spaarne Hospital, Hoofddorp, The Netherlands.
authors.forename: Nick C
authors.initials: NC
authors.lastname: Leegwater
authors.forename: Jore H
authors.initials: JH
authors.lastname: Willems
authors.forename: Richard
authors.initials: R
authors.lastname: Brohet
authors.forename: Peter A
authors.initials: PA
authors.lastname: Nolte
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000627:therapeutic use; D019644:Arthroplasty, Replacement, Hip; D017679:Cryotherapy; D005260:Female; D006621:Hip Joint; D006801:Humans; D048228:Intermittent Pneumatic Compression Devices; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000627:therapeutic use; D015207:Osteoarthritis, Hip / Q000601:surgery*; D010147:Pain Measurement; D010149:Postoperative Pain; D017060:Patient Satisfaction; D010865:Pilot Projects; D011183:Postoperative Complications / Q000517:prevention & control*; D019106:Postoperative Hemorrhage / Q000517:prevention & control*; D016032:Randomized Controlled Trials as Topic; D013530:Surgical Wound Infection; D016896:Treatment Outcome; D014945:Wound Healing
chemical_list: D000701:Analgesics, Opioid; D009020:Morphine